The expected decline of health indicators with economic recessions and improvement with economic growth in the nineteenth century Sweden was reversed in the twentieth century, giving the counterintuitive pattern of higher mortality and lower life expectancy in economic expansions and improvement of these indices in recessions. The change or "tipping point" occurred at the end of the nineteenth century or early in the twentieth century when electrification was introduced into Sweden. All 5 of the reversals of annual industrial electric energy use in the US between 1912 and 1970 were accompanied by recessions with lowered GDP, increased unemployment, decreased mortality and increased life expectancy. The health indices were not related to residential electricity use. The mortality improvement between 1931 and 1932 by state in the US strongly favored urban areas over rural areas. Rural unemployment by state in 1930 was significantly positively correlated with residential electrification percentage by state in 1930. The health effects of economic change are mediated by electrical exposure.