Recent research on the impact of economics on mental and physical health has raised fundamental questions about structural elements in the macro-economy and their role in creating stress. This paper reviews and integrates these sometimes conflicting findings into a cohesive model. Structural elements of our current economic system are identified as possible major stressors: (1) instability in the business cycle; (2) unemployment; (3) inequality in income distribution; and (4) fragmentation of the work process. Research is reviewed linking the economic cycle with suicide and increased psychological symptoms as well as physical illness. Intervention on the institutional level is suggested since these macro-economic elements appear to be more powerful than the individual coping mechanisms of some demographic subgroups. The implications of these findings for primary prevention are discussed. (Author/JAC)