The existing evidence linking recessions to individual and population health presents a puzzle. Some studies show that people who experience the kinds of labor market, housing, and asset shocks that proliferate in recessions suffer negative health consequences, whereas other studies show that mortality rates fall when the economy worsens. This review synthesizes evidence from these distinct research traditions in light of emerging findings from the Great Recession of 2007-2009. It traces pathways by which macroeconomic changes “get under the skin” and generate contradictory aggregate- and individual-level consequences. Research on the longer-term health effects of recessions could be strengthened by integrating theoretical and analytical approaches from sociology. These include a multilevel perspective that considers how individuals cope with recessions as members of families and communities embedded in different policy environments, and attention to cascades of recessionary shocks, individuals' strategies for coping with them, and the way these intersect with health trajectories.