<p>Our study examines the relationship between business cycles and mortality rates in Italy over the period 2004–2019. Using the unemployment rate as a proxy for macroeconomic conditions, we investigate how economic fluctuations affect mortality rates across causes of death, age groups, genders, and educational levels. The analysis relies on data from the National Institute of Statistics (ISTAT) and applies panel data methods to control for province-specific heterogeneity and time effects. The findings reveal a procyclical pattern, with higher unemployment rates associated with lower mortality. Substantial heterogeneity emerges across demographic groups and causes of death. To test robustness, the analysis is extended to include the COVID-19 pandemic years (2020–2021), thereby assessing its impact on the previously identified relationships. Results suggest that the pandemic disrupted established unemployment–mortality dynamics, particularly for transport accidents and respiratory diseases. Overall, the findings highlight the importance of targeted public policies to mitigate health risks during economic expansions and provide insights into how macroeconomic conditions shape public health outcomes in Italy.</p>