U.S. stocks fell, with the Dow Jones industrial average falling nearly 250 points, following a renewed sell-off across stocks worldwide as skepticism about the strength of the global economy intensified.

A late-day rally paced by health care and small-cap shares helped trim declines, with the Nasdaq Composite Index briefly erasing a drop of as much as 3.7 percent. The Dow Jones industrial average and S&P 500 cut their worst losses by more than half. Still, the Standard & Poor’s 500 index closed at its lowest level in 21 months.

Energy companies sank further into five-year lows as oil plunged. International Business Machines Corp. fell to the lowest since 2010 after its earnings forecast missed projections.

The S&P 500 dropped 1.2 percent to 1,859.33 at 4 p.m. in New York, closing at its lowest level since April 2014. The gauge pared a slide of more than 3.6 percent. After falling more than 560 points, the Dow finished down 249.28 points, or 1.6 percent, to 15,766.74. The Nasdaq Composite slipped 0.1 percent.

“We didn’t keep falling off the table,” said Walter “Bucky” Hellwig, who helps manage $17 billion as a senior vice president at BB&T Wealth Management in Birmingham, Alabama. “The last-hour strength is positive, and I think it’s due to the fact that investors are saying, ‘This thing is oversold, I’m going to put some money to work,’ and it’s worked out better than buying it on the up days and then watching it disappear.”

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Even with the final-hour rebound, the selling remained broad-based, with six of the S&P 500’s 10 main groups falling at least 1.3 percent.

Exxon Mobil Corp. sank 4.2 percent, the most since August, and banks fell for a third day with Citigroup Inc. and Bank of America Corp. down more than 3.4 percent.

Global equities’ worst-ever start to a year deepened as oil continued its collapse and a slowdown in China weighs on investor sentiment. Japanese shares joined benchmark indexes in China and Europe in tumbling into a bear market Wednesday, defined as a decline of 20 percent or more from a recent market high.

West Texas Intermediate crude futures, the benchmark for U.S. oil prices, slumped 6.7 percent to $26.55 a barrel.

“What the market is focused on is Chinese hard-landing fear, oil prices and the strength in the dollar,” said Phil Orlando, who helps oversee $360 billion as chief equity-market strategist at Federated Investors Inc. in New York. “We haven’t hit bottom yet.”

About $2.2 trillion has been wiped off the value of U.S. stocks this year.

And experts said any rallies are getting shakier: nerves are weakening in a market where everything from China to oil and the Federal Reserve are proving capable of knocking equities down at any time. It’s a reversal of the optimism that underpinned the last three years of the bull market, when traders viewed bad news as transitory and used declines as opportunities to buy the dip.

The S&P 500 is nearly 13 percent below its all-time high set in May.