Market work, wages, and men's health

How long can Chinese women work after retirement based on health level: Evidence from the CHARLS

Objective

To further enhance the understanding of factors impacting female participation in the workforce based on health levels and to measure the excess work capacity of middle-aged and older female groups by residence and educational level.

Methods

Data of women aged 45-74 were accessed from the China Health and Retirement Longitudinal Study (CHARLS) from 2011, 2013, 2015, to 2018. The health status of women was comprehensively evaluated by single health variables and frailty index. A Probit model was used to measure the excess working capacity of women by region (rural/urban) and educational level, taking all women aged 45-49, rural women aged 45-49, and rural (illiterate) women in all age groups as the benchmark, respectively.

Results

The excess capacity of all Chinese women aged 50-64 is 1.9 years, and that of women aged 50-74 is 5.1 years. The excess work capacity of women in urban and rural areas and with different educational levels is heterogeneous. The excess working capacity of urban women aged 50-64 is 6.1-7.8 years, and that of urban women aged 50-74 is 9.8-14.9 years. The excess working capacity of urban women aged 50-64 is about 6 times that of rural women. The excess work capacity of highly educated women was 3 times higher than that of illiterate women.

Conclusion

The potential work capacity of Chinese women remains to be exploited, especially for urban and highly educated middle-aged and older women with better conditions of health, whose potential is more significant. A rational retirement policy for women and the progressive implementation of an equal retirement age for men and women will contribute to further advancement of gender equality and healthy aging in the workplace in China.

The Effect of Health on the Elderly's Labor Supply in Rural China: Simultaneous Equation Models With Binary, Ordered, and Censored Variables

In this study, we examined the effect of health on the elderly's labor supply in rural China based on the data of the Chinese Health and Nutrition Survey (CHNS) from 1997 to 2006. We used simultaneous equations to address the endogeneity problem of health and estimate the models with censored data of labor supply by the full information maximum likelihood estimation. We found that the failing health does not significantly decrease the elderly's labor supply in rural areas when using both the subjective (self-reported health status) and objective (hypertension diagnosed or not) health indicators. Our finding indicates the phenomenon of “ceaseless toil” for the elderly in rural China, i.e., the elderly almost work their whole life even if they are not physically capable. The results remain robust when using a two-stage limited information maximum likelihood estimation.

Health and occupation: the limits to older adults' work hours

More people are working into older age, raising questions about how many hours they can work before their health becomes compromised. This paper models work-hour tipping points for mental health and vitality among older Australian workers aged 50–70 years. We use longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey, 2005–2016 (about 44,900 observations), and bootstrapping Three Stage Least Squares (3SLS) estimation techniques to adjust for reverse and reciprocal relationships between wages, work hours and health. Our approach corrects for heteroscedasticity in the system equation error terms, and we estimate models on the relatively healthy older adults who have remained employed into older age. Among these older workers we observe weekly thresholds of 39–40 hours beyond which mental health and vitality decline. This average, however, hides variability in work-hour limits linked to overall health and occupation. Thus, weekly tipping points for blue- and pink-collar jobs are 7–9 hours lower compared to white-collar jobs, and even wider gaps (11 hours) are apparent for workers with poorer physical functioning, which becomes common as people age. Our modelling reveals that age is not the biggest limiting factor for how many hours older adults can work, rather their health and the types of jobs are critical, and likely widen the gap in who ages successfully or not.

Unencumbered and still unequal? Work hour - Health tipping points and gender inequality among older, employed Australian couples

Could working into older age offer women an opportunity to ‘catch up’ their careers and redress their financial disadvantage in retirement? This is a period of relative ‘unencumbrance’ from childrearing, potentially freeing women's time for more paid work. Here, we examine whether women aged 50 to 70 are able to increase their workhours, and what happens to their mental health, vitality and wealth. We used a representative household-based panel of employed older Australians (the HILDA survey). The longitudinal bootstrapped 3SLS estimation technique adjusted for reciprocal relationships between wages, workhours, and health, modelled in the context of domestic work time. We found that, relative to their same-aged male counterparts, older women spent 10 h more each week on domestic work, and 9 h less on work that earned income. When women sought to add more paid hours on top of their unpaid hours, their mental health and vitality were impaired. Men were typically able to maintain their workhours and health advantage by spending fewer hours each week on domestic work. Unable to work longer without trading-off their health, and paid less per hour if they did so, our analysis questions whether working into older age offers women a road out of inequality and disadvantage.

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Does working into older age offer women an opportunity to ‘catch up’ with menthanks to ‘unencumbrance’ from childrearing?

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We examine whether women aged 50 to 70 are able to increase their workhours, and what happens to their mental health and vitality.

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Older women spent 10 h more each week on domestic work, and 9 h less on work that earned income.

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When adding more paid hours on top of their unpaid hours, older women's mental health and vitality were impaired.

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Our analysis questions whether working into older age offers women a road out of inequality and disadvantage.

Does inequality have a silver lining? Municipal income inequality and obesity in Mexico

Income inequality and obesity are both widespread socioeconomic issues, particularly salient in middle-income countries. This article seeks to detect the relationship between local income inequality and excess weight in Mexico, using robust municipal income inequality measures generated through small area estimation method and instrumental variable multilevel estimations. Our results emphasize a negative impact of municipal income inequality on individual bodyweight, especially for women. We also explore the potential channels through which income inequality may decrease bodyweight. Three-stage least squares estimations highlight that the social capital pathway, the public policy pathway and the psychological pathway help to explain the negative effect of inequality on excess weight. Our results are fairly robust to alternative inequality measures and nutritional indicators.

The inequality of health-income effect in employed workers in China: a longitudinal study from China Family Panel Studies

Background

The relationship between health and income is an essential part of human capital research. The majority of current analyses using classical regression models show that health has a significant impact on income after controlling for the endogeneity of health due to the measurement error and reverse causality. Currently, the Chinese government implements various policies including health related policies to fiercely fight for the domestic poverty issues, and thus only estimating the average effect of health on income could underestimate the impact for low income population and will make policy makers neglect or not pay enough attention to the significant role of health in poverty alleviation. To study the effect of health on income for workers at different income quantiles, we apply the quantile regression method to a panel data from a Chinese household survey. Furthermore, we test the heterogeneity of this health-income effect for different subgroups of workers characterized by sex, registered residence, and residential area. Lastly, we provide an explanation on the possible mechanism of the health-income effect.

Methods

This study uses data from four waves of the China Family Panel Studies (CPFS)- a biennial longitudinal study spanning from 2012 to 2018. The final data used in the regression analysis includes a balanced sample of 19,540 person-year observations aged between 18 to 70 years, with complete information of demographic and social economic status characteristics, job information, and health status of individuals. We use lagged self-reported health to control the potential endogeneity problem caused by reverse causality between health and income. Our identification on heterogenous treatment effects relies on panel quantile regressions, which generate more information than the commonly used mean regression method, and hopefully could reveal the effects of health on income for workers with income distributed at a wide range of quantiles. In addition, we compare the results derived from panel quantile regressions and mean regressions. Finally, we added interaction terms between health and other independent variables to recover the influence channel of health on income.

Results

The regression estimates show that the effects of health on income are more pronounced for workers distributed on the lower ends of income spectrum, and the health-income effect decreases monotonically with the increase of income. The treatment effect is robust to alternative measures of health and seems to be more pronounced for females than males, for rural workers than their urban counterparts. Finally, we find that health not only directly affects worker’s income but also has different effects on income for different occupation cohorts.

Conclusions

This study provides a different perspective on the impact of individual health status on income, uncovering the heterogeneous effects of health deterioration on income reduction for workers with different incomes by using panel data and rather advanced statistical techniques- panel quantile regressions. At present, the Chinese government is making every effort to solve the problem of poverty and our findings suggest public policies on health and income protections should emphasize different needs of workers with different incomes and special attention should be paid to low-income workers who are much more financially fragile to health deterioration than other income groups.

Cost of poor health to the labour market returns to education in Australia: another pathway for socio-economic inequality

While several studies have estimated returns to education in Australia, there is limited evidence regarding the influence of health on the returns. This paper identifies how health affects returns to education in the labour market using the Heckman selection bias-corrected model. We measured health status using a self-rated health item with five response categories 'poor, fair, good, very good, and excellent'. The findings show that poor health or being unhealthy (defined as 'poor' or 'fair') interacts with education, such that the benefits of education (i.e. higher hourly wage rate) are curtailed in those with health problems; the adverse effect is stronger for those in lower skilled jobs. The estimated returns to an additional year of schooling on average over 2001-2017 is 7.43% and 6.88% for the healthy and unhealthy groups, respectively. Thus, the return for workers with poor health is 7.4% lower than the return for healthier workers (for each additional year of schooling). This gap in the returns is equivalent to a productivity loss of about $19-25 billion per year. The lower returns to education for workers with poor health likely results from lower productivity while at work rather than loss of working days as the estimate is based on an hourly wage rate (rather than days or hours absent from work). These lower returns may also be explained by unhealthy workers accepting lower paid jobs given the same levels of experience, skills and education that healthier counterparts have. The cost of poor health to labour market returns is further amplified in low-skilled occupations, a process which is likely to exacerbate socio-economic inequalities and undercut social mobility.

Incorporating Health into Studies of Political Behavior: Evidence for Turnout and Partisanship

We argue that research on political behavior, including political participation, public opinion, policy responsiveness, and political inequality will be strengthened by studying the role of health. We then provide evidence that health matters for voter turnout and partisanship. Using the General Social Survey (GSS) and The National Longitudinal Study of Adolescent Health (Add Health), we find that people who report poor health are less likely to vote and identify with the Republican Party. Moreover, the effects of health on voter turnout and partisanship appear to have both developmental and contemporaneous components. Taken together, our findings suggest that health inequalities may have significant political consequences.

The Importance of Spousal Education for the Self-Rated Health of Married Adults in the United States

Education's benefits for individuals' health are well documented, but it is unclear whether health benefits also accrue from the education of others in important social relationships. We assess the extent to which individuals' own education combines with their spouse's education to influence self-rated health among married persons ages 25 and older in the United States (N = 337,846) with pooled data from the 1997-2010 National Health Interview Survey. Results from age and gender-specific models revealed that own education and spouse's education each share an inverse association with fair/poor self-rated health among married men and women. Controlling for spousal education substantially attenuated the association between individuals' own education and fair/poor self-rated health and the reduction in this association was greater for married women than married men. The results also suggest that husbands' education is more important for wives' self-rated health than vice versa. Spousal education particularly was important for married women ages 45-64. Overall, the results imply that individuals' own education and spousal education combine to influence self-rated health within marriage. The results highlight the importance of shared resources in marriage for producing health.

Health and Wealth: Empirical Findings and Political Consequences

There is increasing concern that equity in health and health care in Europe may suffer as a result of the expansion of the European Union and the ageing of its populations. This article reviews the findings of the ‘‘ECuity III’’ project: a network of European health economists who have investigated socioeconomic inequalities in health and health care. In order to help inform the policy debate about how to secure health equity in our ageing European societies, the project pays particular attention to the key decisions about income, health and health care in age groups around the retirement age, as these prove to be crucial for a better understanding of cross-country differences in inequalities.

Chronic illness, treatment choice and workforce participation

Choices with respect to labor force participation and medical treatment are increasingly intertwined. Technological advances present patients with new choices and may facilitate continued employment for the growing number of chronically ill individuals. We examine joint work/treatment decisions of end stage renal disease patients, a group for whom these tradeoffs are particularly salient. Using a simultaneous equations probit model, we find that treatment choice is a significant predictor of employment status. However, the effect size is considerably smaller than in models that do not consider the joint nature of these choices.

Work losses related to inflammatory bowel disease in the United States: results from the National Health Interview Survey

BACKGROUND

U.S. studies using varying methodologies have reported different estimates for the indirect, or nonmedical cost per person with inflammatory bowel disease (IBD). Our analysis contributes to this literature by using the 1999 sample of the National Health Interview Survey (NHIS) to estimate the work-loss effect of IBD on work in the United States and the associated cost to society.

METHODS

A weighted logistic regression model was used to estimate the OR of being out of the labor force as determined by predictive variables, including having been diagnosed with IBD, with or without symptoms. Controls included health status indicators and demographic variables. For those people in the labor force, a second analysis was performed to determine the relative influence of the same variables on working less than 12 months versus the entire year. SUDAAN 8.0 was used to generate population estimates, systematically correcting for survey design.

RESULTS

Of IBD patients who had experienced symptoms in the past 12 months, 31.5% reported being out of the labor force (OR = 2.14, relative to the non-IBD group). We estimated the excess in the nonparticipation rate attributable to IBD with symptoms in the past 12 months in the United States to be 12.3%. Based on this, the indirect cost of nonparticipation attributable to IBD in 1998/1999 was more than $3.6 billion U.S. dollars (USD) or $5228 USD per person with IBD and symptoms. According to the second weighted logistic regression, for those who are in the labor force, having IBD had no association with the duration of work.

CONCLUSIONS

By using directly observed data in our analysis, this method of estimation can be used to predict the overall paid-employment burden of IBD.

The social context of health selection: a longitudinal study of health and employment

Health selection out of the labour force has received considerable attention by analysts attempting to disentangle the "true" biological dimensions of ill-health from its social meaning. Rejecting this dualistic separation, we argue that the effect of health on labour force participation is an inherently social process reflecting differential access to material and symbolic rewards that are structured by social position. Using longitudinal data from the US-based Panel Study of Income Dynamics, we examine the extent to which structural arrangements, including those designated by gender, race, education and age, differentially affect the risk of a labour market exit when health is compromised. Individuals employed at entry into the study (from 1984-1990) were followed for the duration of the study or until they left the labour force. Analyses were stratified by gender and age (25-39 and 40-61 years at baseline). We found suggestive evidence that the hazard of labour market exit in the context of perceived ill-health depended on gender, race and education, but in ways that were not constant across each of these social positions. For example, men may be more vulnerable to the labour market effects of poor health, but only in the younger group, black men were less likely to leave the labour force than white men, and education mattered, but only among younger women and older men. While these patterns may reflect differential access to disability pensions or other work-related benefits, we suggest that a more detailed analysis of trajectories of health and employment. as well as the meaning of health states would be useful in further elucidating the social dimensions of health selection.

Productivity losses associated with diabetes in the US

OBJECTIVE

The objective of this study was to estimate the cost of productivity losses in the U.S. attributable to diabetes, with regard to specific demographic and disease-related characteristics in the U.S..

RESEARCH DESIGN AND METHODS

We used the 1989 National Health Interview Survey, a random survey of individuals in the U.S. that included a diabetes supplement. Data on individuals were obtained for labor force participation, hours of work, demographic and occupational characteristics, self-reported health status, and several variables that indicated the presence, duration, and severity (complications) of diabetes. Using multivariate regression analyses, we estimated the association of independent variables (e.g., demographics, health, and diabetes status) with labor force participation, hours of work lost, and the economic value of lost work attributable to diabetes and its complications and duration.

RESULTS

In general, the presence of diabetes and complications were found to be related to workforce participation variables. The magnitude of the lost-productivity costs depended on personal characteristics and on the presence and status of diabetes. In general, the loss of yearly earnings amounted to about a one-third reduction in earnings and ranged from $3,700 to $8,700 per annum.

CONCLUSIONS

Diabetes has a considerable net effect on earnings, and the complications and duration of diabetes have compound effects. Our findings have implications for the cost-effectiveness of diabetes control; the presence of complicating factors is the single most important predictive factor in lost productivity costs attributable to diabetes, and thus the avoidance or retardation of complications will have an impact on indirect health-related costs.

Adaptation and scale of reference bias in self-assessments of quality of life

Adaptation behaviour and different scales of reference can bias self-assessments of well-being by individuals. In this paper, we analyse the impact of these biases on a subjective measure of the quality of health and on the QALY weights derived from this health measure. It is found that the scale of reference of the subjective health measure changes with age. Accounting for adaptation and scale of reference bias lowers most of the QALY weights for health problems and disabilities.

Health problems as determinants of retirement: are self-rated measures endogenous?

We explore alternative measures of unobserved health status in order to identify effects of mental and physical capacity for work on older men's retirement. Traditional self-ratings of poor health are tested against more objectively measured instruments. Using the Health and Retirement Study (HRS), we find that health problems influence retirement plans more strongly than do economic variables. Specifically, men in poor overall health expected to retire one to two years earlier, an effect that persists after correcting for potential endogeneity of self-rated health problems. The effects of detailed health problems are also examined in depth.