Structural social capital and mental health: a panel study

ABSTRACT

The link between social relations and psychological wellbeing is well established in sociological and mental health studies. Since the beginning of the 2000s, this link has been garnering new attention and interest in economic and public health studies. Almost twenty years of empirical studies testing this relationship have established contrasting results for two main reasons. First, the majority of the studies are based on cross-sectional data, leaving out endogeneity and heterogeneity problems; second, mental health measurements are often discordant from each other. This study investigates the relationship between structural social capital and individual self-rated mental health using five waves of the British Household Panel Survey from 1991 to 1995 (unbalanced panel N = 44,684). We take into account the heterogeneity and endogeneity issues and implement fixed effects and lag-dependent variable estimations. Moreover, we used different methodologies to measure mental health as a robustness check. Our findings show the existence of a negative relationship between being both a member of and active in an organization and worse mental health. In addition, being active within an organization in the previous year has a negative effect on worse mental health in the following year.     

Workplace problems,mental health and substance use

Little is known about how workplace problems may influence diagnosable mental health and substance use (MHSU) disorders. We examine the associations between three common workplace problems (experiencing problems with co-workers, job changes and perceived financial strain) and three MHSU disorders (mood, anxiety and substance abuse/dependence). The analysis utilizes longitudinal data on a sample of working-age adults from the National Epidemiological Survey on Alcohol and Related Conditions. These data are well suited for our research objective as the survey was specifically designed to study MHSU disorders. Results show that experiencing these workplace problems is associated with an increased risk for mental health disorders, but not substance use disorders. Importantly, various robustness checks and sensitivity analyses demonstrate that our findings cannot be not fully explained by omitted variables, reverse causality or sample attrition.     

Changes in Inequalities of Access to Dental Care in Australia 1977–2005

Information on dental visits, income and demographic variables were drawn from the Australian National Health Survey between 1977 and 2005. Income‐related inequality in access to dental care was calculated using the generalised concentration index (G) and decomposition methods were employed to examine associations with socio‐demographic and policy‐amenable factors. Statistically significant increases in inequality in dental care use were found after 1995. From 0.026 in 1995, G increased to 0.045 in 2005. The associations between increases in inequality and changes in the uptake of private health insurance suggest a contributory role of the introduction of the Commonwealth government's 30 per cent rebate for private health insurance.     

Alcohol consumption,smoking and wages

The good health of an individual is a combination of uncontrollable factors that includes genetics and random events and controllable factors through the regulation of activities such as smoking and drinking. Since the work of Grossman in the 1970s, a significant relationship between health and earnings has been predicted. In this present paper the 1995 Australian National Health Survey is used to examine simultaneously the effects of drinking and smoking on wages. To model the interaction of smoking with alcohol consumption separate models are fitted for smokers and nonsmokers. These models account for potential selectivity bias resulting from the decision to smoke, and endogeneity arising from a potential causal relationship between earnings and alcohol consumption.     

THE LOSS OF EARNINGS CAPABILITY FROM DISABILITY/HEALTH LIMITATIONS: TOWARD A NEW SOCIAL INDICATOR

Health problems and physical and mental impairments can restrict the kind and amount of work that individuals can perform. Several studies have estimated the loss in earnings experienced by disabled/health-limited workers, but they do not examine the trend in this loss over time. The authors propose an alternative indicator of productivity loss that is more appropriate for inter temporal comparisons: "lost earnings capability"–the difference between the amount of money persons could potentially earn if they were free of disability/health limitations and the amount of money that they can actually earn given their limitations. The estimates indicate that the mean lost earnings capability per disabled/health-limited person grew over the period from 1973 to 1988, while the population with disabilities/health limitations fell. In 1973, lost earnings capacity totaled about 5.3 percent of Gross National Product (GNP); by 1988, the loss had fallen to about 4.5 percent of GNP as a consequence of the reduction in the number of people with limitations. Data are from the Current Population Surveys and the Survey of Income and Program Participation.     

Can a Mixed Health Care System be Desirable on Equity Grounds?*

Should health care provision be public, private, or both? We consider this question in a setting where people differ in their earnings capacity and face some illness risk. We assume that illness reduces an individual's time endowment when waiting for treatment. Treatment can be obtained in a competitive private sector (through private insurance) or in the National Health Service (NHS) where it is provided free of charge but after some (endogenous) waiting time. The equilibrium in the health care sector consists of a waiting time in the NHS such that no patient wants to switch health care provider. This equilibrium is governed by two public policies: the income tax system and the size of the NHS. We find that: (i) a mixed system with a small NHS is never desirable; (ii) actuarially fair sickness insurance is never desirable either; (iii) a mixed system with a sufficiently large NHS may improve on a pure public system if the dispersion of earnings capacities is large enough; and (iv) the welfare gains from such a mixed system are not likely to be significant.     

Introducing ‘Young Minds Matter’

Young Minds Matter: The second Australian Child and Adolescent Survey of Mental Health and Wellbeing provides updated national prevalence estimates of mental disorders in children and adolescents and measures the burden and impact of these disorders and the use of services and unmet need for services in the health and education sectors. The field work for Young Minds Matter included face‐to‐face interviews with the primary carer of 6,310 children and adolescents aged 4–17 years who were randomly selected from across Australia. This article describes the survey, the response rates achieved and the representativeness of the sample.     

Job insecurity and mental health in Canada

Using six cycles of Canada’s longitudinal National Population Health Survey data (2000–2001 to 2010–2011), this article examines the relationship between job insecurity and mental health. Job insecurity is evaluated in both subjective (perception of job insecurity) and objective (probability of joblessness) terms while mental health is measured using a standardized psychological distress index. Applying a person-specific fixed-effects estimator, results indicate that for males and females age 25–64, job insecurity, regardless of how it is measured, is associated with an increase in psychological distress. Results regarding unemployment are not as conclusive, suggesting that it is not so much the actual occurrence of job loss but the threat of unemployment that is associated with higher psychological distress. Estimates of the relationship between job insecurity and psychological distress using pooled ordinary least squares are much larger, implying that much of the psychological distress/job insecurity correlation may be due to unobservable fixed characteristics. All results are robust to the inclusion and exclusion of a host of other potential determinants including income-related variables, education, and various health measures.     

RISK ATTITUDES AND THE DEMAND FOR PRIVATE HEALTH INSURANCE: THE IMPORTANCE OF 'CAPTIVE PREFERENCES'

ABSTRACT ** :  Captivity to a mainstream public insurer, is hypothesized to constrain the choice of purchasing private health insurance, by influencing risk attitudes. Namely, risk averse individuals are more likely to stay captive to the National Health System (NHS). To empirically test this hypothesis we use a small scale database from Catalonia to explore the determinants of private health insurance (PHI) purchase under different forms of captivity along with a measure of risk attitudes. Our results confirm that the captivity corrections are significant and can potentially bias the estimates of the demand for PHI. Risk aversion increases the probability of an individual being captive to the NHS. The latter suggests a potential behavioural (or cultural) mechanism to isolate the influence of risk attitudes on the demand for PHI in publicly financed health systems.     

IS THERE A ‘SECESSION OF THE WEALTHY’? PRIVATE HEALTH INSURANCE UPTAKE AND NATIONAL HEALTH SYSTEM SUPPORT

The purchase of private health insurance (PHI) as a means to partially supplement the National Health System (NHS) coverage is often regarded as a potential signal for a declining support for the NHS. Exploiting the fact that PHI is typically purchased by the most affluent, in this paper we test the so called ‘secession of the wealthy’ hypothesis whereby the likelihood of expressing ‘lack of support for the NHS’ increases with having supplementary PHI. Using empirical data from Catalonia, we draw upon an empirical strategy that circumvents an obvious simultaneity problem by estimating both a recursive bivariate probit as well as an IV probit. After controlling for insurance premium, household income and other socio‐demographic determinants, we find that the purchase of PHI reduces the propensity of individuals to support the NHS. We also find evidence that PHI is a luxury good and sensitive to fiscal incentives.     

中国城乡老年健康及照料状况研究

人口老龄化背景下我国城乡的老年健康及老年照料问题日益严重。利用中国城乡老年人状况调查数据、全国残疾人抽样调查数据以及国家卫生服务利用调查数据,从两周患病率、慢性病患病率、残疾水平、自评健康以及健康预期寿命等方面分析了我国城乡老年人的健康状况,探讨了目前我国城乡老年人的照料提供来源。提出了人口老龄化趋势下提高老年健康水平,应对老年人口照料危机的政策建议。     

The disappearing gay income penalty

Since 1995, labor economists have reported on the income disparities between individuals who engage in same-sex behavior and those that do not. Many of these papers report a significant wage penalty, while others find no effect, but few look at the trend over time. We find, using National Health and Examination Survey (NHANES) data from 1988 to 2007, that the income gap has reversed over time from a penalty to a premium.     

NEW FORMS OF PROVIDER IN THE ENGLISH NATIONAL HEALTH SERVICE

ABSTRACT 1 : A wide ranging set of reforms is being introduced into the English National Health Service (NHS). They are designed to increase the market‐like behaviour of providers of care with a view to improving efficiency, quality and responsiveness of services. This paper is concerned with one aspect of those reforms: namely the policy to increase the diversity of types of providers of care to NHS patients. In this context, increasing diversity means that providers will not all be standard publicly owned NHS organizations. They can be publicly owned but autonomous, or independent (both in for‐profit and not for profit). The paper discusses the wide range of organizational forms available, analyzing their governance structures It then discusses the small amount of evidence currently available about the performance of diverse providers of health care.     

Household Composition, Equivalence Scales and the Reliability of Income Distributions: Some Evidence for Indigenous and Other Australians

Indigenous families experience substantial and multiple forms of economic burden arising from the size and structure of their families and households. Indigenous households are more likely to have more than one family in residence than other Australian households and are more likely to be multigenerational with older Indigenous people living with younger people in extended family households. This paper seeks to characterise the economies of household size in Indigenous and other Australian households using equivalence scales that cover the range of feasible values and 1995 National Health Survey data.     

我国城镇已婚妇女照料父母与自评健康的关系研究

我国老年人以非正式照料为主,妇女承担了主要的照料责任。政府减少对非正式老年照料的支持以及老年人口的快速增长将会加重家庭中女性的照料负担。利用1997、2000、2004和2006年中国营养与健康调查(CHNS)数据和Ordered Probit模型来研究城镇已婚妇女照料父母及其自评健康的关系。在我国城镇,与不照料父母相比,照料父母的已婚妇女更倾向于报告较差的健康水平,并且"自评健康状况非常好"的概率减小,而"自评健康状况一般"的概率增大。应该关注日益繁重的照料责任,以及工作与家庭照料之间的激烈竞争可能给妇女的心理、身体和社会福利带来的负面影响。     

The effects of public health spending on self-assessed health status: an ordered probit model

This paper explores the relationship between public health expenditure and self-assessed health status. Medical resources are imputed according to where individuals reside. The analysis draws upon data from the 1993 National Health Survey. Controlling for a number of individual characteristics, which also determine health status, the estimations indicate that increases in public health expenditure significantly improve both physiological and physical health. The results remain consistent when the model is reestimated and the change in the probability at the mean of the independent variable is calculated.     

The Impact of the NHS Reforms on Queues and Surgical Outcomes in England: Evidence From Hip Fracture Patients

National Health Service (NHS) reform introduced incentives for efficiency and cost effectiveness, yet little is known about their effectiveness in reducing waiting times for surgery or improving post-surgical outcomes. This paper finds that waiting times for hip fracture surgery declined after the NHS reforms, and patients were more likely to be discharged to another provider. However, hospitals have not simply shifted the burden of care to other providers, since lengths of stay ending in a discharge to home fell. The effect of wait time on surgical outcomes is small in magnitude and cannot explain the post-reform improvements in outcomes.     

The dynamics of food insecurity and overall health: evidence from the Canadian National Population Health Survey

The paper explores whether the responses to household food insecurity questions in cycles two and three of the Canadian National Population Health Survey help explain the links between socioeconomic status and health at the individual level. Short-term transitions in food insecurity status are correlated with changes in health status. There is some evidence for females but not for males that conditional on current health, current household food insecurity can lead to lower future health status, even in the short run. There is stronger evidence for both males and females that conditional on current household food insecurity status, lower current health status can lead to an increased probability of future household food insecurity.     

Cost-effectiveness analysis of proton pump inhibitors compared to omeprazole in the healing of reflux oesophagitis

Summary

In 1998, the National Health Service (NHS) in England and Wales spent over £314 million on proton pump inhibitors (PPIs). The National Institute for Clinical Excellence (NICE) guidance on the use of PPIs in dyspepsia advises that the least expensive appropriate PPI be used. Consequently, the objective of this study was to assess the cost-effectiveness of all PPIs for the healing of reflux oesophagitis over 8 weeks from the perspective of the UK's NHS.

A decision analysis model was developed using healing rates derived from a systematic review of all PPIs using omeprazole as a common comparator. The economic analysis indicates that esomeprazole is cost-effective compared with all other PPIs currently available for healing reflux oesophagitis.     

Length of stay and mental health of the immigrant population in Spain: evidence of the healthy immigrant effect

This article analyses the relationship between how long immigrant populations reside in the country of destination and the state of their mental health. The empirical approach to this relationship relies on data from the Spanish National Health Survey 2011–2012. The results confirm a Healthy Immigrant Effect that tends to decline in accordance with how long the immigrant stays. Immigrants who have been residing for less than 10 years in Spain have better mental health than the national population as a whole. It is important to study health disparities among the foreign population and how these evolve to ensure that it has access to health services and that its health care needs are met.