Health status and labor force participation: evidence for urban low and middle income individuals in Colombia

This paper analyzes the relationship between individual health status and labor force participation using the first wave of the Colombian Longitudinal Survey. The empirical modeling strategy accounts for the presence of potential endogeneity between these two variables. The results show that there is a positive relationship between health and labor force participation in both directions, indicating that better health is likely to lead to a higher probability of participation in the labor market, but also that individuals who participate in the labor market are more likely to report better health. Interesting differences are uncovered when comparing the results by gender and/or age groups. For instance, for younger females, health status and higher education positively affect the probability of labor participation, whereas having children under the age of 5 and being married reduce their probability of participation. Our findings also highlight the importance of public policy to guarantee good health conditions of the population which could also have a positive impact on labor productivity and consequently on long-run economic growth.     

Widowhood and health of elderly in India: examining the role of economic factors using structural equation modeling

Evidence on the association between widowhood and health is widely available in the literature. However, there is a dearth of analysis on the mechanism through which widowhood affects the health status of an individual, particularly in old age, specifically whether widowhood among the elderly affects their health through their economic conditions. This paper purports to establish both the direct and indirect effects of widowhood on self-reported health status among aged Indians. We examine the mediating effect of economic factors such as income, labor force participation, extent of economic independence and other economic factors in the relationship between widowhood and health status. Structural Equation Modeling (SEM) is employed to test specific hypotheses. We use unit level 60th round data for the year 2004 surveyed by the National Sample Survey Organization (NSSO). The results confirm that poor economic conditions have a mediating effect on the relationship between widowhood and health and, therefore, any policy to reduce the effect of widowhood on health must be based on economic factors.     

Effects of health insurance on labour supply: evidence from the health care fund for the poor in Vietnam

The expansion of health insurance in emerging countries raises concerns about the unintended negative effects of health insurance on labour supply. This article examines the labour supply effects of the Health Care Fund for the Poor (HCFP) in Vietnam in terms of the number of work hours per month and labour force participation (the probability of employment). Employing various matching methods combined with a Difference-in-Differences approach on the Vietnam Household Living Standard Surveys 2002–2006, we show that the HCFP, which aims to provide poor people and disadvantaged minority groups with free health insurance, has a negative effect on labour supply. This is manifested in both the average number of hours worked per month and the probability of employment, suggesting the income effect of the HCFP. Interestingly, the effects are mainly driven by the non-poor recipients living in rural areas, raising the question of the targeting strategy of the programme.     

The impact of hepatitis C on labor force participation,absenteeism, presenteeism and non-work activities

Abstract

Objective:

Between 2.7 and 3.9 million people are currently infected with the hepatitis C virus (HCV) in the United States. Although many studies have investigated the impact of HCV on direct healthcare costs, few studies have estimated the indirect costs associated with the virus using a nationally-representative dataset.

Methods:

Using data from the 2009 United States (US) National Health and Wellness Survey, patients who reported a hepatitis C diagnosis (n?=?695) were compared to controls on labor force participation, productivity loss, and activity impairment after adjusting for demographics, health risk behaviors, and comorbidities. All analyses applied sampling weights to project to the population.

Results:

Patients with HCV were significantly less likely to be in the labor force than controls and reported significantly higher levels of absenteeism (4.88 vs. 3.03%), presenteeism (16.69 vs. 13.50%), overall work impairment (19.40 vs.15.35%), and activity impairment (25.01 vs. 21.78%). A propensity score matching methodology replicated many of these findings.

Conclusions:

While much of the work on HCV has focused on direct costs, our results suggest indirect costs should not be ignored when quantifying the societal burden of HCV. To our knowledge, this is the first study which has utilized a large, nationally-representative data source for identifying the impact of HCV on labor force participation and work and activity impairment using both a propensity-score matching and a regression modeling framework.

Limitations:

All data were patient-reported (including HCV diagnosis and work productivity), which could have introduced some subjective biases.     

The association of pain with labor force participation,absenteeism, and presenteeism in Spain

Abstract

Objectives:

The aims of this paper are to generate estimates of the association between the severity and frequency of pain in Spain and (i) labor force participation and workforce status and (ii) patterns of absenteeism and presenteeism for the employed workforce.

Methods:

Data are from the internet-based 2010 National Health and Wellness Survey (NHWS). This survey covers both those who report experiencing pain in the last month as well as the no-pain population. An estimated 17.25% of adults in Spain report experiencing pain in the past month. A series of regression models are developed with the no-pain group as the reference category. The impact of pain, categorized by severity and frequency, is assessed within a labor supply framework for (i) labor force participation and (ii) absenteeism and presenteeism. Both binomial and multinomial logistic models are estimated.

Results:

The results demonstrate that severe and moderate pain has a significant, substantive, and negative association with labor force participation and, together with the experience of mild pain, a substantive impact on absenteeism and presenteeism within the employed workforce. Compared to no-pain controls, the strongest association is seen in the case of severe pain, notably severe daily pain and labor force participation (odds ratio 0.363; 95% CI: 0.206–0.637). The association of severe pain with labor force participation is also significant (odds ratio 0.356; 95% CI: 0.217–0.585). There is a clear gradient in the association of pain severity and frequency with labor force participation. The impact of pain is far greater than the potential impact of other health status measures (e.g., chronic comorbidities and BMI). Labor force participation is also adversely associated with pain experience. Persons reporting severe daily pain are far more likely not to be in the labor force (relative probabilities 0.339 vs 0.611). The experience of pain, notably severe and frequent pain, also outstrips the impact of other health status factors in absenteeism and presenteeism. In the former case, the odds ratio associated with severe daily pain is 16.216 (95% CI: 5.127–51.283), which contrasts to the odds ratio for the Charlson comorbidity index of 1.460 (95%CI: 1.279–1.666). Similar results hold for presenteeism. The contribution of moderate and mild pain to absenteeism and presenteeism is more marked than for labor force participation.

Conclusions:

The experience of pain, in particular severe daily pain, has a substantial negative impact both on labor force participation in Spain as well as reported absenteeism and presenteeism. As a measure of health status, it clearly has an impact that outstrips other health status measures. Whether or not pain is considered as a disease in its own right, the experience of chronic pain, as defined here, presents policy-makers with a major challenge. Programs to relieve the burden of pain in the community clearly have the potential for substantial benefits from societal, individual, and employer perspectives.     

EFFECTS OF HEALTH AND CHRONIC DISEASES ON LABOUR FORCE PARTICIPATION OF OLDER WORKING‐AGE AUSTRALIANS*

This study examines the effects of general health and chronic diseases on the labour force participation of older working‐age Australians. To account for potential endogeneity of health status, a simultaneous equation model is estimated and chronic diseases are used as instrumental variables. The effects of chronic diseases on labour force participation are assessed indirectly using the parameters estimated from the simultaneous equation model. The results show that both health status and chronic diseases have significant effects on labour force participation. It also appears that the effects of chronic diseases are more accurately estimated from the simultaneous equation model than from a single equation labour force participation model.     

Survival expectations,subjective health and smoking: evidence from SHARE

This article aims to assess how the risk perceptions of smokers affect survival expectations and subjective health. Data from the Survey of Health, Ageing and Retirement in Europe, which include a numerical measure of subjective survival probability, are used to estimate a joint recursive system of equations that describe the relationships among survival expectations, subjective health status and smoking duration. A finite mixture model is used to address endogeneity and unobservable heterogeneity. This approach allows for two types of individuals with different observable characteristics to be identified in the examined population. We find that only in the population of the first type, current and former smokers incorporate the effects of smoking duration into their assessments of survival probabilities. For both types, quitting smoking affects current perceptions of smoking risks, causing the overestimation of both survival probability and subjective health.     

External validation of the use of vignettes in cross-country health studies

Cross-country comparisons of subjective assessments are rendered difficult if not impossible because of sub-population specific response style. To correct for this, the use of vignettes has become increasingly popular, notably within cross-country health studies. However, the validity of vignettes as a means to re-scale across sample sub-populations critically rests on the assumption of “response consistency” (RC): that vignettes and self-assessments are evaluated on the same scale. In this paper, we seek to test this assumption by applying objective measures of health along with subjective measures and vignettes. Our results indicate that the assumption of RC is not innocuous and that our extended model relaxing this assumption improves the fit and significantly changes the cross-country rankings of health vis-á-vis the standard Chopit model.     

Impact of Low Birth Weight Child on Maternal Labour Force Participation: Evidence from Taiwan

This paper examines the impact of having a low birth weight child on maternal labour force participation. We use the instrumental variable technique, the sister fixed‐effects model and the propensity score matching method to control for the endogeneity of child health. Using a unique national merged parent–child data set from Taiwan, the within‐sister estimates indicate that having a low birth weight child reduces female employment during the first 3 years after the birth, by 1–2 percentage points. Furthermore, the adverse employment effect is found to be particularly strong for those mothers who have an illegitimate child with low birth weight.     

Collectivism in the labor market: Evidence from second generation immigrants in the United States

This study investigates the role of collectivism on labor market outcomes in an individualist country. We explore collectivism as an intergenerationally transmitted cultural value and analyze its explanatory power for the economic outcome of 21,000 male homogamous second generation immigrants in the US. Our collectivism proxy is derived from the country of ancestry’s historical disease environment because collectivistic values have been particularly advantageous in countries with a greater prevalence of disease-causing pathogens. Employing this new collectivism proxy that identifies collectivism more precisely than previously used cultural proxies, we find that higher scores of collectivism are associated with higher labor force participation and income earned in the US. The results on income are channeled through the number of hours worked and self-selection into jobs that require collectivistic traits. By analyzing the labor market performance of second generation immigrants, we are the first to show an occupational selection along cultural skills implying that second generation immigrants sort into occupations that demand skills on which they have a “cultural comparative advantage”.     

Does Labor Market Status Influence Self-Assessed Health?

This study examines whether individuals’ self-assessed health is related to their previous standing in the labor market and their self-assessed health at that time. We find that, once self-assessed health in the past is controlled for, none of the specified reasons behind individuals’ labor market status at that time, including the inability to find work, have a statistically significant adverse impact on current assessment of physical or mental health. We do find, however, that women obtaining a job in the past period will currently perceive that their physical health is improved, and that previously unemployed men with a job to return to in the current period also experienced perceptions of better health in the current period. We present evidence that these perceptions share a common factor with other health indicators such as sick days and quasi-objective measures of physical and mental health.     

The value of health interventions: evaluating asthma case management using matching

Despite large public investments in asthma interventions, there are few rigorous assessments of these programmes and little understanding of what comprises an effective intervention. There is a lack of appropriate data, little technical support is provided, and the programs themselves have little incentive to conduct these analyses. In this study, we apply optimal full matching using propensity scores to estimate the impact of an asthma intervention programme across a range of health outcomes. Our participation model is derived using the Deletion, Substitution and Addition (DSA) algorithm, a method used in epidemiology for model selection. We find that the asthma programme in question has no significant effect on participants that distinguishes them from matched nonparticipants, but it is not clear whether this is due to the effectiveness of the programme, heterogeneity of effects or barriers outside the programme's control. Our findings do show how current programmes could be modified to increase their effectiveness and better inform future research.     

非农就业、母亲照料与儿童健康——来自中国乡村的证据

中国农村女性参与非农就业的比例显著提高,对于增进家庭收入、减少贫困起到了积极的作用。但从女性在家庭中的双重身份——挣取收入者和照看孩子的主要人员出发,其劳动模式和供给行为的改变对于下一代福利的影响和人力资本的积累所起到的作用却是不确定的。本文通过将农村地区妇女的劳动供给状况进行区分,就其劳动参与行为对孩童健康状况的影响进行了探讨。在控制其他因素的情况下,母亲额外单位的劳动时间的增加对孩子的健康状况具有显著的负向影响,且同样的母亲非农劳动时间的增加对于孩童健康的负面影响大于农业劳动时间增加的影响程度,而母亲收入增加对孩子健康状况具有显著的正向影响;边际效果分析表明母亲收入增加对孩子健康的正向影响难以抵销劳动时间增加所带来的负面效果。孩子性别不同所受到的影响亦不同,女童相对而言处于健康的劣势地位。虽然母亲的劳动供给有助于缩小孩子营养状况的性别差距,但却是以所有儿童的健康状况下降为代价的。研究结果预期具有较强的政策含义。     

IMF-Induced Structural Adjustment Programs and Women in Ecuador

This study examines the affect of IMF-induced structural adjustment programs on several key indicators regarding the status of women in Ecuador. In particular, we focus on the evolution of female primary and secondary school enrollment and female labor force participation in time series data from 1987 to 2003. The analysis is conducted using ordinary least squares regression with corrections for heteroscedasticity. The findings suggest that structural adjustment programs reduced female enrollment in primary and secondary schools and caused a reduction in the reported female labor force participation rate.      

The impact of religiosity on self- assessments of health and happiness: evidence from the US Southwest

Using an age stratified random sample from an ongoing population-based study of Mexican Americans 45 years of age or older living in the Southwest this study fexamines the relationship between religiosity and self-rated indices of physical health, subjective health status and happiness. After estimating a set of binary logit models and controlling for individual characteristics such as age and gender, findings indicate that religiously involved respondents have a lower probability of reporting a health problem than those less or not involved. Further, those respondents who attend religious services regularly are more likely to assess themselves healthier and happier than those reporting sporadic or no attendance. However, when the religious variable is factored into six constructs, as the frequency of religious attendance increases the happiness measure initially increases to an inflection point then it continues to increase but at a slower rate. This result is consistent with the argument that those individuals who, on average, attend religious services once a week appear to reap the greatest incremental rewards in terms of assessments of subjective health and overall happiness.     

Differences in the effect of social capital on health status between workers and non-workers

This paper explores the relationship between social capital and self-rated health status in Japan, and how this is affected by the labor market. Data of 3,075 adult participants in the 2000 Social Policy and Social Consciousness survey were used. Controlling for endogenous bias, the main finding is that social capital has a significant positive influence on health status for people without a job but not for those with. This empirical study provides evidence that people without a job can afford to allocate time to accumulate social capital and thereby improve their health status.     

Dynamics of fertility and labour force participation of Canadian women in 1971 and 1981: a cohort approach

The authors analyze the relationship between labor force participation and fertility in Canada using data from the Public Use Sample Tapes from the 1971 and 1981 censuses. Factors considered include age, religion, educational status, and marital status. The authors conclude that "labour force participation of women seems to have less influence on fertility compared to [the] fertility effect on labour force participation."     

Family ties and employment behavior: The role of financial intermediaries

We study the interaction effect of financial intermediaries and family ties on labor participation and employment type in China. Although existing studies examine these effects separately, we investigate the effects of both factors in one model. We give empirical evidence to support earlier arguments that family ties negatively affect labor force participation and positively affect self‐/family‐employment behavior and that financial development positively affects labor force participation. Departing from the extant literature, our results overall indicate a compensating effect of financial intermediaries for family ties in labor participation and employment type. We further argue that there are gender, urban/rural, and age differences in the role of financial intermediaries. The effect of financial intermediaries on the strength of family ties is more relevant for female, rural, and younger people compared to male, urban, and older people.     

Does eco-certification boost regulatory compliance in developing countries? ISO 14001 in Mexico

Private sector initiatives certifying that producers of goods and services adhere to defined environmental process standards are increasingly popular worldwide. According to proponents, they can circumvent chronic barriers to effective public sector environmental regulation in developing countries. But eco-certification programs will have limited effects on producers?? environmental performance if, as one would expect, they select for those already meeting certification standards. Rigorous evaluations of the environmental effects of eco-certification in developing countries that control for selection bias are rare. We use plant-level data on more than 80,000 Mexican facilities to determine whether ISO 14001 series certification of environmental management systems boosts regulatory compliance. We use propensity score matching to control for nonrandom selection into the program. We find that plants recently fined by environmental regulators were more likely to be certified, all other things equal, but that certified plants were subsequently fined just as often as similar uncertified plants. These results suggest that in Mexico, the ISO 14001 program attracts dirty plants under pressure from regulators??not just relatively clean ones??but does not have a large, lasting impact on their regulatory compliance.     

With a little help from our friends: The effect of USAID assistance on SME growth in a transition economy

Using survey data on Macedonian firms that participated in USAID programs providing technical and financial assistance for small and medium-sized enterprises (SMEs) and on firms that did not, we estimate the effectiveness of such assistance in increasing the growth of employment in the assisted firms. We control for selection bias in program participation and use both kernel and caliper propensity score matching to estimate the excess growth of employment in assisted firms. We find that assistance programs raised employment growth by 16-20 percentage points in the first year after assistance and by 26-30 points by the third year.