Parallel session 1C: Economic and occupational aspects of public health
Hermien Dijk - Do Mental Health Problems Cause Problematic Debts?
Problematic debts can have far-reaching consequences for debtors, creditors and society as a whole. This study investigates whether there is a causal effect of mental health problems on the onset of individual problematic debt. We use nationwide individual-level panel data on problematic debt and mental healthcare use. We employ a fixed effects instrumental variable approach, using the death of a sibling or child (bereavement) as instruments for mental health problems. In general, we find a strong correlation between mental health problems and problematic debt. The study furthermore shows that there is a causal relationship between mental health problems and the onset of problematic debt for men. The results from this study indicate that interventions aimed at reducing and preventing problematic debts might be more effective if they include effective strategies for improving mental health and that effective mental health interventions might have long-term societal savings in the form of prevented problematic debts.
Key words: Mental health, Problematic debt, Instrumental variable estimation
Shuye Yu - Use of Spatial Job Flexibility Following a Health Shock
A health shock, defined as a sudden decline in one's health condition, negatively impacts various labour market outcomes (e.g., employment and working hours). However, little is known about the association between health shocks and job flexibility. Using eight waves of an Australian household panel survey (HILDA) between 2012 and 2019, this paper examines the effect of a recent health shock occurring within the last 12 months on the uptake of home-based work, as one typical form of job flexibility. We adopt a Heckman-type sample selection model with panel data to account for the potential bias resulting from the non-random sample selection into the labour market and the unobserved heterogeneity. The results show that, for both genders, home-based work is used more frequently following a recent health shock, while this effect is more prominent for women. We also find evidence that non-random selection into the labour market leads to underestimating the uptake of home-based work for women. Once correcting the sample selection, we observe that their uptake is 25%-100% more than the uncorrected model results. Our results indicate that home-based work could be a useful tool to mitigate health shocks' adverse effect on labour market outcomes.
David van de Ven - The impact of working conditions and health behaviour on work ability and self-rated health
Insight in the impact of working conditions and health behaviour on work ability and self-rated health is essential to develop effective policies aimed at prolongation of working life. This study assessed the associations between working conditions and health behaviour with work ability and self-rated health, focussing on between-individual differences and within-individual changes.
Information was used of 18,349 participants aged 45-64 years from seven waves (2010-2017) of the Dutch Study on Transitions in Employment, Ability and Motivation (STREAM). Differences between individuals and changes within individuals in working conditions and health behaviours (including BMI) were analysed with between-within regression models. The contemporary associations of within-individual improvements and deteriorations in working conditions and health behaviours with changes in self-reported work ability (0-10 scale) and self-rated health (1-5 scale) in the same year were analysed with fixed-effects regression models.
Workers with more unfavourable working conditions reported lower work ability (β’s between -0.10 and -0.35) and poorer self-rated health (β’s:-0.08 to -0.16). Unhealthy behaviours were less strongly associated with lower work ability (β’s:-0.03 to -0.04) and poorer health (β’s:-0.04 to -0.12). Deteriorations in working conditions in a given year were associated with decreased work ability and health in the same year, whereas improvements in working conditions were associated with increased work ability and health. Deteriorations in health behaviour, except for smoking, were associated with decreased work ability and health. Workers with improved health behaviour, except workers who stopped smoking or increased in moderate physical activity, had improved health, but reduced work ability.
Preventing deteriorations in working conditions, and to a lesser extent health behaviour, could be of particular importance for maintaining good work ability and self-rated health among workers
Keywords: Occupational health, sustainable employability, fixed effects models
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