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PubMed1991

Relation of work and retirement to health and well-being in older age.

Patterns of labor-force participation were studied with a broad array of indicators of physical and psychological well-being. The sheer amount of work--whether people work and, if so, how many hours they work--shows little relationship to health and well-being. Drawing on scattered existing research and theory, it is hypothesized and found that persons whose patterns of labor-force participation (or nonparticipation) reflect their personal preference report higher levels of physical and psychological well-being than do those whose level of labor-force involvement is constrained by other factors. The results do not differ by gender, age (65 years and older vs. 55-64 years), or occupation (professional vs. clerical or sales vs. blue-collar workers). Data are from 1,339 respondents 55 years of age or older in the Americans' Changing Lives Survey, a large national, cross-sectional survey of Americans 25 years of age and older with an oversample of those 60 years of age and older, and are analyzed by ordinary least squares multiple regression.

Adult↗
PubMed2005

Changes in women's postmarital employment in Japan and Taiwan.

Research on female labor-force participation has not fully explained why economic development has different effects on married women's employment continuity across societies. I use life-history data from nationally representative samples of women in Japan and Taiwan to examine the divergence in women's patterns of labor-force exit in these two countries during the postwar period. The findings reveal that the effects of family demands, occupation, firm size, and employment sector on women's exit rates differed substantially between Japan and Taiwan. Taken together, these factors account for the different trends in married women's employment during this period. I argue that the cross-national differences in the predictors of women's labor-force withdrawal reflect the extent of incompatibility between work and family responsibilities for married women in these two societies.

Adult↗
PubMed1999

The labor market consequences of family illness.

BACKGROUND: This study examines the impact of mental illness on the labor market performance of family members of afflicted individuals. Numerous research projects have attempted to measure the impact of mental illness and related disorders on the ill individual, yet have traditionally neglected estimating potential costs accruing to family members of the ill. AIMS OF THE STUDY: Previous research estimating the impact of illness on the time allocation decisions of family caregivers has been limited in scope. I obtain estimates of the impact of mental illness on the probability of labor force participation and hours of work of all family members. The general analysis used in this study will pave the way for more accurate assessments of the costs of all types of illness and the estimates obtained will provide policy makers with a much more complete picture of the costs of mental illness. METHODS: The main empirical work in this study includes a probit estimation of labor force participation and a tobit regression of hours worked (including sample selection correction). The data sample, taken from the 1987 National Medical Expenditure Survey, is also partitioned by gender to clarify effects of family illness on labor supply for both females and males. RESULTS: Adult males are found to increase their probability of labor force participation in the presence of mental illness in the family (all else equal) when the mental illness is accompanied by a chronic physical illness. However, females are surprisingly found to have no significant impact on their probability of being a member of the labor market when a family member is afflicted with mental illness. On the other hand, hours of work are significantly reduced for both females and males when the mentally ill family member is afflicted with additional illnesses (physical and/or mental). DISCUSSION: Previous studies have traditionally not considered the effects of family illness on males because females are typically found to be the primary caregiver when a family member falls ill. The findings in this study indicate that men suffer reductions in their hours of work in an equivalent magnitude to females. Thus, males should not be ignored when estimating the opportunity costs of illness in families. IMPLICATIONS FOR HEALTH POLICIES: Current federal and state policies provide for some of the medical costs and replace some of the lost income of ill individuals, but generally do not support family members who are negatively affected by illness. This research provides evidence supporting the arguments of advocates for policy to ameliorate the financial burden borne by family members of the ill. IMPLICATIONS FOR FUTURE RESEARCH: The estimates obtained in this study show that women and men both need to be studied when determining the effects of family illness on labor supply, and should be studied separately to obtain clear results. Also, future research should include examining particular mental illnesses to see whether there is a higher cost of one over the other (e.g., schizophrenia versus major depression), as this may provide valuable information to policy makers. In addition, comparison of the costs of psychological disorders to chronic physical illnesses (such as cancer and heart disease) should be undertaken.

Journal Article↗
PubMed2003

Is position in the occupational hierarchy a determinant of decline in perceived health status?

This study examines the extent to which position in the occupational hierarchy is predictive of declines in perceived health status over a 48 month period in a representative sample of the Canadian labor force. We hypothesized that the proportion of workers reporting a decline in health status would be greater among persons in lower position in the occupational hierarchy, and that these differences in risk would primarily be explained by characteristics of the psychosocial work environment and secondarily by the baseline prevalence of adverse health behaviors. The study cohort was defined as labor force participants aged 18-64 who reported good, very good or excellent health in the 1994 baseline wave of Canada's National Population Health Survey and who participated in the 1998 follow-up survey. Between 1994 and 1998, 16.6% of labor force participants reporting excellent, very good or good health status at baseline reported a decline in perceived health status. For men, the age-adjusted odds of decline in perceived health status were 1.80 (95% CI: 1.24-2.63) and 1.74 (95% CI: 1.19-2.54) for the two lowest occupational classes relative to the highest occupational class. There was no association between position in the occupational hierarchy and the prospective risk of health status decline for women. For men, the association between position in the occupational hierarchy and decline in perceived health status was moderately reduced but remained statistically significant following adjustment for baseline health, health behaviors and psychosocial work exposures. Adjustment for household income did not alter these findings. When stratified by gender, position in the occupational hierarchy was associated with the prospective risk of health status decline for men but not for women. Among men, the collective influence of health behaviors and psychosocial work exposures explained a moderate component of the decline in perceived health status. A more robust measurement of the characteristics of labor market experiences would be expected to improve understanding of the relationship between work and health in this sample.

Adolescent↗
PubMed2005

Gender differences in retirement decisions in Hong Kong.

The study of labor force participation at older ages and the process of retirement do not have a long tradition in Asia's newly developed societies. This study, based on telephone survey of 950 respondents, examines various socio-economic factors that would influence retirement decision among older workers in Hong Kong. The findings show that older men were more likely to participate in the labor force than older women. Interestingly, older workers, in particular older women, with pension were less likely to retire. Having a working spouse decreased the likelihood of retirement and older workers, in particular older women, living with married children were more likely to retire. Poor health also discourages the propensity to continue working at old age. These findings confirm that retirement entails much more than just a decision to stop work, and that there were gender differences in retirement decision. Finally, several policy challenges, with reference to elderly women, concerning older workers' labor force participation were discussed.

Age Distribution↗
PubMed2000

The demographic and socio-economic characteristics of post-1965 immigrants to New York City: a comparative analysis by national origin.

This article analyzes and compares the demographic and socioeconomic characteristics of persons born abroad who immigrated to New York City after 1965 and still lived in the City in 1990. Using data from the 1990 Census, the authors classify persons into the 24 largest national origin groups and compare their demographic and socioeconomic characteristics (sex, age, educational attainment, labor force participation, unemployment, occupation, income, and poverty). The authors pose and answer three empirical questions. The first question is: What are some of the main differences by national origin in the composition of persons immigrating to New York City after 1965? The second question is: What are some of the main differences in the location of post-1965 immigrants in New York's socioeconomic structure? The third question is: What are some of the differences in the economic rewards received by persons who immigrated to New York City since 1965? The authors find that immigrants with less than a high school education have higher labor force participation rates than the US-born population in the same educational category and also have slightly higher earnings. Immigrants with a high school degree have labor force participation rates close to (or slightly higher than) the average for the US-born population but their incomes are slightly lower than the average income for the US-born population. Immigrants with a college degree have participation rates similar or slightly lower than those of the US-born population while their earnings are significantly lower than those of US-born college graduates.

Americas↗
PubMed1989

Work disability among cancer patients.

To identify factors affecting the ability of persons with recent cancer diagnoses to remain in the labor force and retain premorbid levels of work performance, the investigators analyzed data on 247 individuals with lung, pancreatic, prostatic, or cervical cancer. Subjects were selected from a population-based tumor registry. According to Pearson correlations, ordinary least squares multiple regression, and logistic analysis, physical factors related to disease were the strongest predictors of work disability, defined as either leaving the labor force or functioning less fully at work than before becoming ill. The strongest predictors of work disability were physical dysfunction measured by the Sickness Impact Profile (SIP) and disease stage. Social background factors such as age, sex, income, and education were not statistically significant predictors. Two job characteristics, (1) physical demands of work and (2) discretion over hours worked and how much work would be done, predicted work disability, the latter appearing to help prevent this condition. Strictly disease-related factors appear more important here in predicting work disability than in studies of other diseases. Still, it appears that increasing flexibility of working hours and the pace of work could help some individuals with cancer histories remain in the labor force. Unwillingness of employers to facilitate such accommodation where technically feasible may constitute a form of discrimination against the cancer patient.

Activities of Daily Living↗
PubMed1993

Retirement quandary: more retirees at younger ages, living longer.

The authors examine trends in age at retirement and life expectancy in the United States. "We used labor-force data from the Current Population Survey...to calculate the percentage change in labor-force participation rates for five-year birth cohorts over a series of five-year intervals.... Using these percentage changes, corrected for mortality during each five-year interval, we calculated the average age at retirement (median age) from the early 1950s to the late 1990s."

Age Factors↗
PubMed1981

Work force policy perspectives: registered nurses.

If the decline in full-time labor force participation by registered nurses in hospitals is to be reversed, the issue of equal pay for comparable work must be addressed. Under pressure for cost containment, policies tend to focus on labor force economics rather than on limitations of services. While the two are interrelated, wage policies must be considered independently. This article describes the network which determines how nurse salaries are set: the relationship between the private sector, the general schedule and the Veteran's Administration. The effects of this system are documented, using testimony from a case in the tenth circuit, as well as comparisons with other reference groups: policemen, teachers, laborers, and VA career fields. The evidence suggests that there is a need for policy intervention. Prime areas for action are the comparability practices by governments, particularly in the areas of classification standards and pay setting. Hospital personnel practices which continue past effects of occupational segregation also should be changed.

Cost Control↗
PubMed1997

Direct and indirect medical costs incurred by Canadian patients with rheumatoid arthritis: a 12 year study.

OBJECTIVE: To perform the first prospective longitudinal study of direct (health services utilized) and indirect costs (diminished productivity represented by income loss) incurred by patients with rheumatoid arthritis (RA) in Saskatoon and Montreal, followed for up to 12 and 4 years, respectively. METHODS: 1063 patients reported on health status, health services utilization, and diminished productivity every 6 months. RESULTS: Annual direct costs were $3788 (1994 Canadian dollars) in the late 1980s and $4656 in the early 1990s. Given that the average age exceeded 60 years, few participated in labor force activities or considered themselves disabled from the labor force and their indirect costs were substantially less, $2165 in the late 1980s and $1597 in the early 1990s. Institutional stays and medications made up at least 80% of total direct costs. Lengths of stay in acute care facilities remained constant, but the rate of hospitalization increased in the early 1990s, increasing average hospital costs per patient from $1563 in the late 1980s to $2023 in the early 1990s. For nonacute care facilities, rate of admission as well as length of stay increased over time, increasing costs per patient in Saskatoon 5-fold, from $291 to $1605. Those with greater functional disability incurred substantially higher direct and those under 65 years incurred higher indirect costs. CONCLUSION: Direct costs are higher than indirect costs. The major component is due to institutional stays that, in contrast to other direct cost components, is increased in the older and more disabled. Measures to reduce longterm disability by earlier, more aggressive intervention have the potential to produce considerable cost savings. However, it is unknown which strategies will have the greatest effect on outcome and accordingly, how resources can be optimally allocated.

Aged↗
PubMed2002

The effect of renal insufficiency on workforce participation in the United States: an analysis using National Health and Nutrition Examination Survey III data.

BACKGROUND: End-stage renal disease is associated with workforce nonparticipation, but no previous study has assessed the impact of renal insufficiency on employment status from a population standpoint. METHODS: To determine whether renal insufficiency is independently associated with labor force participation, an analysis was performed using observational data from the Third National Health and Nutrition Examination Survey, which represents a cross-sectional sample of the US population. Five thousand five hundred fifty-eight subjects of the civilian noninstitutionalized US population aged 18 to 64 years provided complete information regarding key variables. A logistic regression equation with workforce participation as the dependent variable was created. Explanatory variables included age, sex, race, marital status, census region, and education, as well as the health-state indicators of general health status, presence or absence of diabetes, hypertension, stroke, congestive heart failure, myocardial infarction, and an indicator of renal function. Renal dysfunction was defined by serum creatinine values greater than 1.7 mg/dL (150 micromol/L) for women and greater than 2.0 mg/dL (180 micromol/L) for men. RESULTS: Renal dysfunction was independently associated with labor force nonparticipation, with an odds ratio of 7.94 (95% confidence interval, 1.60 to 39.43). This relationship remained statistically significant after subjects with markedly elevated serum creatinine levels were excluded. CONCLUSION: A previously unrecognized independent association between renal function and labor force participation was identified. This group of patients warrants further attention regarding identification of specific factors leading to nonemployment, potential for workforce rehabilitation, and assessment of the impact of renal insufficiency in other functional spheres.

Adolescent↗
PubMedDate not supplied

The U.S. study of work incapacity and reintegration.

In many countries, including the United States, the number of persons being awarded long-term or permanent disability benefits has risen dramatically in recent years. Government agencies, advocates for the disabled, and others are looking for ways to help persons with disabilities return to the labor force. The Work Incapacity and Reintegration (WIR) Study was developed to address that issue. The United States and five other countries--Germany, Denmark, Sweden, Israel, and the Netherlands--have participated in a cross-national study of work incapacity under the auspices of the International Social Security Association. The study had two objectives: to examine the factors that influence the pattern of work resumption among persons disabled by a back condition and to identify the medical and nonmedical interventions that are most effective in helping such persons reenter the labor force. Samples for the U.S. national study were drawn from four cohorts: Social Security Disability Insurance (DI) beneficiaries, Supplemental Security Income (SSI) beneficiaries, and recipients of temporary disability insurance (TDI) benefits from the states of California and New Jersey. Only the TDI recipients were included in the comparative study. This article discusses the study design and methodology and summarizes the findings of the U.S. national study. Findings from the U.S. study show significant differences between the two cohorts in terms of work resumption and other characteristics. The proportions of respondents from the TDI cohorts who were working at the third and final study contact ranged from 53 percent to 65 percent, compared with less than 5 percent of the DI and SSI respondents. Respondents from the DI and SSI cohorts were on average about 10 years older than the TDI respondents, were less well educated, and reported more physical demands in their usual work. They also reported lower levels of functional capacity, higher levels of pain, and a much greater tendency to have other chronic illnesses. The types of medical treatments provided were remarkably uniform across cohorts and, within cohorts, between those who did and did not resume working. Thus, no medical intervention was identified that showed a significantly higher success rate in terms of facilitating a return to work. However, changes made in the work environment by the employer were an important factor in work reintegration; about 80 percent of respondents who resumed working did so with the help of workplace accommodations. In addition, since respondents with fewer physical demands in their job were more likely to return to work, there appears to be some potential for job retraining as a means of promoting a return to work. The Social Security Administration should consider these findings in developing strategies to help disabled workers reenter the labor force.

Adult↗
PubMed1998

Chronicity of back problems during working life.

STUDY DESIGN: A follow-up study of a cohort of 444 patients aged 16 to 59 years who consulted with their general practitioners (GPs) in 1987-1988 for an incident episode of back pain. OBJECTIVES: To determine the proportion of patients with back pain in whom chronic back problems develop after a follow-up of 7 years, to compare health outcomes and labor force participation of patients with and without chronic back problems and to identify determinants of chronicity. SUMMARY OF BACKGROUND DATA: The incidence and prevalence of back pain are very high. A large proportion of the costs related to medical consumption, absence from work, and disability are probably caused by chronic back problems. It is unknown what proportion of back problems become chronic, especially after a long follow-up period, and which factors can predict chronicity. METHODS: Data on the course of the symptoms and medical consumption from the period between 1987-1988 and 1991 were gathered retrospectively. Data on several health outcomes, including LFP, and data on some work characteristics were collected prospectively in 1991. A more extensive data set on health outcomes including psychologic status and working situation was collected in 1994. RESULTS: Chronic back problems developed in 28% of the patients. These patients reported more pain, higher levels of medical resource consumption, worse health outcomes, and lower labor force participation. Episodes of back pain before 1987-1988, severe pain in 1991, and disability score in 1991 were positively associated with chronicity in 1994, difficulties with job performance in 1991, and frequent stooping in the subgroup of patients who held a paying job in the follow-up period. CONCLUSIONS: Even after a follow-up of 7 years, the proportion of people with chronic back problems was high. The consequences for quality of life, labor force participation, and consumption of medical resources are clear. Further research is necessary to examine determinants and ways to prevent chronicity.

Adolescent↗
PubMed2001

Life situation and posttraumatic symptoms: a follow-up study of refugees from the former Yugoslavia living in Sweden.

Posttraumatic symptoms were assessed by means of the Harvard Trauma Questionnaire among 27 severely traumatized refugees from the former Yugoslavia in psychiatric treatment and then 3 years later, after an average of 5.5 years in Sweden. At follow-up the subjects also answered a questionnaire about their life situations. No significant change in average symptom level had taken place at follow-up. Seventeen subjects met the DSM IV criteria for posttraumatic stress disorder (PTSD) at both times. However, five subjects who met the PTSD criteria in the first study did not at follow-up, and the opposite was true for another five subjects. Fifteen subjects reported contact with psychiatric care during the past year. Unemployment and dependence on social welfare were high at follow-up. The unemployment rate of 32% was almost six times greater than that for the regular Swedish labor force but comparable to that of the whole Bosnian labor force in Sweden. Social contacts with the majority population were as common as with compatriots, but two-thirds of the subjects expressed a wish for more social contacts outside the family. Positive factors in the subjects' life situations were the housing situation and the fact that most subjects had at least reasonable knowledge of the majority language. However, a minority of the group still had no formal competence in Swedish, with negative consequences for labor market integration and social contact with Swedes. Two-thirds of the group had made no definite decision to stay in Sweden.

Adult↗
PubMed1996

Immigration policy and the U.S. economy: an institutional perspective.

The author examines some aspects of the current situation concerning immigration to the United States. He predicts that the 1990s will witness the largest flow of immigrants into the population and labor force of any decade in the country's history; furthermore, since there is no universally accepted right to immigrate, the adoption of migration policy is one area of economic policymaking that is not controlled by market forces. He also notes that while the country's need is for a highly skilled, motivated, and educated labor force, the majority of current immigrants have low skill levels and relatively little education. The need to develop and implement a migration policy that is in tune with the country's economic objectives is stressed. He concludes that "the resurrection of mass immigration from out of the nation's distant past was a political accident; its perpetuation in the 1990s is contrary to national interest. Immigration reform, therefore, needs to be [in] the forefront of the nation's economic policy agenda."

Americas↗
PubMed1983

Migrant information, job search and the remigration decision.

"Labor force migration poses two important questions for the economist. The first concerns the nature, magnitude and direction of labor force response to perceived earnings differentials over space. The latter and more complex question concerns the effectiveness, or efficiency, of this response--namely migration--and other market mechanisms in reducing these earnings differentials over time." Both questions are addressed in this paper "by examining relationships among: (1) quality of information obtained prior to a move, (2) search duration at the migration destination, and (3) the likelihood of subsequent (perhaps corrective) remigration." These relationships are analyzed using the human capital model of migration-remigration and data from the 1970 U.S. census.

Americas↗
PubMed2005

Men who work at age 70 or older.

The federal policy on older workers has shifted from the encouragement of early withdrawal from the labor force to the encouragement of continuous participation in the labor force. In this light, it is instructive to investigate the backgrounds of elderly people who work at age 70 or older. This article presents the findings of a study, using data from the 1993 Asset and Health Dynamics of the Oldest Old Study, that investigated the effects of health, economic conditions (net worth, employer-provided pensions, and supplemental medical insurance coverage), education, and spouse's work status on the probability of working among men aged 70 or older. The study addressed the probability of working, the probability of working fulltime and of working part-time, and the probability of being self-employed and of being employed by others. Implications for policy are discussed.

Aged↗
PubMed1983

Industrial shifts, female employment, and occupational differentiation: a dynamic model for American cities, 1960-1970.

Sex-linked occupational differentiation has been seen as influenced by both the industrial structure of the economy and the sex composition of the labor force. Here, with a sample of 70 SMSAs, it was found (a) that the odds of men relative to women of joining professional and managerial occupations increased between 1960 and 1970, and (b) that this increase was dependent on the growth of tertiary industries and the greater number of women joining the cash economy. The observed effect of industrial shifts on sex-occupational differentiation, however, is argued to be a spurious consequence of the gender-composition of the work force. Specifically, the development of tertiary industries generates greater demand for female labor. Intensive recruitment of women to the labor force in turn increases occupational differentiation because females, in sex-typed labor markets, are likely to be channeled in disproportionate numbers away from upper-status occupations. The findings demonstrate that traditional modernization theory is unable to account for this. However, the results lend support to expectations derived from a labor market sex-segmentation approach.

Career Choice↗