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

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Abstract

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.

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Notes

  1. https://www.abc.net.au/news/2016-04-12/presenteeism-costing-the-economy-billions/7318832.

  2. Though these people work in office, these workers have similar job control level, work hours and wage rate to other blue collar workers on average.

  3. https://www.abs.gov.au/ausstats/abs@.nsf/mf/6302.0?opendocument&ref=HPKI.

References

  1. OECD: Education policy analysis 2003. OECD, Paris (2003)

    Book  Google Scholar 

  2. Psacharopoulos, G., Patrinos, H.: Returns to investment in education: a further update. Educa. Econ. 12(2), 112–134 (2004)

    Google Scholar 

  3. Deaton, A.: Inequalities in income and inequalities in health. NBER Working Paper No. 7141, (1999)

  4. Deaton, A.: Policy implications of the gradient of health and wealth. Health Aff. (Millwood) 21(2), 13–30 (2002)

    Article  Google Scholar 

  5. Domina, T., Penner, A., Penner, E.: Categorical inequality: schools as sorting machines. Ann. Rev. Soc. 43, 311–330 (2017)

    Article  Google Scholar 

  6. Blundell, R., Dearden, L., Meghir, C., Sianesi, B.: Human capital investment: the returns from education and training to the individual, the firm and the economy. Fisc. Stud. 20(1), 1–23 (1999)

    Article  Google Scholar 

  7. Becker, G.: Human Capital, a Theory and Empirical Analysis with Special Reference to Education. Columbia University Press, NBER (1964)

    Google Scholar 

  8. Harvey, L.: New realities: the relationship between higher education and employment. Tert. Educ. Manag. 6(1), 3–17 (2000)

    Article  Google Scholar 

  9. Card, D., Cardoso, H., Kline, P.: Firms and labor market inequality: evidence and some theory. J. Labor. Econ. 36, 13–70 (2018)

    Article  Google Scholar 

  10. Abowd, J., Kramarz, F., Margolis, D.: High wage workers and high wage firms. Econometrica 67, 251–333 (1999)

    Article  Google Scholar 

  11. Syverson, Ch.: What determines productivity? J. Econ. Lit. 49(2), 326–365 (2011)

    Article  Google Scholar 

  12. Battu, H., Belfield, C., Sloane, P.: Human capital spillovers in the workplace: evidence for the service sector in Britain. Int. J. Manpow. 25, 123–138 (2004)

    Article  Google Scholar 

  13. Wirz, A.: Private returns to education versus education spill-over effects or what co-workers account for. Empir. Econ. 34(2), 315–342 (2008)

    Article  Google Scholar 

  14. Coady, D, Dizioli, A.: Income inequality and education revisited: persistence, endogeneity, and heterogeneity. IMF Working Paper. (2017)

  15. Dooley, D., Prause, J., Ham-Rowbottom, K.: Underemployment and depression: longitudinal relationships. J Health Soc Behav 41(4), 421–436 (2000)

    Article  CAS  PubMed  Google Scholar 

  16. Knapp, M.: Hidden costs of mental illness. Br. J. Psychiatry 183(6), 477–478 (2003)

    Article  PubMed  Google Scholar 

  17. Kessler, R., Heeringa, S., Lakoma, M., Petukhova, M., et al.: The individual-level and societal-level effects of mental disorders on earnings in the United States: results from the National Comorbidity Survey Replication. Am. J. Psychiatry 165(6), 703–711 (2008)

    Article  PubMed  PubMed Central  Google Scholar 

  18. Schofield, D., Shrestha, R., Passey, M., Earnest, A., Fletcher, S.: Chronic disease and labour force participation among older Australians. Med J. Aust. 189(8), 447–450 (2008)

    Article  PubMed  Google Scholar 

  19. Schofield, D., Shrestha, R., Percival, R., Passey, M., Callander, E., Kelly, S.: The personal and national costs of mental health conditions: Impacts on income, taxes, government support payments due to lost labour force participation. BMC Psychiatry 11(72), 1–7 (2011)

    Google Scholar 

  20. Medibank Private:. The health of Australia’s workforce, 1 July 2011, available at https://www.trenchhealth.com.au/articles/MEDI_Workplace_Web_Sp.pdf. Accessed 2 Oct 2019. (2005)

  21. Grossman, M.: On the concept of health capital and the demand for health. J. Polit. Econ. 80(2), 223–255 (1972)

    Article  Google Scholar 

  22. Becher, H., Dollard, M.: Psychosocial safety climate and better productivity in Australian workplaces: costs, productivity, presenteeism, absenteeism. Report, available at https://www.safeworkaustralia.gov.au/system/files/documents/1705/psychosocial-safety-climate-and-better-productivity-in-australian-workplaces-nov-2016.pdf. (2016) Accessed 12 Oct 2019

  23. Miller, P., Mulvey, C., Martin, N.: What do twins studies reveal about the economic returns to education?: A comparison of australian and US findings. Am. Econ. Rev. 85(3), 586–599 (1995)

    Google Scholar 

  24. Miller, P., Mulvey, C., Martin, N.: The return to schooling: estimates from a sample of young australian twins. Labour Econ. 13(5), 571–587 (2006)

    Article  Google Scholar 

  25. Wei, H.: Measuring economic returns to post-school education in Australia, Research Paper cat. No. 1351.0.55.032, Australia Bureau of Statistics, Canberra. (2010)

  26. Wei, H.: Measuring economic returns to post-school education in Australia: evidence from 1981–2011 Australia Censuses. Economic Analysis and Reporting Section, Australia Bureau of Statistics. https://www.cese.nsw.gov.au//images/stories/PDF/Income_Mobility_ABS.pdf

  27. Sinning, M.: How much is it worth? New estimates of private returns to university education in Australia. University of Queensland, RWI and IZA. (2104)

  28. Leigh, A.: Returns to education in Australia. Econ. Pap. Econ. Soc. Australia 27(3), 233–249 (2010). https://doi.org/10.1111/j.1759-3441.2008.tb01040.x

    Article  Google Scholar 

  29. Summerfield, M., Bevitt, A., Friedin, S., Hahn, M., et al.: HILDA user manual—release 16. Melbourne Institute of Applied Economics and Social Research. University of Melbourne, Melbourne (2017)

    Google Scholar 

  30. Idler, E.L., Benyamini, Y.: Self-rated health and mortality: a review of twenty-seven community studies. J. Health Soc. Behav. 38(1), 21–37 (1997)

    Article  CAS  PubMed  Google Scholar 

  31. Møller, L., Kristensen, T.S., Hollnagel, H.: Self-rated health as a predictor of coronary heart disease in Copenhagen, Denmark. J. Epidemiol. Community Health 50(4), 423–428 (1996)

    Article  PubMed  PubMed Central  Google Scholar 

  32. Ware, J., Snow, K., Kosinksi, M., Gandek, B.: SF36 health survey manual and interpretation guide. Lincoln RI. (2000)

  33. Card, D.: Estimating the return to schooling: progress on some persistent econometric problems. Econometrica 69(5), 1127–1160 (2001)

    Article  Google Scholar 

  34. Heckman, J., Lochner L., Todd P.: Earnings functions, rates of return and treatment effects: the Mincer equation and beyond. In: Hanushek, E., Welch F., Handbook of the Economics of Education vol.,1 chap 7, Elsevier, Amsterdam (2006)

  35. Oreopoulos, PH., Petronijevic, U.: Making college worth it: A review of research on the returns to higher education. Working Paper No. 19053, NBER, Cambridge, MA. (2013)

  36. Heckman, J., Humphries, J., Veramendi, G.: Returns to education: the casual effects of education on earnings, health, and smoking. J. Polit. Econ. 126(JS1), 197–246 (2018)

    Article  Google Scholar 

  37. Grossman, M.: The relationship between health and schooling: what’s new? Nord. J. Health Econ. 3(2015), 7–17 (2015)

    Article  Google Scholar 

  38. Oreopoulos, P., Salvanes, K.: Priceless: the nonpecuniary benefits of schooling. J. Econ. Perspect. 25(1), 159–184 (2011)

    Article  Google Scholar 

  39. Grossman, M.: The relationship between health and schooling. East. Econ. J. 34(3), 281–292 (2008)

    Article  Google Scholar 

  40. Grossman, M., Lee, F.: Health and wage: a simultaneous equation model with multiple discrete indicators. Int. Econ. Rev. 23(1), 199–221 (1982)

    Article  Google Scholar 

  41. Haveman, R., Wolfe, B., Kreider, B.: Market work, wages, and men’s health. J. Health Econ. 13(1994), 163–182 (1994)

    Article  CAS  PubMed  Google Scholar 

  42. Lochner, L.: Non-production benefits of education: crime, health, and good citizenship. Working Paper No. 16722, NBER, Cambridge, MA. (2011)

  43. Benzeval, M., Bond, L., Campbell, M., Egan, M., Lorenc, T., Petticrew, M., Popham, F.: How does money influence health? Technical Report. Joseph Rowntree Foundation, York. https://researchonline.lshtm.ac.uk/id/eprint/2167225. (2014). Accessed 18 Oct 2019

  44. Wilkinson, R.: Income distribution and life expectancy. BMJ 304(6820), 165–168 (1992)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Heckman, J.: Sample selection bias as a specification error. Econometrica 47(1), 153–161 (1979)

    Article  Google Scholar 

  46. StataCorp: Stata user’s guide release 7. A Stata Press Publication, StataCorp LP, College Station (2001)

    Google Scholar 

  47. Urzua, S.: Racial labor market gaps: the role of abilities and schooling choices. J. Hum. Res. 43(40), 919–971 (2008)

    Google Scholar 

  48. Arleen L. Home investments in children. University of Chicago, and National Bureau of Economic Research, p. 299–351. In Economics of the family: marriage, children, and human capital, edited by Theodore W. Schultz (1974)

  49. Becker, G.: A theory of marriage. University of Chicago, and National Bureau of Economic Research, p.299–351. In Economics of the Family: Marriage, Children, and Human Capital, edited by Theodore W. Schultz. https://www.nber.org/books/schu74-1. (1974). Accessed 13 Oct 2019

  50. A De Grip. Evaluating human capital obsolescence, research centre for education and the labour market (R.O.A.) Maastricht University Maastricht, Netherlands. https://www.oecd.org/els/emp/34932083.pdf. (2004) Accessed 12 Oct 2019

  51. Eurofound: Sixth European working conditions survey—overview report (2017 update). Publications Office of the European Union, Luxembourg (2017)

    Google Scholar 

  52. Booth, A., Frank, J.: Earnings, productivity, and performance-related pay. J. Labour Econ. 17(3), 447–463 (1999)

    Article  Google Scholar 

  53. Mitchell, R., Ozminkowski, R., Serxne, S.: Improving employee productivity through improved health. J. Occup. Environ. Med. 55(10), 1142–1148 (2013)

    Article  PubMed  Google Scholar 

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  1. Research School of Population Health, The Australian National University, Canberra, ACT, Australia

    Tinh Doan, Lyndall Strazdins & Liana Leach

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  1. Tinh Doan
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Doan, T., Strazdins, L. & Leach, L. Cost of poor health to the labour market returns to education in Australia: another pathway for socio-economic inequality. Eur J Health Econ 21, 635–648 (2020). https://doi.org/10.1007/s10198-020-01163-2

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