Edvard Johansson

Obesity and labour market success in Finland: The difference between having a high BMI and being fat

This paper examines the relationship between obesity and labour market success in Finland, using various indicators of individual body composition along with body mass index (BMI). Weight, height, fat mass and waist circumference are measured by health professionals. We find that only waist circumference has a negative association with wages for women, whereas no obesity measure is significant in the linear wage models for men. However, all measures of obesity are negatively associated with womens employment probability and fat mass is negatively associated with mens employment probability. We also find that the use of categories for waist circumference and fat mass has a substantial influence on the results. For example, the category for high fat mass is associated with roughly 5.5% lower wages for men. All in all, the results indicate that in the absence of measures of body composition, there is a risk that labour market penalties associated with obesity are measured with bias.

Alcohol-related mortality, drinking behavior, and business cycles

This paper explores the connection between alcohol-related mortality, drinking behavior, and macroeconomic conditions in Finland using both aggregate and microlevel data from recent decades. The aggregate data reveal that an improvement in economic conditions produces a decrease in alcohol-related mortality. Microlevel data show that alcohol consumption increases during economic expansion while the probability of being a drinker remains unchanged. This demonstrates that alcohol-related mortality and self-reported alcohol consumption may be delinked in the short-run business cycle context. One explanation for this paradox is that most harmful forms of drinking are not captured in survey-based data used to study the effect of macroeconomic conditions on alcohol consumption. Our evidence does not overwhelmingly support the conclusions reported for the United States that temporary economic downturns are good for health.

Job Security and Employee Well-Being: Evidence from Matched Survey and Register Data

We examine the effects of establishment- and industry-level labor market turnover on employees’ well-being. The linked employer-employee panel data contain both survey information on employees’ subjective well-being and comprehensive register-based information on job and worker flows. Labor market turbulence decreases well-being as experienced job satisfaction and satisfaction with job security are negatively related to the previous year’s flows. We test for the existence of compensating wage differentials by explaining wages and job satisfaction with average uncertainties, measured by an indicator for a high moving average of past excessive turnover (churning) rate. The results are consistent with compensating wage differentials, since high uncertainty increases real wages, but has no effect on job satisfaction.

Alcohol consumption and sickness absence: evidence from microdata

BACKGROUND Aggregate time-series evidence has shown that overall per capita alcohol consumption is associated with sickness absence. This study re-examines the relationship between alcohol consumption and sickness absence by using individual-level microdata and methods that yield results which are less likely to be due to spurious correlations. METHODS Data on sickness absence and alcohol consumption for 18 Finnish regions over the period 1993-2005 was used. Sickness absence was measured as the number of sickness absence days during 1 year. Alcohol consumption was measured as the number of alcohol drinks consumed per week. The individual-level relationship between alcohol consumption and sickness absence was estimated by using Poisson regression models. Unobserved determinants of lifestyle behaviours associated with the region and survey year were controlled for. Personal characteristics as well as the clustering of observations by regions were also taken into account. RESULTS The estimates show that alcohol consumption is associated with sickness absence. The positive relationship between alcohol consumption and sickness absence is particularly pronounced for low-educated males. CONCLUSIONS Aggregate time-series evidence for the relationship between alcohol consumption and sickness absence is confirmed by using individual-level microdata. The policy lesson is that it is important to take into account the effects of alcohol consumption on the prevalence of sickness absence (i.e. labour supply on an intensive margin) when one is considering the level of taxation of alcoholic beverages.

Do established health-related quality-of-life measures adequately capture the impact of chronic conditions on subjective well-being?

OBJECTIVES The paper explores how two well-established, utility-based health-related quality-of-life (HRQoL) measures (EQ-5D and 15D) capture the negative effects of various chronic conditions on subjective well-being (SWB). This is important, as both SWB and health utility can be important aims of health policy and instruments in resource allocation. METHODS A general population survey representing the Finnish population aged 30 years and over covering 25 self-reported somatic conditions and four psychiatric disorders diagnosed by interviews. RESULTS Both EQ-5D and 15D fail to capture the effects of some chronic conditions on SWB, but the conditions differ between the instruments. Even after controlling for both EQ-5D and 15D simultaneously, common psychiatric disorders decrease SWB by 0.4 points on a scale 1-10. CONCLUSIONS Using health utility as a basis for resource allocation is likely to underfund the treatment of psychiatric disorders, in comparison to their effect on the SWB of the population. Different HRQoL instruments yield somewhat different results for different conditions.

A note on the impact of hours worked on mortality in OECD countries

We investigate whether an increase in hours worked per employed person raises the total mortality rate in a sample of 23 OECD countries. We build on earlier research but extend the analysis by introducing the number of hours worked per employed as an additional regressor. Contrary to our expectations, we found that an increase in the number of hours worked actually has significantly negative effect on mortality rate, even controlling for income. Although one explanation may be that fluctuations in hours of work is in fact in this setting more a measure of the capacity use rate of the economy than a measure of how stressful work is for individuals who are working, more research on the topic is needed to find a plausible explanation for the observed phenomenon.

The physical strenuousness of work is slightly associated with an upward trend in the BMI.

This paper examines the relationship between the physical strenuousness of work and the BMI in Finland, using individual microdata at 5-year intervals over the period 1972--2002. Data came from the National FINRISK Study which contains self-reported information on the physical strenuousness of a respondents occupation. Our estimates show that the changes in the physical strenuousness of work explain around 7% at most of the increase in BMI for Finnish males observed over a period of 30 years. The main reason for this appears to be the effect of the physical strenuousness of work on BMI which is rather moderate. According to the point estimates, BMI is 2.4% lower when a males occupation is physically very demanding and involves lifting and carrying heavy objects compared with a sedentary job (reference group of the estimations), other things being equal. Furthermore, it is very difficult to associate the changes in the occupational structure with the upward trend in BMI for females, and the contribution of the changes in the occupational structure is definitely even smaller for females than it is for males. All in all, we show that the changes in self-reported occupation show a slight association with the changes in the logarithm of the BMI scores.

Institutionalisation and subjective wellbeing for old-age individuals: is life really miserable in care homes?

ABSTRACT In this paper we examine whether there are systematic differences in the quality of life, depending on whether an individual is institutionalised or not, holding health status and income level constant. In doing this we use a nationally representative data set, the Health 2000 in Finland. When controlling for health and functional status, demographics and income level, we find that individuals who are living in old-age homes actually report significantly higher levels of subjective wellbeing than those who are living at home. We argue that this finding emerges from queuing for care homes. This implies that there are individuals living at home who are so frail that they should really be living in an old-age institution, but because of the queues for that particular mode of living, they are living at home with a decreased quality of life as a consequence.

Economic inequality and population health: looking beyond aggregate indicators

This paper studies the sensitivity of various health indicators to income inequality as measured by regional Gini coefficients, using individual microdata from Finland over the period 1993-2005. There is no overall association between income and health at the regional level. We discovered that, among men, there are no significant associations between income inequality and several measures of health status. Among women or among both sexes combined, there are some indications of associations in the predicted direction between income inequality and physical health, disability retirement, sick leave, and consumption of medicines, but none are robust to different model specifications. Only among the population aged less than 30 there is some indication that mental health is associated with inequality. Our findings confirm that income inequality in small populations (not large enough to measure the overall class pyramid of the society) is often immaterial for health outcomes.

Heritability of Lifetime Income

Using 15 years of data on Finnish twins, we find that 24% (54%) of the variance of women’s (men’s) lifetime income is due to genetic factors and that the contribution of the shared environment is negligible. We link these figures to policy by showing that controlling for education reduces the variance share of genetics by 5-8 percentage points; by demonstrating that income uncertainty has a genetic component half the size of its variance share in lifetime income; and by exploring how the genetic heritability of lifetime income is related to the macroeconomic environment, as measured by GDP growth and the Gini-coefficient of income inequality.