Impact Of Poor Health Research Articles

Health and Labour Market Outcomes of North Korean Refugees in South Korea

ABSTRACT This study utilises the National Health Insurance Service of Korea (NHIS) data which include the results of annual and bi-annual health screening of North Korean refugees together with indicators of their employment and earnings and investigates the relationship between the refugees’ health and labour market outcomes. We find that the refugees with poor health significantly underperform healthy refugees in the labour market, and the impact of poor health at the time of entry lasts longer than 10 years. We also find that poor health has greater detrimental effects on refugees than on non-refugees.

Compulsive immobility: Understanding the role of health on collective efficacy

Most health care approaches to understanding social ills are rooted in strain or ecological models. Strain models assume that the impact of poor physical health operates through the individual, that it is the individual suffering from poor health who engages in social ills as a means of adapting, and that the impact of poor health is rather direct and immediate. Meanwhile, ecological approaches of health acknowledge how poor health may impact others and the collective, but poorly account for the case in which this is not so, leaving unexplained the many instances of people who are in poor health but remain actively engaged with their communities and preserve relationships that nurture trust, shared norms, and cooperation. To rectify this problem, we introduce the concept of “compulsive immobility”: the situation in which those in poor health are compelled to stay indoors and refrain from community socialization. We argue that compulsive immobility mediates the relationship between poor physical health and collective efficacy, suggesting that illness, specifically to a point of physical immobility (e.g., bedridden), enables poor health to detract from collective efficacy. This allows scholars to both acknowledge how poor health may impact the individual and community, while specifying the mechanism through which it operates. To support our claim, we draw on GSS data to examine the relationship among poor health, health-related immobility, and collective efficacy. Our results provide empirical support for our argument, revealing that general health conditions influenced the level of generalized trust directly and indirectly through compulsive immobility. We conclude with suggestions on how compulsive immobility might impact neighborhood crime and propose ways through which subsequent research may refine and further test compulsive immobility as a mediator between poor health and collective efficacy.

“A farmer’s time is expensive”: A qualitative study exploring the knowledge attitudes and perceptions of farmers regrading health and safety in Northern Ireland

Abstract The agricultural sector is important to Northern Ireland (NI) as it accounts for almost 10% of all jobs and 75% of all land usage. Despite a reduction in fatalities in other sectors, the number of fatalities in the agricultural sector in NI has remained stubbornly consistent. This research looked to use qualitative data to explore the knowledge, attitudes, perceptions and factors that influence health and safety measures and controls. Using a snowball sampling technique, a number of semi structure interviews were undertaken with participants to explore these areas. The findings of these semi-structured interviews identified six key themes: the importance of health and safety; the impact of poor health and safety; different generational attitudes; fear; time management and finance. This revealed that although participants feel they have some level of knowledge around health and safety, they felt this was lacking. However, a lack of knowledge did not mean they were unaware of the importance of health and safety and its potential impacts, although they perceived that farmers of a different generation to themselves were more at risk. Participants also indicated they were willing to make value judgements, where the need for action and cost of health and safety outweighs the importance implementing appropriate measures and control. Therefore, despite understanding the importance of health and safety, until the cost benefit equation is rebalanced for farmers in NI they still face significant risks to their health and safety.

Briefing: Promoting construction health and safety through procurement

The use of procurement as an instrument to promote improved occupational safety practices among suppliers has received little attention. There is also limited guidance on how to improve standards through procurement. Part 1 of this briefing note sets out the impact of poor health and safety practices on poverty and why using procurement can help to raise health and safety standards. Part 2 provides guidance on how this can be achieved through the procurement process.

The impact of poor health on academic performance: New evidence using genetic markers

This paper examines the influence of health conditions on academic performance during adolescence. To account for the endogeneity of health outcomes and their interactions with risky behaviors we exploit natural variation within a set of genetic markers across individuals. We present evidence that specific genetic markers have good statistical properties to identify the impacts of ADHD, depression and obesity. These markers help reveal a new dynamism from poor health to lower academic achievement with substantial heterogeneity in their impacts across genders. Our investigation further exposes the considerable challenges in identifying health impacts due to the prevalence of comorbid health conditions, with clear implications for the health economics literature.

The Golden Age of the Arts? Taking Part Survey Findings on Older People and the Arts

The UK has an ageing population, and this trend is likely to continue. This article uses data from a new survey called ‘Taking Part’ to analyse patterns of arts engagement among older people (defined as those aged 55 and over) and the reasons for and barriers to older people engaging with the arts. While levels of engagement generally decline among older groups, those aged 55–74 make up a substantial part of the audience for a number of arts events including classical music, opera and craft exhibitions. Indeed, the analysis shows that the 55–64 age cohort is among the most actively involved with the arts. Adults in older age groups also engage with the arts, participating in a range of activities including crafts, reading and watching arts programmes on TV. When analysed further, socio-demographic factors including gender, disability status and socio-economic status emerge as important predictors of arts engagement among older people. Data on motivations and attitudes show that older people engage in the arts for enjoyment, relaxation, to see a specific performer or event and for a sense of a social occasion. In terms of barriers to arts engagement, time is less of an issue for older people, while the impact of poor health (particularly among people with a limiting disability) and the lack of social networks and transport is intensified among older age groups. The article closes with a consideration of the implications for arts engagement among older people of a number of projected future trends, including continuing population ageing and increasing average number of years spent in poor health, increasing Internet use, the narrowing of gender inequalities in life expectancy, the growth in ethnic minority representation among older people and pension reform.

Poor Health Kills Small Business: Illness And Microenterprises In South Africa

Small businesses contribute almost 50 percent of total employment and 30 percent of gross domestic product in South Africa, but the impact of poor health and AIDS on these businesses is poorly documented. Using three waves of longitudinal data from predominantly African neighborhoods in peri-urban Durban, South Africa, this project investigates the connections between the health of the owner of a micro- and small enterprise (MSE) and the MSE's growth, survival, or exit. The results show that poor baseline health and declines in health over time are both significantly associated with subsequent business closure.

Meeting the Needs of Disabled Older Persons: Can the Fragments Be Pieced Together?

ONE of the first things we learn in geriatrics is that, as people get older, their health needs extend beyond the purely medical. Actually, this is the case for other populations (e.g., very young children and all patients with devastating illnesses). The common issue is that these patients are unable to take their illnesses in stride and go on with the rest of their lives. Rather, health becomes the overriding force in their lives, and resources must be mounted to compensate for the deficits incurred by disease and debility. In geriatrics, the onset of functional impairment (particularly in activities of daily living) marks the transition of the role of health from bit player to lead actor. Certainly, older persons have larger disease burdens, but there is much more contributing to the impact of poor health including the loss of social support, financial limitations, and societal barriers such as the lack of geriatric-friendly housing and communities. When all of these are considered, it becomes obvious that care for the functionally impaired, community-dwelling elderly patient requires more than a physician or a health care system can provide. In the United States, we are celebrating the 40th anniversary of the Medicare program, a landmark piece of legislation enacted by the Johnson administration. As conceived, this program intended to relieve elderly Americans of the worry of becoming health care paupers once they retired and lost their commercial health insurance. The program has been enormously successful, though costly. Older persons have excellent access to health care and receive plenty of it. Yet, in its design and implementation, there have been inherent flaws in Medicare that fail to recognize the basic principle that medical care alone is insufficient. This oversight is understandable. The fee-for-service Medicare system was largely based on the Blue Cross and Blue Shield insurance plans, which were medically oriented and rewarded the volume of medical services provided, particularly procedures. In addition, life expectancy in the 1960s was substantially shorter (1) than today, and the numbers of older persons, those who were frail, was relatively small. Now, halfway through the first decade of the millennium, we are anticipating 75 million baby boomers who will begin to reach Medicare eligibility based on age in 2011. Moreover, the most rapidly growing age group in the United States is the 85 years and older population. With advancing age, functional impairment rises. For example, 20% of persons 65–74 years of age have difficulty with activities of daily living, whereas 53% of those 85 years and older have difficulty with these tasks (2). Providing assistance with these tasks largely remains outside the benefits package provided by Medicare. These demographic data underscore the pressing need to reconsider how health care is conceptualized for older persons. In the United States, several attempts have been initiated to blend medical and social services to meet the comprehensive medical and social needs of frail older persons. Among the most prominent has been the Program for Allinclusive Care of the Elderly (PACE) and the social health maintenance organizations (S/HMO). Both have had some successes (3,4) but they also have limitations (e.g., participants’ inability to retain their own physicians, high premiums for those who are not eligible for Medicaid, modest interest among insurers) and have not become widely available. In this issue of the Journal, Beland and colleagues report the results of a large, carefully conducted trial of an integrated (blending health and social services) health care delivery system (SIPA; French acronym for System of Integrated Care for Older Persons) launched in Canada (5). Some notable features of the SIPA system include assessment followed by evidence-based interdisciplinary protocols for the conditions that frail older people commonly experience (e.g., falls, heart failure, depression, dementia, medications). SIPA mobilized medical and social services, including case management, to keep patients out of the hospital. Another positive aspect of the program is that the patient’s family physician continues to provide the medical care. Moreover, the program provided financial incentives for physician participation ($400 annually, the equivalent of $33 [Canadian] per member per month) to compensate for time spent communicating with the multidisciplinary team. Although the results are not as positive as one might have hoped, the authors state that the findings of reducing more expensive care (acute care) while increasing less expensive care (e.g., home health) met the study’s hypotheses. Obviously, the model of care would have been more compelling if total costs were reduced. It is hard to persuade insurers and delivery systems to adopt change in the absence of a bottom line benefit on health or costs. Nevertheless, costs are a fickle outcome because of health care delivery idiosyncrasies and outliers, which can substantially influence

Wealth Accumulation and the Health of Union Army Veterans, 1860-1870.

How did the wartime health of Union Army recruits affect their wealth accumulation through 1870? Wounds and exposure to combat had strong negative effects on subsequent savings, as did illnesses while in the service. The impact of poor health was particularly strong for unskilled workers. Health was a powerful determinant of nineteenth-century economic mobility. Infectious diseases' influences on wealth accumulation suggest that the economic gains from the improvement of the disease environment should be enormous. The direct economic costs of the Civil War were probably much greater than previously thought, given the persistent adverse health effects of wartime experiences.

The Impact of Poor Health on Factor Productivity

A number of recent studies have illustrated the link between health and economic growth. This paper argues that a key mechanism through which health affects growth is via total factor productivity (TFP). We first estimate TFP based on a production function and then estimate the determinants of TFP, paying particular attention to three indicators of health that are particularly problematic in developing regions: malnutrition, malaria and waterborne diseases. We find the impact of poor health on TFP to be negative, significant, and robust across a wide variety of specifications.

Impairment, disability and handicap as risk factors for depression in old age. The Gospel Oak Project V.

An association between disablement and late-life depression is often reported in cross-sectional studies. However, many lack effect sizes, and do not control for confounding. Therefore, it is difficult both to quantify the overall impact of poor health on depression and to understand which aspects are most salient. A catchment area survey of all over 65-year-old residents of an electoral district in London, UK, using a population register derived from a door-to-door census was undertaken. Depression was measured using SHORT-CARE, and the consequences of disease classified according to the WHO International Classification of Impairments, Disabilities and Handicaps. Six hundred and fifty-four subjects were interviewed out of an older population of 889. The prevalence of SHORT-CARE pervasive depression was 17%. Impairment, disability and, particularly, handicap were strongly associated with depression. The adjusted odds ratio for depression in the most handicapped quartile compared with the least was 24.2 (8.8-66.6). The population attributable fraction (PAF) for depression attributable to handicap was 0.78. The PAFs for recent life events and female gender were much lower. Handicap explained most of the depression associated with individual impairments and disabilities. Adjusting for handicap abolished or weakened the associations between depression and social support, income, older age, female gender and living alone. Even given some uncertainty in distinguishing handicap and depression as constructs, and the impossibility of deciding direction of causality, it seems likely that handicap is of central significance to late-life depression. Handicap may be more amenable to intervention than either impairment or disability.

The relationship between health and labor market status.

Few relationships seem more self-evident than the impact of poor health on labor market behavior. Chronic health conditions that diminish basic physical and mental capabilities are typically expected to disrupt normal work functioning, not only by preventing the performance of some job-related tasks altogether, but also by raising the difficulty or cost of discharging these role responsibilities beyond levels that a reasonable person would judge tolerable. As a result, individuals with impaired health are expected to reduce the amount of time spent in the labor force, the date or age of their complete withdrawal from the job market, and/or the kind of work performed. Because the onset of chronic health problems is not uncommon at any age, and incidence rises steeply with age, health-related work adjustments are likely to be required of most persons at some stage of the life course. In fact, an extensive set of institutional arrangements for retirement and disability insurance benefits has developed over time to cushion the expected losses in market income brought about by these health-induced changes in work effort. Yet, the impact of poor health on labor market status (and the corresponding magnitude of the economic toll exacted by various health problems) is at present neither fully understood nor measured with any precision. Uncertainty about the relation­ ship arises from the difficulty of gauging the extent to which the severity of physical and mental conditions varies across the population in poor health and the degree to which institutional arrangements, such as disability program

The Effect of Chronic Disease on Work Behavior over the Life Cycle

hours of work, lower wage rates, early retirement and disability transfer programs. Approximately 14 percent of working age individuals report they have a health problem which restricts their activity [34]. While a number of studies exist documenting the relationship between health and labor market activity, most of the evidence specifically examining the association between poor health and labor force participation is derived from cross-sectional analyses. Furthermore, the majority of these studies consider the impact of poor health in general as opposed to specific chronic health conditions.' Thus, while the accumulated evidence clearly indicates that poor health has significant negative effects on labor force participation, these findings are limited because they do not consider the influence of chronic disease on work behavior over the life cycle.2 The purpose of this paper is to explore the effect of the onset of a chronic disease-arthritis -on work behavior over life cycle. Arthritis is an excellent health condition to study in this context for at least two reasons. First, while arthritis is a painful and crippling disease, it is rarely lifethreatening.3 Thus, the major impact of this disease is reflected by the influence it has on the capacity to work. Second, arthritis is the most common chronic disease and second leading cause of work disability in the United States [11]. In fact, the Arthritis Foundation reports that more than 40 million Americans or one in seven persons have some form of this disease. The econometric technique used here-a dynamic hazard model-is the appropriate methodology to examine the health-work relationship over the life cycle because this approach estimates the pattern of labor force behavior after disease onset. Since the results indicate the duration of

Effects of Smoking and Being Overweight on Current Earnings

Medical researchers have demonstrated the potent influences of smoking and being overweight on the deterioration of health. Economists have documented the sizable impact of poor health on earnings. We looked for statistical associations between smoking and being overweight on the one hand and current earnings on the other using a national probability sample of American workers employed 20 or more hours a week. Using multiple regressions that included a variety of control variables, for both male and female workers no strong statistical associations could be found. These results should not be interpreted as suggesting that smoking and being overweight do not have profound influences on lifetime earnings through their effects on health. The results suggest only that among workers currently employed 20 hours or more a week, no residual short-run direct association exists between smoking or being overweight and current annual earnings.

Smoking, disabilities and health: Their effect on labor market experience

Summary The economic cost to society due to cigarette smoking of employed males between the ages of 18 and 65 was $10.25 billion in 1968 which was 1.19% of 1968 GNP. Individual non-white and white male smokers suffered a 8% and 6% decrease in their 1968 labor income. The economic cost of smoking is actually larger, because unemployed male, and unemployed and employed female cigarette smokers of all ages were excluded. Also, the exclusion of non-cigarette smokers underestimates the economic cost of smoking, especially since the effect of non-cigarette smoking is much greater than cigarette smoking. Multicollinearity between smoking and drinking, though, decreases the precision of the estimates of the cost of smoking, but does not necessarily lead to bias in the regression coefficients on SMOKE. In the future, there is need for improvement in the measure of smoking, even though the data used in this study is superior to other data. A more appropriate measure would be a smoking index, which includes depth and length of inhalation, duration of smoking habit, and amount and kind of cigarettes smoked per day. Also, the measure of drinking needs a great deal of improvement. The total cost to society of disabilities to employed males between the ages of 18 and 65 was $9.743 or 1.13% of 1968 GNP. The average individual loss in labor income due to disabilities was 59% and 40% for non-white and white employed disabled workers. The individual cost of disabilities is about four times that of smoking, although the total cost is about the same, because there are so few disabled individuals compared to the number of smokers. The total loss due to disabilites is actually much larger because employed women, and unemployed women and men were excluded, and contrary to smoking, disabilities and labor force participation are significantly and inversely related. Also, to measure more precisely the cost of disabilities, future research should strive to incorporate a measure of disabilities which is not self-reported. Previous authors who used disabilities as a measure of health actually estimated the impact of disabilities instead of health on labor market experience. It has been shown in this study that both health and disabilities have a large independent impact on labor market experience, even though DIS and HEALTH are significantly correlated. Future research should continue to more carefully model and estimate the separate impact of both, because the effectiveness of various types of policy actions which might be initiated to combat the impact of poor health and disabilities depend crucially on the independent effects of both on labor market experience. For instance, disabilities are permanent, so that a retraining program for the newly disabled may be appropriate, while an anti-smoking campaign may be appropriate if an increase in health is desired.

The Impact of Poor Health on Earnings

T HE overall impact of poor health on earnings is large the average disabled man aged 18 to 64 years suffers a 37% reduction in yearly earnings. This loss is the result of the effects of poor health on all the components of earnings: labor force participation, weeks worked per year, hours worked per week, and earnings per hour. In each case there is a substantial effect of health, not just when a comparison is made between well and sick persons, but also when adjustments are made to account for the different socio-economic characteristics of the two groups. This analysis not only provides estimates of the effect of health on each component of earnings, but also the aggregate earnings loss attributable to long term disability 23 billion dollars in 1966. The first section outlines some of the previous analyses concerning the effects of health on the various components of earnings and briefly describes the data and method used in this study. The effects of health are usually measured by comparing the status of persons who are well with those who are disabled. The second and third sections offer this comparison as well as the true effects of health which are based on the difference between the current status of the disabled and their estimated status, based on how they would have behaved had they been well, taking into account the different socioeconomic characteristics of the well and disabled groups. The first of these two sections provides the comparisons for each of the components of earnings. As the analysis is carried out for subsamples of men and women, and blacks and whites, it is possible to examine the different ways in which disability affects different groups. The second section of the pair continues the analysis in terms of a more aggregate measure the overall loss of earnings to the economy within a year. A final section provides a brief summary and an outline of the major findings and conclusions.