Does health status improve after re-assumption of ABM employment?

Due to structural problems of the East German economy the level of unemployment will probably remain high for the next ten years. Thus, thousands of health-employment-schemes are established to reduce negative social and financial consequences of unemployment for those groups that are most affected. In this study the effects of temporary re-employment on health within the bounds of a job-creating measure are examined. By questionnaire employees of two firms in Magdeburg that exclusively occupies former unemployed men and women were asked about their subjective health status and changes in health status since re-employment. 217 employees filled the questionnaire (response rate: 50%; mean age: 45 years, mean duration of former unemployment: 18 months). About one half of the employees (48%) report positive effects on health after re-employment. This percentage is highest in the age group 50 years and older. The frequency of health impairments remained unchanged for half of the workers, the rest mainly stated fewer impairments. Poor working conditions or physical overtaxing decreases the positive effects of re-employment. Employees who had a positive attitude towards their work report on positive effects on health and other aspects of life more than average. CONCLUSIONS: Negative consequences of unemployment on physical and psychological health are well understood. On the other hand, our study demonstrates positive effects on health and a reduction of health impairments by temporary job-creating measures. This is influenced by the working conditions and the social environment of the employees. Further investigation are needed for detailed medical evaluation of job-creating schemes.     

Does living by the coast improve health and wellbeing?

It is often assumed that spending time by the coast leads to better health and wellbeing, but there is strikingly little evidence regarding specific effects or mechanisms to support such a view. We analysed small-area census data for the population of England, which indicate that good health is more prevalent the closer one lives to the coast. We also found that, consistent with similar analyses of greenspace accessibility, the positive effects of coastal proximity may be greater amongst more socio-economically deprived communities. We hypothesise that these effects may be due to opportunities for stress reduction and increased physical activity.     

Does non-employment contribute to the health disadvantage among lone mothers in Britain,Italy and Sweden? Synergy effects and the meaning of family policy

This study analyses self-rated health and non-employment and potential synergy effects among lone and couple mothers aged 25-59 in Britain, Sweden and Italy, representing different family policy categories using data from national surveys (2000-2005). Synergy effects on health were calculated by synergy index. Non-employment only marginally contributed to the excess risk of poor health among lone mothers but there were synergy effects between lone motherhood and non-employment in all three countries, producing a higher risk of poor health than would be expected from a simple addition of these exposures. Results are discussed in relation to the different family policy and living contexts.     

Does health predict the reporting of racial discrimination or do reports of discrimination predict health? Findings from the National Longitudinal Study of Youth

Racial discrimination may contribute to diminished well-being, possibly through stress and restricted economic advancement. Our study examines whether reports of racial discrimination predict health problems, and whether health problems predict the reporting of racial discrimination. Data come from years 1979 to 1983 of the US National Longitudinal Study of Youth, focusing on respondents of Black (n = 1851), Hispanic (n = 1170), White (n = 3450) and other (n = 1387) descent. Our analyses indicate that reports of racial discrimination in seeking employment predict health-related work limitations, although these limitations develop over time, and not immediately. We also find that reports of discrimination at two time-points appear more strongly related to health-related work limitations than reports at one time-point. A key finding is that these limitations do not predict the subsequent reporting of racial discrimination in seeking employment. These findings inform our knowledge of the temporal ordering of racial discrimination in seeking employment and health-related work conditions among young adults. The findings also indicate that future research should carefully attend to the patterns and timing of discrimination.     

Does job satisfaction improve the health of workers? New evidence using panel data and objective measures of health

This paper evaluates the relationship between job satisfaction and measures of health of workers using the German Socio-Economic Panel. Methodologically, it addresses two important design problems encountered frequently in the literature: (a) cross-sectional causality problems and (b) the absence of objective measures of physical health that complement self-reported measures of health status. Not only does using the panel structure with individual fixed effects mitigate the bias from omitting unobservable personal psycho-social characteristics, but employing more objective health measures such as health-system contacts and disability addresses such measurement problems relating to self-report assessments of health status.We find a positive link between job satisfaction (and changes over time therein) and subjective health measures (and changes therein); that is, employees with higher or improved job satisfaction levels feel healthier and are more satisfied with their health. This observation also holds true for more objective measures of health. Particularly, improvements in job satisfaction over time appear to prevent workers from (further) health deterioration.     

Does increasing cigarette excise tax improve people's health? The cases of heart attacks and stroke

INTRODUCTION: Recently, public health advocates have fervently supported an increase in the cigarette excise tax as a means of reducing smoking. Likewise, political leaders have heavily relied on the cigarette excise tax as a means of encouraging a reduction in the overall rates of cigarette use. However, little is known about whether the cigarette excise tax is a valid tool for reducing the negative effects of smoking on public health. Our objective is to examine whether increasing the cigarette excise tax will reduce the morbidity rates of heart attack and stroke, which have consistently been among the major causes of death and disability in the United States. METHODS: We used the static and dynamic panel-data model to explore the impact of the US regional cigarette excise tax on morbidity rates of heart attack and stroke. These rates of heart attack and stroke are estimated based on the 1970-2000 National Hospital Discharge Survey (NHDS). RESULTS: Study results show that the causal relationship between cigarette excise tax and morbidity rates of heart attack and stroke is unclear. However, the morbidity rates of non-smoking-related hypertension and high cholesterol-related diseases are positively correlated with the morbidity rates of heart attack and stroke. CONCLUSIONS: We did not find clear empirical evidence to support the hypothesis that raising the cigarette excise tax effects a reduction the morbidities of heart attack and stroke. Therefore, use of the cigarette excise tax may not be an effective means to improve the health of the US population.     

Do immigrants improve the health of natives?

This paper studies the effects of immigration on health. Specifically, we merge information on individual characteristics from the German Socio-Economic Panel (1984–2009) with detailed local labour market characteristics, and we then exploit the longitudinal component of the data to determine how immigration affects the health of both immigrants and natives over time. We find that immigrants to Germany are healthier than natives upon their arrival (the healthy immigrant effect) but that immigrants’ health deteriorates over time. We show that the convergence in health is heterogeneous across immigrants and occurs more rapidly among those working in more physically demanding jobs. Because immigrants are significantly more likely to work in strenuous occupations, we investigate whether changes in the spatial concentration of immigrants affect the health of the native population. Our results suggest that immigration reduces the likelihood that residents will report negative health outcomes. We show that these effects are concentrated in blue-collar occupations and are stronger among low-educated natives. Improvements in natives’ average working conditions and workloads help explain the positive effects of immigration on the health of the native population.     

Does treating maternal depression improve child health management? The case of pediatric asthma

Past studies have demonstrated an association between maternal depression and poor management of pediatric asthma. Using an instrumental variables strategy to address the endogeneity of depression treatment, I build on this literature to answer the question of whether treating maternal depression leads to an improvement in pediatric asthma management. I show that treatment of mother's depression improves management of child's asthma, resulting in a reduction in asthma costs in the 6-month period following diagnosis of $798 per asthmatic child whose mother is treated for depression.     

Household Food Insecurity During Childhood and Subsequent Health Status: The Early Childhood Longitudinal Study—Kindergarten Cohort

Objectives. We examined long-term patterns of household food insecurity in children from kindergarten through eighth grade and the association between those patterns and children’s proxy-reported health status in eighth grade.Methods. We obtained data from the Early Childhood Longitudinal Study—Kindergarten Cohort, a study that followed a nationally representative sample of students from kindergarten entry in 1998–1999 through eighth grade. We classified food insecurity according to the number of years of reported household food insecurity over 4 observation years. We estimated logistic regression models to estimate the association between cumulative food insecurity exposure and health outcomes.Results. Food insecurity was generally a transient rather than a persistent condition. Persistent food insecurity over the 9-year period was associated with lower health status in eighth grade, whereas more transient food insecurity was not significantly associated with health outcomes in most models.Conclusions. Single-year estimates substantially underestimate the share of children whose households experienced food insecurity at some point during their childhood years. Persistent food insecurity is an important public health issue for children. Policy interventions to alleviate children’s persistent food insecurity may promote child health.During 2008, food insecurity reached its highest rate—14.7%—since formal measurement of the condition began in the mid-1990s, and this rate has persisted through 2010.1 Among households with children, the food-insecurity rate reached 20.2% in 2010.1 Previous research has linked food insecurity and other measures of food-related hardship to a wide array of negative health indicators in children, including lower parent-reported measures of child health status, higher incidence of health-related limitations, and higher frequency of headaches and stomachaches.2–11 Much of this work is cross-sectional, however, making it difficult to ascertain causality.Consistent with this cross-sectional framework, existing work has generally considered food hardship during a relatively short window2–8,11—most commonly a 1-year period—whereas the impacts may plausibly differ with the length of exposure. Little is known about the extent to which food insecurity is transient or persistent during childhood and about the implications of differing patterns of food insecurity for child outcomes.A notable exception is a recent study in Canada, in which Kirkpatrick et al. found that experiencing 2 or more episodes of hunger over a 10-year period was associated with lower parent-reported health status among children, after controlling for initial health status and a variety of socioeconomic characteristics.10 This is the strongest evidence to date of a causal impact of food hardships on health outcomes and the first evidence that degree of exposure plays a role. Other work has considered severity of food insecurity, with some evidence of a dose–response relationship with health outcomes, albeit in a cross-sectional context.5We examined cumulative exposure to household food insecurity over a 9-year period among a national sample selected when in kindergarten and the relationship between that exposure and children’s parent-reported health status in eighth grade. We were interested in the persistence of food insecurity over an extended period, and we paid particular attention to differentiating longer-term food insecurity from more recent exposure. We also focused on isolating the impact of food insecurity from the impact of income and poverty.     

Does extending health insurance coverage to the uninsured improve population health outcomes?

Background

An ongoing debate exists about whether the US should adopt a universal health insurance programme. Much of the debate has focused on programme implementation and cost, with relatively little attention to benefits for social welfare.

Objective

To estimate the effect on US population health outcomes, measured by mortality, of extending private health insurance to the uninsured, and to obtain a rough estimate of the aggregate economic benefits of extending insurance coverage to the uninsured.

Method

We use state-level panel data for all 50 states for the period 1990–2000 to estimate a health insurance augmented, aggregate health production function for the US. An instrumental variables fixed-effects estimator is used to account for confounding variables and reverse causation from health status to insurance coverage. Several observed factors, such as income, education, unemployment, cigarette and alcohol consumption and population demographic characteristics are included to control for potential confounding variables that vary across both states and time.

Results

The results indicate a negative relationship between private insurance and mortality, thus suggesting that extending insurance to the uninsured population would result in an improvement in population health outcomes. The estimate of the marginal effect of insurance coverage indicates that a 10% increase in the population-insured rate of a state reduces mortality by 1.69–1.92%. Using data for the year 2003, we calculate that extending private insurance coverage to the entire uninsured population in the US would save over 75 000 lives annually and may yield annual net benefits to the nation in excess of $US400 billion.

Conclusion

This analysis suggests that extending health insurance coverage through the private market to the 46 million Americans without health insurance may well produce large social economic benefits for the nation as a whole.     

Immigration and the health of U.S. black adults: Does country of origin matter?

Previous work suggests that regional variation in pre-migration exposure to racism and discrimination, measured by a region's racial composition, predicts differences in individual-level health among black immigrants to the United States. We exploit data on both region and country of birth for black immigrants in the United States and methodology that allows for the identification of arrival cohorts to test whether there are sending country differences in the health of black adults in the United States that support this proposition. While testing this hypothesis, we also document heterogeneity in health across arrival cohorts and by duration of U.S. residence among black immigrants. Using data on working-age immigrant and U.S.-born blacks taken from the 1996-2010 waves of the March Current Population Survey, we show that relative to U.S.-born black adults, black immigrants report significantly lower odds of fair/poor health. After controlling for relevant social and demographic characteristics, immigrants' cohort of arrival, and immigrants' duration in the United States, our models show only modest differences in health between African immigrants and black immigrants who migrate from the other major sending countries or regions. Results also show that African immigrants maintain their health advantage over U.S.-born black adults after more than 20 years in the United States. In contrast, black immigrants from the Caribbean who have been in the United States for more than 20 years appear to experience some downward health assimilation. In conclusion, after accounting for relevant factors, we find that there are only modest differences in black immigrant health across countries of origin. Black immigrants appear to be very highly selected in terms of good health, although there are some indications of negative health assimilation for black immigrants from the Caribbean.     

“Meaningful Use” of ambulatory EMR: Does it improve the quality and efficiency of health care?

The US government has initiated incentive programs to encourage the adoption of Electronic Medical Records (EMR). To qualify for the incentive payment, healthcare providers need to demonstrate “meaningful use” of EMR systems, which requires the use of certified EMRs and the implementation of a set of standard functionalities. In this paper, we examine how the meaningful use of EMRs would affect health care outcomes in outpatient settings. Our results show that the use of core functionalities required by “meaningful use” criteria and the use of certified EMRs have a positive impact on the quality and efficiency of health care. In addition, we find the relationship between the meaningful use and quality of care is moderated by the length of use. The implications of this study are also discussed.     

Does voluntary health insurance improve health and longevity? Evidence from European OECD countries

The European Journal of Health Economics - The financing structure of the healthcare system and, particularly, the voluntary health insurance (VHI) constituent, has been a vital pillar in improving...     

Can Caesarean section improve child and maternal health? The case of breech babies

This paper examines the health effects of Caesarean section (CS) for children and their mothers. We use exogenous variation in the probability of CS in a fuzzy regression discontinuity design. Using administrative Danish data, we exploit an information shock for obstetricians that sharply altered CS rates for breech babies. We find that CS decreases the child's probability of having a low APGAR score and the number of family doctor visits in the first year of life. We find no significant effects for severe neonatal morbidity or hospitalizations. While mothers are hospitalized longer after birth, we find no effects of CS for maternal post-birth complications or infections. Although the change in mode of delivery for the marginal breech babies increases direct costs, the health benefits show that CS is the safest option for these children.     

Does birth weight predict childhood diet in the Avon longitudinal study of parents and children?

STUDY OBJECTIVE: Low birth weight predicts cardiovascular disease in adulthood, and one possible explanation is that children with lower birth weight consume more fat than those born heavier. Therefore, the objective of this study was to investigate associations between birth weight and childhood diet, and in particular, to test the hypothesis that birth weight is inversely related to total and saturated fat intake. DESIGN: Prospective cohort study. SETTING: South west England. PARTICIPANTS: A subgroup of children enrolled in the Avon longitudinal study of parents and children, with data on birth weight and also diet at ages 8, 18, 43 months, and 7 years (1152, 998, 848, and 771 children respectively). MAIN RESULTS: Associations between birth weight and diet increased in strength from age 8 to 43 months, but had diminished by age 7 years. Fat, saturated fat, and protein intakes were inversely, and carbohydrate intake was positively associated with birth weight at 43 months of age, after adjusting for age, sex, and energy intake. After adjustment for other confounders, all associations were weakened, although there was still a suggestion of a relation with saturated fat (-0.48 (95% CI -0.97, 0.02) g/day per 500 g increase in birth weight. Similar patterns were seen in boys and girls separately, and when the sample was restricted to those with complete data at all ages. CONCLUSIONS: A small inverse association was found between birth weight and saturated fat intake in children at 43 months of age but this was not present at 7 years of age. This study therefore provides little evidence that birth weight modifies subsequent childhood diet.     

How does violence exposure affect the psychological health and parenting of young African-American mothers?

Urban, minority, adolescent mothers are particularly vulnerable to violence exposure, which may increase their children's developmental risk through maternal depression and negative parenting. The current study tests a conceptual model of the effects of community and contextual violence exposure on the mental health and parenting of young, African-American mothers living in Washington, DC. A path analysis revealed significant direct effects of witnessed and experienced violence on mothers' depressive symptoms and general aggression. Experiences of discrimination were also associated with increased depressive symptoms. Moreover, there were significant indirect effects of mothers' violence exposure on disciplinary practices through depression and aggression. These findings highlight the range of violence young African-American mothers are exposed to and how these experiences affect their mental health, particularly depressive symptoms, and thus disciplinary practices.