No physically demanding work in later life
People in physically demanding professions should be given assistance to retrain after reaching the age of 50. This is necessary to prevent these individuals from being harmed by the demands of their professions to the extent that they are no longer able to work. The effect on health of one year of physically demanding work in later life is similar to the effect of no less than sixteen months of ageing. These are among the key findings of doctoral research into the effect of policy on differences in health between rich and poor carried out by health economist Bastian Ravesteijn. He will defend his dissertation on Thursday, 19 May 2016, at Erasmus University Rotterdam.
How can government policy reduce differences in health between rich and poor? This is the main question addressed in Measuring the Impact of Public Policy on Socioeconomic Disparities in Health, Ravesteijn’s dissertation. He studied the effect of policy on differences in health between rich and poor.
In one of his studies, Ravesteijn argues that people in physically demanding professions should be given assistance to retrain after reaching the age of 50. The purpose of this assistance would be to prevent the individuals concerned from being harmed by the demands of their professions to the extent that they are no longer able to work. The effect on health of one year of physically demanding work in later life is similar to the effect of no less than sixteen months of ageing. The effect is six months for limited control over daily activities at work, which is often the case in physically demanding professions. The longer an individual continues to work in a physically demanding profession, the longer the individual is exposed to effects of work that are detrimental to his or her health, especially if the demanding nature of the work is amplified because of the relatively advanced age of the individual concerned.
Top five physically demanding professions
Ravesteijn compiled a list of 320 professions, ranked according to the degree in which they are physically demanding. The physically most demanding common professions are mason, carpenter, mail sorter, baker and nurse. The top five for limited control over the daily activities consist of assembly line worker, operator of machines in chemical plants, mason, mail sorter and cashier. For his research, Ravesteijn used data on work and health in the Netherlands and Germany, where people were observed for up to a period of 29 years. It was therefore possible to take factors that affected both selection in occupational groups and health into account.
In addition, Ravesteijn shows that people in professions that are not highly valued in the Netherlands experience ill health three times as often as those in highly valued professions. The death rate of people in professions that are not highly valued is twice as high. A general increase of the state pension age is therefore more disadvantageous to people in physically demanding professions, because the additional period of two years during which they must continue to work constitutes a proportionally larger share of their life expectancy after retirement. A sharper increase of the state pension age for people in physically less demanding professions, usually highly educated people on higher incomes, however, would seem to be a sensible policy measure.
Effects of a middle school
One of the other studies concerns the effects of a middle school on equal opportunities in education and on health in later life. According to the doctoral candidate, postponing the choice of education type by a couple of years ensures greater equality between rich and poor.
In countries like the Netherlands, Germany, and Austria, children already choose a secondary education level after primary school, which means that they are separated from each other at an early stage and educated at different levels. By contrast, since the 1970s, children of different backgrounds in northern European countries like Finland have remained together and received the same kind of education until the age of 16. This inclusive approach prevents children from heading in a certain direction in terms of their education at an excessively young age. Because the middle school in Finland was introduced in certain localities earlier than in others, it was possible for Ravesteijn to estimate the effects of this system while taking differences between birth cohorts and regions into account.
The doctoral candidate concludes that the middle school in Finland, where the age at which a choice regarding type of education had to be made was increased by five years, had a positive effect on children from low-income families. The probability that they would go on to obtain a university degree increased from 6% to 7.5%. However, the likelihood of a university education for children from families with higher incomes decreased from 24% to 22.5% as a result of the middle school.
The higher age at which a choice regarding type of education had to be made affected the entire course of life. Ravesteijn’s study shows that, until the age of 50, the mortality risk of children from poor families decreased by 20%. Also in this respect, the effect on children with wealthier parents was negative: their originally lower mortality risk increased by 25%, which meant that the difference between rich and poor in terms of mortality risk virtually disappeared. In the old system, the mortality risk of children from families with lower incomes was 50% higher.
About the doctoral candidate
After graduating in political science from the University of Amsterdam, Bastian Ravesteijn (1983) went on to complete a research master’s programme in Economics at Tinbergen Institute. The doctoral candidate of Erasmus School of Economics is currently Harkness Research Fellow at Harvard Medical School’s Department of Health Care Policy.