Research School of Population Health, The Australian National University, Canberra, ACT, Australia.
Eur J Health Econ. 2020 Jun;21(4):635-648. doi: 10.1007/s10198-020-01163-2. Epub 2020 Feb 11.
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.
尽管已有多项研究对澳大利亚的教育回报进行了估算,但有关健康对回报影响的证据有限。本文使用 Heckman 选择偏差校正模型来确定健康状况在劳动力市场中对教育回报的影响。我们使用五个反应类别(“差、一般、好、很好和优秀”)的自评健康项目来衡量健康状况。研究结果表明,健康状况较差或不健康(定义为“差”或“一般”)与教育相互作用,导致有健康问题的人教育回报(即更高的小时工资率)受到限制;对低技能工作者的不利影响更强。在 2001 年至 2017 年期间,平均每增加一年教育的回报分别为健康组和不健康组的 7.43%和 6.88%。因此,健康状况较差的工人的回报率比健康工人低 7.4%(对于每增加一年的教育)。这种回报差距相当于每年约 190 亿至 250 亿美元的生产力损失。健康状况较差的工人教育回报率较低可能是由于工作时生产力较低,而不是由于工作天数减少,因为这一估计是基于小时工资率(而不是缺勤天数或小时数)。不健康的工人由于相同的工作经验、技能和教育水平,可能会接受工资较低的工作,这也可能解释了较低的回报率。在低技能职业中,健康状况不佳对劳动力市场回报的成本进一步放大,这一过程可能会加剧社会经济不平等,削弱社会流动性。