Cabib Ignacio, Azar Ariel, Baumann Isabel, Biehl Andr, Corna Laurie, Mautz Eric, Yopo-Díaz Martina
Instituto de Sociología & Escuela de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile; Centro UC Estudios de Vejez y Envejecimiento, Pontificia Universidad Católica de Chile, Santiago, Chile.
Department of Sociology, Purdue University, West Lafayette, IN, USA; Department of Sociology, University of Chicago, Chicago, IL, USA.
Health Policy. 2025 Feb;152:105216. doi: 10.1016/j.healthpol.2024.105216. Epub 2024 Nov 27.
We explore the association between adulthood employment patterns and later life health among men and women in four liberal regime countries: two from Europe (England and Switzerland) and two from the Americas (United States and Chile). We carefully harmonized life-history data from the surveys SHARE (N = 1,143), HRS (N = 4,006), ELSA (N = 3,083), and EVDA (N = 802). The samples included individuals born between 1944 and 1954, with information on employment histories from age 15 to 65 and on 11 health outcomes in later life. In line with welfare regime and health literature, we find significant differences in health outcomes between countries, which are likely explained by differences in health systems. However, we extend previous literature by showing that positive health outcomes are consistently explained by standard employment histories, and poor health outcomes are consistently explained by non-standard employment histories. Importantly, men and women following the same employment pathway across countries are either similarly penalized or compensated in their health. This suggests that it is not gender per se that affects health in later life, but the employment trajectory experienced. Nonetheless, women are disproportionately more likely to experience non-standard employment and thus suffer a greater health disadvantage. Policy measures to mitigate negative health effects of non-standard employment trajectories may therefore pay attention to the specific reasons why women are more likely to experience non-standard trajectories.
我们探究了四个自由政体国家中男性和女性成年后的就业模式与晚年健康之间的关联,这四个国家分别是:两个来自欧洲(英国和瑞士),两个来自美洲(美国和智利)。我们仔细整合了来自以下调查的生活史数据:SHARE(样本量N = 1,143)、HRS(样本量N = 4,006)、ELSA(样本量N = 3,083)和EVDA(样本量N = 802)。样本包括出生于1944年至1954年之间的个体,包含从15岁到65岁的就业历史信息以及晚年11项健康结果的信息。与福利制度和健康文献一致,我们发现不同国家之间在健康结果上存在显著差异,这可能是由卫生系统的差异所导致的。然而,我们拓展了先前的文献,表明积极的健康结果始终由标准就业历史所解释,而不良健康结果始终由非标准就业历史所解释。重要的是,在不同国家遵循相同就业路径的男性和女性在健康方面要么受到类似的惩罚,要么得到类似的补偿。这表明影响晚年健康的并非性别本身,而是所经历的就业轨迹。尽管如此,女性经历非标准就业的可能性不成比例地更高,因此在健康方面处于更大的劣势。因此,减轻非标准就业轨迹对健康产生负面影响的政策措施可能需要关注女性更有可能经历非标准轨迹的具体原因。