The wear and tear on health: What is the role of occupation?

Bastian Ravesteijn*, Hans van Kippersluis, Eddy van Doorslaer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

37 Citations (Scopus)


Health is well known to show a clear gradient by occupation. Although it may appear evident that occupation can affect health, there are multiple possible sources of selection that can generate a strong association, other than simply a causal effect of occupation on health. We link job characteristics to German panel data spanning 29 years to characterize occupations by their physical and psychosocial burden. Employing a dynamic model to control for factors that simultaneously affect health and selection into occupation, we find that selection into occupation accounts for at least 60% of the association. The effects of occupational characteristics such as physical strain and low job control are negative and increase with age: late-career exposure to 1 year of high physical strain and low job control is comparable to the average health decline from ageing 16 and 6 months, respectively.

Original languageEnglish
Pages (from-to)e69-e86
JournalHealth Economics (United Kingdom)
Issue number2
Early online date13 Sept 2017
Publication statusPublished - Feb 2018

Bibliographical note

The Commonwealth Fund ; the Innovative Medicines Initiative Joint Undertaking, Grant/Award Number: 115621 ; European Union's Seventh Framework Program, Grant/Award Number: FP7/2007–2013 ; National Institute on Aging of the National Institutes of Health, Grant/Award Number: R01AG037398 ; NWO, Grant/Award Number: 016.145.082

Funding Information:
The authors acknowledge funding from the Netspar research grant ?Occupational choice and health: which jobs offer better health prospects for a long career??; Ravesteijn receives funding from the Commonwealth Fund and from the SPRINTT project of the Innovative Medicines Initiative Joint Undertaking under grant agreement number 115621, resources of which are composed of financial contribution from the European Union's Seventh Framework Program (FP7/2007?2013) and EFPIA companies' ?in kind contribution.? van Doorslaer and van Kippersluis acknowledge funding from the National Institute on Aging of the National Institutes of Health (R01AG037398), and van Kippersluis further acknowledges funding from NWO (Veni grant 016.145.082). We wish to thank anonymous reviewers, conference and seminar attendees in Sydney, Frankfurt, and Los Angeles for their valuable comments, with special thanks to Owen O'Donnell.

Publisher Copyright:
© 2017 The Authors Health Economics Published by John Wiley & Sons Ltd

Research programs

  • EUR ESE 30
  • EUR ESE 35
  • EMC NIHES-05-63-02 Quality
  • EMC NIHES-05-63-03 Competition


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