The Rise in Absenteeism: Disentangling the Impacts of Cohort, Age and Time

We examine the remarkable rise in absenteeism among Norwegian employees since the early 1990's, with particular emphasis on disentangling the roles of cohort, age, and time. Based on a fixed effects model, we show that individual age-adjusted absence propensities have risen even more than aggregate absence rates from 1993 to 2005, debunking the popular hypothesis that the rise in absenteeism resulted from the inclusion of new cohorts – with weaker work-norms – into the workforce. We also reject the idea that the rise in absenteeism resulted from more successful integration of workers with poor health; on the contrary, a massive rise in disability rolls during the 1990’s suggest that poor-health workers have left the labor market in unprecedented numbers.sickness absence, endogenous selection, multicollinearity, fixed effects logit

The Anatomy of Absenteeism

Based on comprehensive administrative register data from Norway, we examine the determinants of sickness absence behavior; in terms of employee characteristics workplace characteristics, panel doctor characteristics, and economic conditions. The analysis is based on a novel concept of a worker's steady state sickness absence propensity, computed from a multivariate hazard rate model designed to predict the incidence and the duration of sickness absence for all workers. Key conclusions are i) that most of the cross-sectional variation in absenteeism is caused by genuine employee heterogeneity; ii) that the identity of a person's panel doctor has a significant impact on absence propensity; iii) that sickness absence insurance is frequently certified for reasons other than sickness; and iv) that the recovery rate rises enormously just prior to the exhaustion of sickness insurance benefits.sickness absence, multivariate hazards, MMPH, NPMLE

The Sick Pay Trap

In most countries, employers are financially responsible for sick pay during an initial period of a worker's absence spell, after which the public insurance system covers the bill. Based on a quasi-natural experiment in Norway, where pay liability was removed for pregnancy-related absences, we show that firms' absence costs significantly affect employees' absence behavior. However, by restricting pay liability to the initial period of the absence spell, firms are discouraged from letting long-term sick workers back into work, since they then face the financial risk associated with subsequent relapses. We show that this disincentive effect is statistically and economically significant.absenteeism, social insurance, experience rating, multivariate hazard rate models

Ageing and labor productivity

We exploit a policy-induced shift in the labor supply of elderly (age 63–67) workers in Norway to explore how aging of the workforce within existing firms is likely to affect labor productivity and the demand for younger workers. Our results are imprecise, but indicate that a higher share of age 63–67 workers increases total wage costs and has a small positive effect on labor productivity in the short run. Postponed retirement of existing elderly workers leads to a significant decline in the hiring of younger (below age 30) workers.publishedVersio

Preference-based instrumental variables in health research rely on important and underreported assumptions: a systematic review

Objective: Preference-based instrumental variables (PP IV) designs can identify causal effects when patients receive treatment due to variation in providers’ treatment preference. We offer a systematic review and methodological assessment of PP IV applications in health research. Study Design and Setting: We included studies that applied PP IV for evaluation of any treatment in any population in health research (PROSPERO: CRD42020165014). We searched within four databases (Medline, Web of Science, ScienceDirect, SpringerLink) and four journals (including full-text and title and abstract sources) between January 1, 1998, and March 5, 2020. We extracted data on areas of applications and methodology, including assumptions using Swanson and Hernan’s (2013) guideline. Results: We included 185 of 1087 identified studies. The use of PP IV has increased, being predominantly used for treatment effects in cancer, cardiovascular disease, and mental health. The most common PP IV was treatment variation at the facility-level, followed by physician- and regional-level. Only 12 percent of applications report the four main assumptions for PP IV. Selection on treatment may be a potential issue in 46 percent of studies. Conclusion: The assumptions of PP IV are not sufficiently reported in existing work. PP IV studies should use reporting guidelines

Long term outcomes and causal modelling of compulsory inpatient and outpatient mental health care using Norwegian registry data: protocol for a controversies in psychiatry research project

Objectives: Compulsory mental health care includes compulsory hospitalisation and outpatient commitment with medication treatment without consent. Uncertain evidence of the effects of compulsory care contributes to large geographical variations and a controversy on its use. Some argue that compulsion can rarely be justified and should be reduced to an absolute minimum, while others claim compulsion can more frequently be justified. The limited evidence base has contributed to variations in care that raise issues about the quality/appropriateness of care as well as ethical concerns. To address the question whether compulsory mental health care results in superior, worse or equivalent outcomes for patients, this project will utilise registry‐ based longitudinal data to examine the effect of compulsory inpatient and outpatient care on multiple outcomes, including suicide and overall mortality; emergency care/injuries; crime and victimisation; and participation in the labour force and welfare dependency. Methods: By using the natural variation in health providers' preference for compulsory care as a source of quasi‐randomisation we will estimate causal effects of compulsory care on short‐ and long‐term trajectories. Conclusions: This project will provide valuable insights for service providers and policy makers in facilitating high quality clinical care pathways for a high risk population group

Children and labor market outcomes: separating the effects of the first three children

We use miscarriage as a biological shock to fertility to estimate the effect of the first three children on women’s and men’s labor market outcomes. For women, we find that the effect is almost the same for the first, second and third child in the short run. The reduction in female earnings in the three first years after birth is on average 28 percent for the first child, 29 percent for the second child and 22 percent for the third child. The reduction is caused by drops in labor supply at the intensive margin and the extensive margin, concentrated among women in the middle part of the income distribution. There is considerable catching up after five years, but effects of the first two children persist ten years later, although they are imprecisely estimated. For men, we find evidence of increased labor supply and earnings after the first two children. We also find indications that having the first child increases take-up of health-related welfare benefits, such as disability insurance, for women, and that having a second and/or a third child increases couple stability.publishedVersio

The impact of macroeconomic fluctuations on voting behavior

Politics have an impact on the economy. But has the state of the economy any impact on politics? Can economic fluctuations explain fluctuations in voters’ policy demand? Can the outcome of elections be traced back to changes in growth and unemployment? In the classical explanation of voting behavior, factors such as class, religion, and structure of the society are used as determinants for policy preferences . The aim of my thesis is to explain short-run fluctuations in policy preferences with short-run fluctuations in the economy. A synthesis can be made of these two approaches. “Short-run” economic variables can explain fluctuations in policy demand from election to election within a country. Trends in policy demand are more often the result of by “long-run” sociological variables, that change slowly over time. Using a dataset for 23 OECD countries and their elections between 1960 and 1995, I have investigated whether such a model can explain changes in policy sentiments. The results indicate that a high unemployment rate makes the median voter vote more conservative (right). High economic growth makes the median voter vote more radical (left). The sociological variables explain a large part of the political variation between countries. I argue that the key to understanding these fluctuations is social insurance. The middle class, who constitutes the main segment of the voters in OECD countries, rely on social insurance provided by the welfare state. Their demand for insurance depends on their perception of their future income and job security. Insurance is considered a normal good – something you want more if your income rises. If the economy prospers, your expected income increases. Consequently, you would like to buy more social insurance. Left parties are known to increase budgets and provide more social insurance – at the price of higher tax payments. At the day of election, voters cast their vote to signal what kind of public policies they prefer in the forthcoming period. In this way, the vote can be seen as a signal to politicians of how much insurance the public wants. This helps explain why the median voter seems to vote more radical when economic growth is high, which also has strong support in the data. The need for insurance is, however, not only influenced by the willingness to pay for it. The risk of needing it is just as important. I argue that voters, at the beginning of a recession, fear for their jobs and thus buy more insurance. Consequently, I expect voters to vote more radical if the unemployment rate rises at the time of the election. At this point in time, the welfare state functions as insurance for the middle class. They know that the recession will remove jobs but not whose jobs that is to be lost. At the bottom of the recession, when the unemployment rate peaks, voters no longer need to fear for their jobs. They have either kept it or lost it. The uncertainty that made voters prefer more insurance is gone. At this point one should expect voters to be less willing to pay taxes since the tax payments will cover the unemployment benefits of the few that lost their job – paid by the many that kept theirs. Consequently, one should expect the median voter to demand more right policies when the unemployment rate is high. The latter prediction has strong support in the data analysis. The prediction that an increase in the unemployment rate prior to the election leads to more radical voting has only some support in the data. Just as politics influence the economy does the state of the economy influence politics. Voters’ policy demand seems to be influenced by both economic growth and the unemployment rate