Is There an Health Establishment-Size Premium?
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1 Is There an Health Establishment-Size Premium? Tommaso Tempesti University of Massachusetts Lowell USE Conference October 25, 2017
2 The Employer s Size Wage Premium Large literature on the employer s size wage premium.
3 The Employer s Size Wage Premium Large literature on the employer s size wage premium. Is there also an employer s size health premium?
4 The Employer s Size Wage Premium Large literature on the employer s size wage premium. Is there also an employer s size health premium? The employer s size wage premium remains unexplained (Troske 1999).
5 The Employer s Size Wage Premium Large literature on the employer s size wage premium. Is there also an employer s size health premium? The employer s size wage premium remains unexplained (Troske 1999). Maybe workers at larger firms are healthier and hence are more productive.
6 The Employer s Size Wage Premium Large literature on the employer s size wage premium. Is there also an employer s size health premium? The employer s size wage premium remains unexplained (Troske 1999). Maybe workers at larger firms are healthier and hence are more productive. Or maybe but they trade higher wages for lower health.
7 Occupational Health and Fringe Benefits Unhealthy workers have a higher chance of injury (Galizzi and Tempesti 2015)
8 Occupational Health and Fringe Benefits Unhealthy workers have a higher chance of injury (Galizzi and Tempesti 2015) Injury rate is higher at medium sized firms (Leigh 1989).
9 Occupational Health and Fringe Benefits Unhealthy workers have a higher chance of injury (Galizzi and Tempesti 2015) Injury rate is higher at medium sized firms (Leigh 1989). Do unhealthy workers tend to work at medium size firms?
10 Occupational Health and Fringe Benefits Unhealthy workers have a higher chance of injury (Galizzi and Tempesti 2015) Injury rate is higher at medium sized firms (Leigh 1989). Do unhealthy workers tend to work at medium size firms? Larger employers more likely to offer health insurance benefits.
11 Occupational Health and Fringe Benefits Unhealthy workers have a higher chance of injury (Galizzi and Tempesti 2015) Injury rate is higher at medium sized firms (Leigh 1989). Do unhealthy workers tend to work at medium size firms? Larger employers more likely to offer health insurance benefits. Do they have healthier workers and, therefore, lower insurance premia?
12 Trade and Health Firm s size is a key variable in trade models (Melitz 2003).
13 Trade and Health Firm s size is a key variable in trade models (Melitz 2003). Productivity is assumed to be increasing in firm s size.
14 Trade and Health Firm s size is a key variable in trade models (Melitz 2003). Productivity is assumed to be increasing in firm s size. Trade liberalization reallocates market shares from smaller, less productive firms, to larger and more productive firms.
15 Trade and Health Firm s size is a key variable in trade models (Melitz 2003). Productivity is assumed to be increasing in firm s size. Trade liberalization reallocates market shares from smaller, less productive firms, to larger and more productive firms. New variants of Melitz s model also allow for firm size-wage premium.
16 Trade and Health Firm s size is a key variable in trade models (Melitz 2003). Productivity is assumed to be increasing in firm s size. Trade liberalization reallocates market shares from smaller, less productive firms, to larger and more productive firms. New variants of Melitz s model also allow for firm size-wage premium. The source of the premium relevant for gains from trade.
17 Trade and Health Firm s size is a key variable in trade models (Melitz 2003). Productivity is assumed to be increasing in firm s size. Trade liberalization reallocates market shares from smaller, less productive firms, to larger and more productive firms. New variants of Melitz s model also allow for firm size-wage premium. The source of the premium relevant for gains from trade. Trade and health: Trade liberalization increases injury rate at smaller firms (McManus and Schaur 2015).
18 Empirical Model Linear probability model: h = β 0 + β 1 size + β 2 X + ɛ
19 Empirical Model Linear probability model: h = β 0 + β 1 size + β 2 X + ɛ where h is a dummy which measures good health, size are establishment size dummies.
20 Empirical Model Linear probability model: h = β 0 + β 1 size + β 2 X + ɛ where h is a dummy which measures good health, size are establishment size dummies. X i is a vector of individual controls.
21 Data Source: National Health Institute Survey (NHIS).
22 Data Source: National Health Institute Survey (NHIS). Pooled cross-sections for
23 Data Source: National Health Institute Survey (NHIS). Pooled cross-sections for Extensive health information.
24 Data Source: National Health Institute Survey (NHIS). Pooled cross-sections for Extensive health information. Adult Sample also contains work-related questions such as establishment-size.
25 Measures of Health I use four dummy variables.
26 Measures of Health I use four dummy variables. Excellent or very good self-rated health status.
27 Measures of Health I use four dummy variables. Excellent or very good self-rated health status. No functional limitation, e.g. difficulty pushing or pulling large objects.
28 Measures of Health I use four dummy variables. Excellent or very good self-rated health status. No functional limitation, e.g. difficulty pushing or pulling large objects. Good mental health, i.e. low psychological distress (Kessler score lower than 10).
29 Measures of Health I use four dummy variables. Excellent or very good self-rated health status. No functional limitation, e.g. difficulty pushing or pulling large objects. Good mental health, i.e. low psychological distress (Kessler score lower than 10). No previous health condition equals 1 if never diagnosed with at least one of the following: asthma, cancer, coronary heart, disease, diabetes, heart attack, heart condition/disease, hypertension, stroke, ulcer.
30 Table: Good Health Status b/se b/se b/se b/se b/se 1 to 9 employees -0.02*** -0.02*** *** 10 to 24 employees -0.02*** -0.02*** ** 25 to 49 employees -0.01** -0.02*** ** 50 to 99 employees -0.02*** -0.02*** * 100 to 249 employees -0.02*** -0.02*** to 499 employees -0.01** -0.01** to 999 employees -0.02** -0.02** employees Omitted Omitted Omitted Omitted Omitted Age -0.01*** -0.01*** -0.01*** -0.01*** Black -0.08*** -0.06*** -0.05*** -0.05*** Other -0.04*** -0.05*** -0.05*** -0.05*** White Omitted Omitted Omitted Omitted Hispanic -0.09*** -0.04*** -0.03*** -0.03*** Male 0.04*** 0.03*** 0.03*** 0.02*** Born Outside U.S *** 0.02*** Married 0.05*** 0.04*** 0.03*** 0.03*** Number of persons in family -0.01*** -0.00*** -0.00** -0.00*** High-School Dropout Omitted Omitted Omitted High-School 0.10*** 0.09*** 0.08*** Some College 0.15*** 0.14*** 0.12*** College 0.24*** 0.21*** 0.19*** More than College 0.28*** 0.25*** 0.21*** Years on Current Job 0.00*** 0.00*** Weekly Hours *** Yearly earnings (2014k) 0.00*** Observations (subsample) R-squared Industry, year and region dummies always included.
31 Health Status Results Positive size-health premium disappears after controlling for education.
32 Health Status Results Positive size-health premium disappears after controlling for education. Premium turns negative when controlling for previous year s earnings.
33 Health Status Results Positive size-health premium disappears after controlling for education. Premium turns negative when controlling for previous year s earnings. No robust evidence of a positive size-health premium.
34 Health Status Results Positive size-health premium disappears after controlling for education. Premium turns negative when controlling for previous year s earnings. No robust evidence of a positive size-health premium. Same result for no functional limitation and good mental health dummies.
35 Table: No Previous Health Condition b/se b/se b/se b/se b/se 1 to 9 employees 0.02*** 0.01** 0.02*** 0.02*** 0.02*** (0.01) (0.00) (0.00) (0.00) (0.01) 10 to 24 employees 0.03*** 0.01*** 0.02*** 0.02*** 0.03*** (0.01) (0.01) (0.01) (0.01) (0.01) 25 to 49 employees 0.02*** 0.01** 0.02*** 0.02*** 0.02*** (0.01) (0.01) (0.01) (0.01) (0.01) 50 to 99 employees ** (0.01) (0.01) (0.01) (0.01) (0.01) 100 to 249 employees * 0.01** (0.01) (0.01) (0.01) (0.01) (0.01) 250 to 499 employees (0.01) (0.01) (0.01) (0.01) (0.01) 500 to 999 employees (0.01) (0.01) (0.01) (0.01) (0.01) employees Omitted Omitted Omitted Omitted Omitted Demographics Y Y Y Y High-School Dropout Omitted Omitted Omitted High-School 0.02*** 0.02*** 0.01** (0.01) (0.01) (0.01) Some College (0.01) (0.01) (0.01) College 0.05*** 0.06*** 0.04*** (0.01) (0.01) (0.01) More than College 0.07*** 0.08*** 0.06*** (0.01) (0.01) (0.01) Years on Current Job 0.00*** 0.00 (0.00) (0.00) Weekly Hours -0.00*** -0.00*** (0.00) (0.00) Yearly earnings (2014k) 0.00*** (0.00) Observations (subsample) R-squared Industry, year and region dummies always included.
36 No Health Condition Reported Predicted Probabilities Number of employees at work
37 Predicted Probabilities No Health Condition By Job Tenure and #Employees 0-2 Years 3-7 Years 7+ Years Job Tenure 1-49 Employees Employees Employees
38 No Previous Condition Results Size-health premium is always negative for all specifications.
39 No Previous Condition Results Size-health premium is always negative for all specifications. Smaller establishment have healthier new hires.
40 No Previous Condition Results Size-health premium is always negative for all specifications. Smaller establishment have healthier new hires. Size-health premium is especially negative for longer tenure workers.
41 Conclusion No evidence of a positive establishment size-health premium.
42 Conclusion No evidence of a positive establishment size-health premium. The premium is actually negative for no previous health conditions.
43 Conclusion No evidence of a positive establishment size-health premium. The premium is actually negative for no previous health conditions. Next steps:
44 Conclusion No evidence of a positive establishment size-health premium. The premium is actually negative for no previous health conditions. Next steps: Study the relationship between establishment size and work-related injury while controlling for controlling for worker s health.
45 Conclusion No evidence of a positive establishment size-health premium. The premium is actually negative for no previous health conditions. Next steps: Study the relationship between establishment size and work-related injury while controlling for controlling for worker s health. Study the establishment size-health insurance benefits premium while controlling for worker s health.
46 Table: Summary Statistics Variable Mean Std. Dev. Good Self-Reported Health Has No Condition No Functional Limitations Good Mental Health to 9 employees to 24 employees to 49 employees to 99 employees to 249 employees to 499 employees to 999 employees employees Age White Black Non-white and non-black Hispanic Male Born Outside U.S Married Number of persons in family High-School Dropout High-School Some College College More than College Years on Current Job Weekly Hours Yearly earnings (2014k) N
47 Table: Good Health Status b/se b/se b/se b/se b/se -0.02*** -0.02*** *** 1 to 9 employees (0.01) (0.01) (0.00) (0.00) (0.01) -0.02*** -0.02*** ** 10 to 24 employees (0.01) (0.01) (0.01) (0.01) (0.01) 25 to 49 employees -0.01** -0.02*** ** (0.01) (0.01) (0.01) (0.01) (0.01) 50 to 99 employees -0.02*** -0.02*** * (0.01) (0.01) (0.01) (0.01) (0.01) -0.02*** -0.02*** to 249 employees (0.01) (0.01) (0.00) (0.00) (0.00) 250 to 499 employees -0.01** -0.01** (0.01) (0.01) (0.01) (0.01) (0.01) 500 to 999 employees -0.02** -0.02** (0.01) (0.01) (0.01) (0.01) (0.01) employees Omitted Omitted Omitted Omitted Omitted Age -0.01*** -0.01*** -0.01*** -0.01*** (0.00) (0.00) (0.00) (0.00) -0.08*** -0.06*** -0.05*** -0.05*** Black (0.00) (0.00) (0.00) (0.00) -0.04*** -0.05*** -0.05*** -0.05*** Other (0.01) (0.01) (0.01) (0.01) White Omitted Omitted Omitted Omitted Hispanic -0.09*** -0.04*** -0.03*** -0.03*** (0.00) (0.00) (0.00) (0.00) Male 0.04*** 0.03*** 0.03*** 0.02*** (0.00) (0.00) (0.00) (0.00) Born Outside U.S *** 0.02*** (0.00) (0.00) (0.00) (0.00) Married 0.05*** 0.04*** 0.03*** 0.03*** (0.00) (0.00) (0.00) (0.00) Number of persons -0.01*** -0.00*** -0.00** -0.00*** in family (0.00) (0.00) (0.00) (0.00) 0.10*** 0.09*** 0.08*** High-School (0.01) (0.01) (0.01) Some College 0.15*** 0.14*** 0.12*** (0.01) (0.01) (0.01) College 0.24*** 0.21*** 0.19*** (0.01) (0.01) (0.01) More than College 0.28*** 0.25*** 0.21*** (0.01) (0.01) (0.01) High-School Dropout Omitted Omitted Omitted Years on Current Job 0.00*** 0.00*** (0.00) (0.00) Weekly Hours *** (0.00) (0.00) Yearly earnings (2014k) 0.00*** (0.00) Observations (subsample) Observations (pop.n) R-squared Industry, year and region dummies always included.
48 Table: No Previous Health Condition b/se b/se b/se b/se b/se 1 to 9 employees 0.02*** 0.01** 0.02*** 0.02*** 0.02*** (0.01) (0.00) (0.00) (0.00) (0.01) 10 to 24 employees 0.03*** 0.01*** 0.02*** 0.02*** 0.03*** (0.01) (0.01) (0.01) (0.01) (0.01) 25 to 49 employees 0.02*** 0.01** 0.02*** 0.02*** 0.02*** (0.01) (0.01) (0.01) (0.01) (0.01) 50 to 99 employees ** (0.01) (0.01) (0.01) (0.01) (0.01) 100 to 249 employees * 0.01** (0.01) (0.01) (0.01) (0.01) (0.01) 250 to 499 employees (0.01) (0.01) (0.01) (0.01) (0.01) 500 to 999 employees (0.01) (0.01) (0.01) (0.01) (0.01) employees Omitted Omitted Omitted Omitted Omitted Age -0.01*** -0.01*** -0.01*** -0.01*** (0.00) (0.00) (0.00) (0.00) -0.03*** -0.02*** -0.02*** -0.02*** Black (0.00) (0.00) (0.00) (0.00) Other 0.01** (0.01) (0.01) (0.01) (0.01) White Omitted Omitted Omitted Omitted Hispanic 0.02*** 0.03*** 0.03*** 0.03*** (0.00) (0.00) (0.00) (0.00) Male 0.01** (0.00) (0.00) (0.00) (0.00) Born Outside U.S. 0.11*** 0.11*** 0.11*** 0.11*** (0.00) (0.00) (0.00) (0.00) Married 0.02*** 0.02*** 0.02*** 0.01*** (0.00) (0.00) (0.00) (0.00) Number of persons in family 0.00* 0.00*** 0.00*** 0.00** (0.00) (0.00) (0.00) (0.00) High-School 0.02*** 0.02*** 0.01** (0.01) (0.01) (0.01) Some College (0.01) (0.01) (0.01) College 0.05*** 0.06*** 0.04*** (0.01) (0.01) (0.01) More than College 0.07*** 0.08*** 0.06*** (0.01) (0.01) (0.01) High-School Dropout Omitted Omitted Omitted Years on Current Job 0.00*** 0.00 (0.00) (0.00) Weekly Hours -0.00*** -0.00*** (0.00) (0.00) 0.00*** Yearly earnings (2014k) (0.00) Observations (subsample) Observations (pop.n) R-squared Industry, year and region dummies always included.
Continued on Reverse Side
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