Health, Well-Being and Work History Patterns: Insight on Territorial Differences

Abstract

The progressive flexibility of labour relations has not always been perceived by workers as an opportunity, but as an ever-growing sense of precariousness. This appears all the more true in a country like Italy, where the labour market has long been characterized by some rigidity. Health is a fundamental domain of well-being and, although the relationship between health and job insecurity has been clearly highlighted, the correct causal effect along with differences at the territorial level have not always been brought into focus. The aim of this paper is to provide insights on health status differentials across Italian territories, in relation to individual working histories. To analyze the potential causal effects of career on self-reported health (SRH) a propensity score approach, based on the inverse probability of treatment weighing, has been used. Available data shows great differences at territorial level: in Northern Italy, the economic conditions seem to increase the probability of having good health, while in the other regions of Italy key factors seem to be age, children or the sector and size of the company where an individual works. Our findings have also shown the presence of a causal effect on the work history patterns of SRH in northern Italy, and not elsewhere. This may imply that in an area with high occupational levels having only a temporary employment is perceived as the merest chance, and could generate stress both at a physical and mental level. In other areas, high unemployment levels seem to arouse low expectations and the only fact of having a job—even if temporary—can be perceived as a positive aspect.

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Notes

  1. 1.

    What Istat experienced with the introduction of the BES was particularly significant also in relation to the possibility of using these indicators in order to affect the country’s economic policy. In fact, starting from 2016, BES became part of the objectives included in the so-called Economic and Financial Document (DEF), which is one of the main public finance instruments of the Italian Government. Starting from 2018 the list—which first had included 4 indicators—was extended to a total of 12 indicators, which are monitored with a view to guaranteeing a fair and sustainable growth of the Italian economy.

  2. 2.

    We have also performed a sensitivity analysis and we have excluded issues related to non-ignorable or Informative Drop-out (ID) based on the observed individual features. Focusing on the universe of respondents to IT-SILC, for respondents we do not dispose of the tax code we have established whether this exclusion affects the representativeness of our sample, as well as to verify to what extent the excluded observations differ from the included ones with respect to the observed covariates. We have fitted a logistic regression model for the drop-out process to evaluate the probability of informative drop-out, depending on observed covariates, after a cross-validation process. Parameters in the model are estimated by maximum likelihood and inferences drawn through conventional likelihood procedures.

  3. 3.

    At least 7 out of 10 years.

  4. 4.

    The latter category is represented by the so called "partita iva", i.e. individuals employed with a taxpayer identification number that formally are non-subordinate workers, but, in most of the cases, they work not as employer, but as employees, with reduced social and welfare guarantees.

  5. 5.

    For a deep explanation of the underlined methodology see Lunceford and Davidian (2004).

  6. 6.

    The models have been fit using R and package ipw (Van der Wal and Geskus 2011) with default settings.

  7. 7.

    Different studies suggest lower risk factors (smoking, drinking, diet, exercise, use of illegal drugs, household safety, use of preventive medical care, and care for hypertension and diabetes) associated with the better educated.

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Acknowledgements

We are very grateful to the Ministry of the Economy and Finance for the use of AD-SILC dataset. AD-SILC dataset can be required, for research proposal, to the Ministry of the Economy and Finance. We are also grateful to two anonymous reviewers for the valuable suggestions provided.

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Ciccarelli, A., Fabrizi, E., Romano, E. et al. Health, Well-Being and Work History Patterns: Insight on Territorial Differences. Soc Indic Res (2020). https://doi.org/10.1007/s11205-020-02393-w

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Keywords

  • Health
  • Well-being
  • Work history patterns
  • Causal effect
  • Precariousness
  • Territorial gap