"Previous estimates on the association between body weight and wages in the literature have been contingent on education and occupation. This paper examines the direct effect of BMI on wages and the indirect effects operating through education and occupation choice, particularly for late-teen BMI and adult wages. Using the National Longitudinal Survey of Youth 1979 data, we show that education is the main pathway for the indirect BMI wage penalty. The total BMI wage penalty is underestimated by 18% for women without including those indirect effects. Whereas for men there is no statistically significant direct BMI wage penalty, we do observe a small indirect wage penalty through education"--National Bureau of Economic Research web site
SummaryThis study assesses differential labour performance by body mass index (BMI), focusing on heterogeneity across three distinct employment statuses: unemployed, self-employed and salaried. Data were drawn from the Korean Labor and Income Panel Study. The final sample included 15,180 person-year observations (9645 men and 5535 women) between 20 and 65 years of age. The findings show that (i) overweight/obese women are less likely to have salaried jobs than underweight/normal weight women, whereas overweight/obese men are more likely to be employed in both the salaried and self-employed sectors than underweight/normal men, (ii) overweight/obese women have lower wages only in permanent salaried jobs than underweight/normal weight women, whereas overweight/obese men earn higher wages only in salaried temporary jobs than underweight/normal weight women, (iii) overweight/obese women earn lower wages only in service, sales, semi-professional and blue-collar jobs in the salaried sector than underweight/normal weight women, whereas overweight/obese men have lower wages only in sales jobs in the self-employed sector than underweight/normal weight women. The statistically significant BMI penalty in labour market outcomes, which occurs only in the salaried sector for women, implies that there is an employers' distaste for workers with a high BMI status and that it is a plausible mechanism for job market penalty related to BMI status. Thus, heterogeneous job characteristics across and within salaried versus self-employed sectors need to be accounted for when assessing the impact of BMI status on labour market outcomes.
With a parallel increase in the consumption of food away from home, particularly fast food, and the obesity prevalence in the United States, evidence on the potential effectiveness of fiscal pricing policies to curb obesity is needed. We estimate changes in the dispersion of the entire conditional distribution of body mass index (BMI) associated with changes in fast food prices for adults using the National Longitudinal Survey of Youth 1979 in cross‐sectional and longitudinal quantile regression models. We find that the ordinary least squares estimate for men underestimates the negative relationship of fast food prices with BMI at the 50th and upper quantiles in cross‐sectional models although the statistical significance disappears in the longitudinal individual fixed effects quantile regression. Among subpopulations, we find that a 10% increase in the price of fast food is associated with 0.9% and 0.7% lower BMI for low‐income women and women with any children, respectively, at the 90th quantile in a longitudinal individual fixed effects model. Our results imply that fiscal pricing policies such as fast food taxes might have a greater impact on the weight outcomes of low‐income women or women with children in the upper tail of the conditional BMI distribution (JEL I00, I19).
Purpose. To explore the relationships of selected health behaviors to medication adherence. Design. A retrospective cohort study. Setting. Data from Korean national health insurance claims between January 2010 and June 2011. Subjects. Patients aged 65 years and older with hypertension (N = 662,170), hyperlipidemia (N = 244,702), or diabetes (N = 179,285). Measures. Medication adherence as a medication possession ratio from January to June 2011 as a dependent variable. The waist circumference (cm) and the body mass index (weight in kilogram divided by height in meter squared) as a marker for obesity. Smoking, drinking, and physical activity as main independent variables. Analysis. A multivariate logistic regression. Results. Nonobese patients, as based on the waist circumference, were more likely to adhere to their medication (by 8.9% for hypertension, 6.2% for diabetes, and 3.5% for hyperlipidemia). Current smokers were less likely to adhere to their medication (by 8.7% for hypertension and 6.8% for diabetes), and moderate and heavy drinkers were also less likely to show medication adherence for diabetes (by 12.9% and 6.4%). Mild physical activity was related to a 1.1% to 1.8% increase in the likelihood of medication adherence across the three disease groups. Conclusion. Health promotion programs for self-care health behaviors of elderly patients should emphasize good medication adherence to achieve successful self-management of diseases.
Abstract Background The rapid growth of prescription drug expenditures is a major problem in South Korea. Accordingly, the South Korean government introduced a positive listing system in 2006. They also adopted various price reduction policies. Nevertheless, the total expenditure for lipid-lowering drugs have steadily increased throughout South Korea. The present study explores the factors that have influenced the increased expenditures of lipid-lowering drugs with a particular focus on the effects of statins in this process. Methods This paper investigates the National Health Insurance claims data for prescribed lipid-lowering drugs collected between January 1, 2005 and December 31, 2009. We specifically focused on statins and assessed the yearly variation of statin expenditure by calculating the increased rate of paired pharmaceutical expenditures over a 2 year period. Our study classified statins into three categories: new entrants, core medicines and exiting medicines. For core medicines, we further examined influencing factors such as price, amount of drugs consumed by volume, and prescription changes (substitutes for other drug). Results Statin expenditure showed an average annual increase of 25.7% between 2005 and 2009. Among the different statins, the expenditure of atorvastatin showed a 36.6% annual increase rate, which was the most dramatic among all statins. Also we divided expenditure for core medicines by the price factor, volume factor, and prescription change. The result showed that annual weighted average prices of individual drug decreased each year, which clearly showed that price influenced statin expenditure in a negative direction. The use of generic drugs containing the same active ingredient as name-brand drugs increased and negatively affected statin expenditure (Generic Mix effect). However, the use of relatively expensive ingredients within statin increase, Ingredient Mix effect contributed to increased statin expenditure (Ingredient Mix effect). In particular, the volume effect was found to be critical for increasing statin expenditure as the amount of statin consumed increased steadily throughout the study period. Conclusions The recent rapid increase in statin expenditure can largely be attributed to an increase in consumption volume. In order to check drug expenditures effectively in our current situation, in which chronic diseases remain steadily on the rise, it is necessary to not only have supply-side initiatives such as price reduction, but also demand-side initiatives that could control drug consumption volume, for example: educational programs for rational prescription, generic drug promotional policies, and policies providing prescription targets.
