Forskningskommentar: Hvor har den nye genforskningen brakt oss?

Er skoletapere genetisk forskjellige fra skolelys?1 Satt på spissen var det spørsmålet for en australsk studie om gener og utdanning (Martin et al. 2011). Forskerne undersøkte ikke mindre enn 2,5 millioner genetiske forskjeller (dvs. SNPer, se nedenfor). Jakten ga få resultater. Bare én av genvariantene hadde en statistisk signifikant, men svært svak sammenheng med utdanningsnivået til de 9500 individene i utvalget. Samlet gjorde den genetiske variasjonen rede for kun 0,2 prosent – to promille – av ulikhetene i utdanning

Fordelingsvirkninger av overføringer og trygdekutt blant alvorlig syke menn

Artikkelen analyserer inntektsutviklingen 1993–2008 blant menn som døde av sykdom i 2009/2010 mens de var i 60-årsalderen (N=4611). Et typisk forløp er at inntektene fra eget arbeid begynner å falle om lag ti år før dødsfallet og går etter hvert mot null. Bortfallet av arbeidsinntekter starter gjerne 5–6 år tidligere blant lavt utdannede enn blant høyt utdannede. Selv om en fatal sykdom begrenser deltakelsen i lønnet arbeid, vil nivået på samlet personinntekt ofte holde seg ganske stabilt ettersom velferdsstatens overføringer i stor grad kompenserer for nedgangen i arbeidsinntekt. De sosioøkonomiske forskjellene i muligheten for arbeidsinntekter når en blir alvorlig syk innebærer at reduserte ytelser for syke og uføre i særlig grad vil ramme lavt utdannede og føre til større sosial ulikhet i inntekt

Does the socioeconomic context explain both mortality and income inequality? Prospective register-based study of Norwegian regions

Abstract Background Studies from various countries have observed worse population health in geographical areas with more income inequality. The psychosocial interpretation of this association is that large income disparities are harmful to health because they generate relative deprivation and undermine social cohesion. An alternative explanation contends that the association between income inequality and ill health arises because the underlying social and economic structures will influence both the level of illness and disease and the size of income differences. This paper examines whether the observed association between mortality and income inequality in Norwegian regions can be accounted for by the socioeconomic characteristics of the regions. Methods Norwegian register data covering the entire population were utilised. An extensive set of contextual and individual predictors were included in multilevel Poisson regression analyses of mortality 1994-2003 among 1.6 millions individuals born 1929-63, distributed across 35 residential regions. Results Mean income, composition of economic branches, and percentage highly educated in the regions were clearly connected to the level of income inequality. These social and economic characteristics of the regions were also markedly related to regional mortality levels, after adjustment for population composition, i.e., the individual-level variables. Moreover, regional mortality was significantly higher in regions with larger income disparities. The regions' social and economic structure did not, however, account for the association between regional income inequality and mortality. A distinct independent effect of income inequality on mortality remained after adjustment for regional-level social and economic characteristics. Conclusions The results indicate that the broader socioeconomic context in Norwegian regions has a substantial impact both on mortality and on the level of income disparities. However, the results also suggest, in a way compatible with the psychosocial interpretation, that on top of the general socioeconomic influences, a higher level of income inequality adds independently to higher mortality levels. Previous publication This article is a reworked version of the study 'Er inntektsforskjeller dødelige?' [Are income inequalities lethal?] which was published in Norwegian in Tidsskrift for velferdsforskning [Journal for welfare research], Vol. 13 (4), 2010.</p

Health-related exit from employment before and during the COVID-19 pandemic in Norway: Analysis of population-wide register data 2013–2021

People with health problems experience various labor market disadvantages, such as hiring discrimination and heightened risk of firing, but the impact of deteriorating economic conditions on health-related labor market mobility remains poorly understood. The strength of the downturn/crisis will most likely make a difference. During minor downturns, when few employees are made redundant, health-related exit may occur frequently since employers prefer to keep those with good health on the payroll. However, during major economic crises, when large-scale downsizing and firm closures abound, there will be less discretionary room for employers. Thus, some mechanisms that usually are damaging for people with health problems (e.g., seniority rules and negative connotations), can be neutralized, ultimately leading to smaller health differentials in labor market outcomes. The current study used population-wide administrative register data, covering the years 2013–2021, to examine health-related exit from employment (to unemployment/social assistance) before and during the COVID-19 pandemic in Norway. The pandemic spurred a major crisis on the Norwegian labor market and led to a record-high unemployment rate of 10.6 percent in March 2020. Restricting the analytical samples to labor market insiders, linear probability models showed that previous recipients of health-related benefits had a higher unemployment likelihood in the pre-crisis year 2019. The relative importance of poor health changed non-negligibly, however, during the COVID-19 pandemic. When identical statistical analyses were run on the crisis year 2020, health-related exit from employment was dampened. Yet, this labor market equalization was not followed by smaller health differentials in work income in 2021, mainly because people with good health retained or regained decent-paying jobs when the economic conditions improved again. In conclusion, major economic crises can lead to an equalization of labor market disadvantages for people with health problems, but health-related inequalities may reemerge when the economy recovers.publishedVersio

‘Crowded out’? Immigration Surge and Residents’ Employment Outcomes in Norway

This study uses Norwegian public register data in a spatial correlation approach, and analyzes associations between regional variations in immigration and employment outcomes 2004–2015 in a cohort of adult residents (N = 1.3 million). A higher share of immigrants in the regional population and an immigrant population dominated by low-educated were associated with slightly negative work income trends and less employment opportunities for residents, in particular for low- educated natives and earlier immigrants. A steep increase in the immigrant share of the regional population was, on the other hand, associated with better employment outcomes for all analyzed resident categories. Overall, regional immigration differences were only modestly related to the out- comes. Findings indicate that the institutional context has limited the role of market mechanisms in the labor market, and a booming regional economy will tend to neutralize potentially negative effects of immigration on residents’ employment

Is it Easier to Be Unemployed When the Experience Is More Widely Shared? Effects of Unemployment on Self-rated Health in 25 European Countries with Diverging Macroeconomic Conditions

The economic crisis in Europe since 2008 has led to high unemployment levels in several countries. Previous research suggests that becoming unemployed is a health risk, but is job loss and unemployment easier to cope with when unemployment is widespread? Using EU-SILC panel data (2010-2013), this study examines short-term effects of unemployment on self-rated health (SRH) in 25 European countries with diverging macroeconomic conditions. Ordinary least squares regressions show that the unemployed are in worse health than the employed throughout Europe. The association is reduced considerably, but remains significant in several countries when time-invariant personal characteristics are accounted for using individual-level fixed-effects models. Propensity score kernel matching shows that both being and becoming unemployed are associated with slightly worse SRH. There is a weak tendency towards less health effects of unemployment in countries where the experience is widely shared. In particular, countries with a very low unemployment rate stand out with larger health effects. The results overall suggest that a changed composition of the unemployed population is an important explanation for the weaker unemployment - health association in high-unemployment countries

‘Crowded out’? Immigration Surge and Residents’ Employment Outcomes in Norway

This study uses Norwegian public register data in a spatial correlation approach, and analyzes associations between regional variations in immigration and employment outcomes 2004–2015 in a cohort of adult residents (N = 1.3 million). A higher share of immigrants in the regional population and an immigrant population dominated by low-educated were associated with slightly negative work income trends and less employment opportunities for residents, in particular for low- educated natives and earlier immigrants. A steep increase in the immigrant share of the regional population was, on the other hand, associated with better employment outcomes for all analyzed resident categories. Overall, regional immigration differences were only modestly related to the out- comes. Findings indicate that the institutional context has limited the role of market mechanisms in the labor market, and a booming regional economy will tend to neutralize potentially negative effects of immigration on residents’ employment

Hva er det med Arendal og Ålesund - og Oslo?

Det er overraskende klare forskjeller i levealder mellom norske byer. I Arendal og Tromsø er dødeligheten påtakelig høyere enn i Ålesund, Molde og Lillehammer. Aller verst er Oslo, som har uvanlig høy dødelighet, tatt i betraktning det høye utdannings- og inntektsnivået. I dette notatet blir en rekke forklaringer på disse dødelighetsforskjellene undersøkt. Ulikheter i befolkningssammensetning – alder, kjønn, inntekt, utdanning, skilsmisser, uføretrygding – betyr lite. Heller ikke kan dødsårsakene forbundet med røyk, alkohol og uvettig bilkjøring gjøre rede for mer enn litt av ulikheten i dødelighet. Flyttemønsteret ser heller ikke ut til å ha noen innvirkning. Årsakene til levealdersforskjellene er åpenbart kompliserte, men notatet påviser at byene med høy dødelighet har særlig høy dødsrisiko blant de lavt utdannede, og disse byene har ofte større inntektsulikhet og mer markant sosial ulikhet

Hva er det med Arendal og Ålesund - og Oslo?

Det er overraskende klare forskjeller i levealder mellom norske byer. I Arendal og Tromsø er dødeligheten påtakelig høyere enn i Ålesund, Molde og Lillehammer. Aller verst er Oslo, som har uvanlig høy dødelighet, tatt i betraktning det høye utdannings- og inntektsnivået. I dette notatet blir en rekke forklaringer på disse dødelighetsforskjellene undersøkt. Ulikheter i befolkningssammensetning – alder, kjønn, inntekt, utdanning, skilsmisser, uføretrygding – betyr lite. Heller ikke kan dødsårsakene forbundet med røyk, alkohol og uvettig bilkjøring gjøre rede for mer enn litt av ulikheten i dødelighet. Flyttemønsteret ser heller ikke ut til å ha noen innvirkning. Årsakene til levealdersforskjellene er åpenbart kompliserte, men notatet påviser at byene med høy dødelighet har særlig høy dødsrisiko blant de lavt utdannede, og disse byene har ofte større inntektsulikhet og mer markant sosial ulikhet

Income inequality and foregone medical care in Europe during The Great Recession: multilevel analyses of EU-SILC surveys 2008–2013

BACKGROUND: The association between income inequality and societal performance has been intensely debated in recent decades. This paper reports how unmet need for medical care has changed in Europe during The Great Recession, and investigates whether countries with smaller income differences have been more successful than inegalitarian countries in protecting access to medical care during an economic crisis. METHODS: Six waves of EU-SILC surveys (2008—2013) from 30 European countries were analyzed. Foregone medical care, defined as self-reported unmet need for medical care due to costs, waiting lists, or travel difficulties, was examined among respondents aged 30–59 years (N = 1.24 million). Countries’ macro-economic situation was measured by Real Gross Domestic Product (GDP) per capita. The S80/S20 ratio indicated the country’s level of income inequality. Equity issues were highlighted by separate analyses of disadvantaged respondents with limited economic resources and relatively poor health. Cross-tabulations and multilevel linear probability regression models were utilized. RESULTS: Foregone medical care increased 2008—2013 in the majority of the 30 countries, especially among the disadvantaged parts of the population. For the disadvantaged, unmet need for medical care tended to be higher in countries with larger income inequalities, regardless of the average economic standard in terms of GDP per capita. Both for disadvantaged and for other parts of the samples, a decline in GDP had more severe effects on access in inegalitarian countries than in countries with less income inequality. CONCLUSIONS: During The Great Recession, unmet need for medical care increased in Europe, and social inequalities in foregone medical care widened. Overall, countries with a more egalitarian income distribution have been more able to protect their populations, and especially disadvantaged groups, against deteriorated access to medical care when the country is confronted with an economic crisis