Health is well known to show a clear gradient by occupation. Although it may appear evident that occupation can affect health, there are multiple possible sources of selection that can generate a strong association, other than simply a causal effect of occupation on health. We link job characteristics to German panel data spanning 29 years to characterize occupations by their physical and psychosocial burden. Employing a dynamic model to control for factors that simultaneously affect health and selection into occupation, we find that selection into occupation accounts for at least 60% of the association. The effects of occupational characteristics such as physical strain and low job control are negative and increase with age: late-career exposure to 1 year of high physical strain and low job control is comparable to the average health decline from ageing 16 and 6 months, respectively.

The Commonwealth Fund; the Innovative Medicines Initiative Joint Undertaking, Grant/Award Number: 115621 ; European Union's Seventh Framework Program, Grant/Award Number: FP7/2007–2013 ; National Institute on Aging of the National Institutes of Health, Grant/Award Number: R01AG037398; NWO, Grant/Award Number: 016.145.082,
Health Economics
Erasmus School of Economics

Ravesteijn, B., van Kippersluis, H., & van Doorslaer, E. (2017). The wear and tear on health: What is the role of occupation?. Health Economics, 27(2), e69–e86. doi:10.1002/hec.3563