Abstract
Like many OECD countries, Germany is currently facing a shortage of long-term care (LTC) workers. This situation is concerning in the context of the ageing of the German population. A potential reason why Germany fails to recruit and retain LTC workers is that LTC jobs are particularly demanding (physical and psychological strain) which may be harmful to health. However, there is a lack of empirical evidence demonstrating this effect. This article fills the gap in the literature by exploring to what extent LTC jobs reduce workers’ health over time. We estimate a dynamic panel data model on the German Socio-Economic Panel (v.35; 1984–2018), which allows adressing selection issues into occupations. Our paper provides innovative findings on the impact of LTC occupations on workers’ health. We confirm that LTC jobs have a negative impact on self-reported health. Our results have strong policy implications: we emphasize the need to provide sufficient assistance to LTC workers, who are at risk of facing more health issues than other workers. This issue is key to increase the attractiveness of LTC jobs and reduce turnover in the LTC workforce.
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Notes
The OECD’s definition excludes the hospital sector of LTC jobs. Nevertheless, distinguishing between the hospital and residential/home sectors is only possible after 2012 using the revised NACE classification (see Table 6). To include as little noise as possible in our estimation, we include the hospital sector among LTC jobs before 2013 but differentiate the two sectors after this year. Panel C corrects this approach.
Duration (or job tenure) is defined here as the number of waves/years observed in the job.
Few immigrants (2% of our sub-sample) acquired German citizenship over the period considered. We only consider here responses in the first wave.
For parsimony, we comment on the results only for panel B, but the conclusions hold for panel A.
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Appendices
Appendix A
Detail description of similar jobs
Appendix B
Self-perceived health for panels A, B and C
See Fig. 2.
Appendix C
Sensitivity analyses
Appendix D
Stratified analyses—Panel A
Appendix E
Stratified analyses—Panel B
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Rapp, T., Ronchetti, J. & Sicsic, J. Are long-term care jobs harmful? Evidence from Germany. Eur J Health Econ 22, 749–771 (2021). https://doi.org/10.1007/s10198-021-01288-y
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DOI: https://doi.org/10.1007/s10198-021-01288-y