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Do Hospital Stays Modify Locus of Control?

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Abstract

The assumption of stable non-cognitive skills is important in the economic literature. This paper proposes to test this assumption by investigating whether a specific non-cognitive skill, locus of control, is stable after the occurrence of a health-related event, namely a hospital stay. To do so, we use a representative and longitudinal dataset of individuals living in Germany (SOEP). Our results show that mean-level changes in locus of control are, on average, small. In addition, we report evidence that length and frequency of hospital stays have only little influence on locus of control. Young adult women (i.e., aged 18–35 years old) and old men (i.e., aged 66 years and more) experience, however, larger locus of control change. Empirical studies analyzing the impact of locus of control for these subgroups might, therefore, rely on a locus of control measurement prior to the desired outcome to limit reverse causality or simultaneity bias.

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Notes

  1. Non-cognitive skills describe the personal attributes not thought to be measured by IQ or achievement tests. These attributes go by many names in the economic literature including soft-skills, personality, character skills or socio-emotional skills. We follow Cobb-Clark and Schurer (2013) and Kautz et al. (2014) by considering, throughout the paper, locus of control as a non-cognitive skill.

  2. LoC captures beliefs that are distinct, but complementary to risk, time and social preferences (Becker et al. (2011)).

  3. Reporting bias covers a wide range of different biases such as social desirability bias, or recall bias (see more on Sterne et al. 2008; Baker et al. 2004; Kerkhofs and Lindeboom 1995).

  4. Justification bias results from an individual exaggerating health status as a way to justify an exit from the labor force or to get benefit from a mental health insurance (Benítez-Silva et al. 2004; Lindeboom and Van Doorslaer 2004).

  5. In addition, hospital stays affect a sizeable part (around 20%) of the German population every year (Schmidt et al. 2004).

  6. We investigate whether LoC is related to sample attrition. To do so, we regress the individuals’ LoC on the number of waves he or she is observed in the dataset. We find a positive relationship between individuals with an internal LoC and the number of waves, indicating that these individuals are less likely to leave the sample. Note that this procedure is similar as the one investigating by Cobb-Clark et al. (2014). We find similar a result using a Probit modeling the probability of being out of the estimation sample.

  7. We also run a Cronbach’s alpha test to provide additional reliability of the LoC questions. We find a Cronbach’s alpha of 0.60 for the whole set of questions and 0.65 when question 4 is dropped. The other studies relying on the LoC in the SOEP data find the exact same value (Preuss and Hennecke 2018) or a very similar one (0.62 in Heineck and Anger 2010).

  8. We also conduct a similar factor analysis for the whole sample of SOEP respondents. We find that the 10 questions load onto the two same factors. This indicates that our distinction between internal and external control tendency is not specific to the estimation sample, but rather seems to be representative of the German population. These results are available on request.

  9. The average hourly wage is obtained by dividing individual labor earnings from main job by the number of annual hours worked (Steiner 2017). It equals 15,18 euros for the whole estimation sample and 13,28 euros for the women estimation sample (these findings are consistent with the average hourly wage provided by the German bureau of statistics).

  10. We do not report results on LoC change for men, as there are only significant for those aged 66 years and more. In such an age category, men are more likely to be retired than earning wage on the labor market.

  11. We are not able to control for other events that might impact both the perception of control and hospital stays.

  12. See more on the Eurostat page.

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  1. Irdes, 119 bis rue Manin, 75019, Paris, France

    Antoine Marsaudon

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Correspondence to Antoine Marsaudon.

Additional information

I give special thanks to Yves Arrighi, Andrew Clark, Brigitte Dormont, Matteo Galizzi, Daniel Herrera, Hélène Huber, Andrew Jones, Fabrice Le Lec, Nicolas Sirven, Lea Toulemon, Setti Rais, Lise Rochaix, Xavier Rousset, Brendan Vannier, and Marjon Van der Pol. I also thank all participants of the \(2{nd}\) LIRAES’s doctoral day, of the \(12{\text{th}}\) doctorissime day, of the Work in Progress Seminar of Paris School of Economics, and of the \(40{\text{th}}\) Days of French Health Economists. I would like to thank the two anonymous reviewers for their many insightful comments and suggestions.

Appendix

Appendix

Fig. 4
figure 4

Principal factor analysis. Note: Factors 1 and 2 represent, respectively, external and internal locus of control. The internal index aggregates the answers of questions 1, 6 and 9. The external index aggregates the answers of questions 2, 3, 5, 7, 8 and 10. The question 4 loads into a third factor and is not used in this analysis. We also conduct a similar factor analysis for the whole sample of SOEP respondents. We find that the 10 questions load onto the two same factors. This indicates that our distinction between internal and external control tendency is not specific to the estimation sample, but rather seems to be representative of the German population. These results are available on request. We also run a Cronbach’s alpha test to provide additional reliability of the LoC questions. We find a Cronbach’s alpha of 0.60 for the whole set of questions and 0.65 when question 4 is dropped. The other papers relying on the LoC in the SOEP data find the exact same value (Preuss and Hennecke 2018) or a very similar one (0.62 in Heineck and Anger 2010). Source: SOEP data

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Table 7 Locus of control change after hospital stays
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Marsaudon, A. Do Hospital Stays Modify Locus of Control?. De Economist 170, 257–277 (2022). https://doi.org/10.1007/s10645-022-09404-w

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