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An instrumental variables evaluation of the effect of antidepressant use on employment among HIV-infected women using antiretroviral therapy in the United States: 1996-2004

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Author Info

  • Omar Galárraga
  • David S. Salkever
  • Judith A. Cook

    (Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA)

  • Stephen J. Gange

    (Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA)

Abstract

Depression is a common condition among patients with HIV. This paper uses panel data for 1234 participants from the Women's Interagency HIV Study to estimate the effect of antidepressant use on the likelihood of being employed among women receiving highly active antiretroviral therapy (HAART) in the United States from 1996 to 2004. We show that naive regressions of antidepressant use on employment generally result in negative or non-significant coefficients, whereas the instrumental variables (IVs) approach shows a positive and significant effect of antidepressant use on the employment probability of women living with HIV. We use IVs to predict antidepressant use independently of outcomes, thus addressing potential biases (e.g. more depressed women are more likely to receive antidepressant treatment, but they are also more likely to be unemployed). The results are consistent for linear (random and fixed effects) as well as non-linear (bivariate probit) specifications. Among women receiving HAART, and controlling for individual and local area labor market characteristics, the use of antidepressants is associated with a 29-percentage-point higher probability of being employed. Improved efforts to test, diagnose and treat depression among HIV-positive patients may improve not only clinical indicators but also labor market outcomes. Copyright © 2009 John Wiley & Sons, Ltd.

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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 19 (2010)
Issue (Month): 2 ()
Pages: 173-188

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Handle: RePEc:wly:hlthec:v:19:y:2010:i:2:p:173-188

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. David Salkever & Eric Slade & Mustafa Karakus, 2006. "Differential Effects of Atypical versus Typical Antipsychotic Medication on Earnings of Schizophrenia Patients: Estimates from a Prospective Naturalistic Study," PharmacoEconomics, Springer Healthcare | Adis, Springer Healthcare | Adis, vol. 24(2), pages 123-139.
  2. Robert Moffitt, 2005. "Remarks on the analysis of causal relationships in population research," Demography, Springer, Springer, vol. 42(1), pages 91-108, February.
  3. Joshua D. Angrist, 2000. "Estimation of Limited-Dependent Variable Models with Dummy Endogenous Regressors: Simple Strategies for Empirical Practice," NBER Technical Working Papers, National Bureau of Economic Research, Inc 0248, National Bureau of Economic Research, Inc.
  4. Susan L. Ettner & Richard G. Frank & Ronald C. Kessler, 1997. "The Impact of psychiatric disorders on labor market outcomes," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 51(1), pages 64-81, October.
  5. Fone, David & Dunstan, Frank & Williams, Gareth & Lloyd, Keith & Palmer, Stephen, 2007. "Places, people and mental health: A multilevel analysis of economic inactivity," Social Science & Medicine, Elsevier, Elsevier, vol. 64(3), pages 633-645, February.
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  7. Mroz, Thomas A, 1987. "The Sensitivity of an Empirical Model of Married Women's Hours of Work to Economic and Statistical Assumptions," Econometrica, Econometric Society, Econometric Society, vol. 55(4), pages 765-99, July.
  8. James J. Heckman & Thomas E. MaCurdy, 1985. "A Simultaneous Equations Linear Probability Model," Canadian Journal of Economics, Canadian Economics Association, Canadian Economics Association, vol. 18(1), pages 28-37, February.
  9. James J. Heckman, 1977. "Dummy Endogenous Variables in a Simultaneous Equation System," NBER Working Papers 0177, National Bureau of Economic Research, Inc.
  10. Hausman, Jerry A, 1978. "Specification Tests in Econometrics," Econometrica, Econometric Society, Econometric Society, vol. 46(6), pages 1251-71, November.
  11. Christopher F Baum & Mark E Schaffer & Steven Stillman, 2002. "IVREG2: Stata module for extended instrumental variables/2SLS and GMM estimation," Statistical Software Components S425401, Boston College Department of Economics, revised 28 Jul 2014.
  12. Joshua Angrist & Alan Krueger, 2001. "Instrumental Variables and the Search for Identification: From Supply and Demand to Natural Experiments," Working Papers, Princeton University, Department of Economics, Industrial Relations Section. 834, Princeton University, Department of Economics, Industrial Relations Section..
  13. Duggan, Mark, 2005. "Do new prescription drugs pay for themselves?: The case of second-generation antipsychotics," Journal of Health Economics, Elsevier, Elsevier, vol. 24(1), pages 1-31, January.
  14. Imbens, Guido W & Angrist, Joshua D, 1994. "Identification and Estimation of Local Average Treatment Effects," Econometrica, Econometric Society, Econometric Society, vol. 62(2), pages 467-75, March.
  15. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, Econometric Society, vol. 65(3), pages 557-586, May.
  16. Bernell, Stephanie Lazarus & Shinogle, Judith Ann, 2005. "The relationship between HAART use and employment for HIV-positive individuals: an empirical analysis and policy outlook," Health Policy, Elsevier, Elsevier, vol. 71(2), pages 255-264, February.
  17. Angrist, Joshua D, 2001. "Estimations of Limited Dependent Variable Models with Dummy Endogenous Regressors: Simple Strategies for Empirical Practice: Reply," Journal of Business & Economic Statistics, American Statistical Association, American Statistical Association, vol. 19(1), pages 27-28, January.
  18. Susan L. Ettner & Richard G. Frank & Ronald C. Kessler, 1997. "The Impact of Psychiatric Disorders on Labor Market Outcomes," NBER Working Papers 5989, National Bureau of Economic Research, Inc.
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Cited by:
  1. García-Gómez, Pilar & Labeaga, José M. & Oliva, Juan, 2012. "Employment and wages of people living with HIV/AIDS," MERIT Working Papers 043, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).

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