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Self-employment, health, and health care: When the going gets tough, the tough get going?

Author

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  • Garrouste, Clémentine
  • Paraponaris, Alain
  • Sirven, Nicolas

Abstract

This study provides a life-course analysis of the relationship between self-employment, health, and health care use among individuals aged 50 and older in Europe. Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE), we apply first-difference and dynamic panel data models that go beyond standard approaches in mitigating endogeneity concerns. Our findings show that the self-employed enjoy better health at younger ages, consistent with a selection effect. In addition, they experience a steeper decline in physical health over time. We also document two distinct phases of health care use: during working life, the self-employed are more likely to be hospitalised, suggesting delayed care until acute needs arise; after retirement, the number of medical visits increases, consistent with a lower opportunity cost of care.

Suggested Citation

  • Garrouste, Clémentine & Paraponaris, Alain & Sirven, Nicolas, 2026. "Self-employment, health, and health care: When the going gets tough, the tough get going?," Economics & Human Biology, Elsevier, vol. 60(C).
    • Handle: RePEc:eee:ehbiol:v:60:y:2026:i:c:s1570677x25001005
    DOI: 10.1016/j.ehb.2025.101567
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