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When the Going Gets Tough, the Tough Get Going? Health and Self-employment in Europe

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Abstract

We provide a comprehensive picture of the change in the health status for the self-employed aged 50 and upwards in Europe. We find that self-employed workers are in better physical health than employees at younger ages, due potentially to a selection effect. We also find a negative effect of self-employment status on objective health, leading to worse physical conditions at older ages, despite a catching-up of healthcare consumption after retirement. The examination of the evolution of the self-employed healthcare consumption enables us to distinguish two components: an intense health restoration effect and a regular one, corresponding to two distinct periods in their life. We interpreted the former effect as the increased probability of the self-employed to be hospitalized during their careers, meaning that the self-employed seek care later or for serious reasons only. The latter effect or the regular restoration effect meaning a greater number of medical visits for the self-employed after retirement which is potentially due to a reduction in the opportunity cost of the use of healthcare resources.

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  • Clémentine Garrouste & Alain Paraponaris & Nicolas Sirven, 2025. "When the Going Gets Tough, the Tough Get Going? Health and Self-employment in Europe," AMSE Working Papers 2529, Aix-Marseille School of Economics, France.
    • Handle: RePEc:aim:wpaimx:2529
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    1. repec:dau:papers:123456789/5065 is not listed on IDEAS
    2. Adriaan Kalwij & Frederic Vermeulen, 2008. "Health and labour force participation of older people in Europe: What do objective health indicators add to the analysis?," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 619-638, May.
    3. Florence Jusot & Sandy Tubeuf & Alain Trannoy, 2013. "Circumstances And Efforts: How Important Is Their Correlation For The Measurement Of Inequality Of Opportunity In Health?," Health Economics, John Wiley & Sons, Ltd., vol. 22(12), pages 1470-1495, December.
    4. Jonathan Gruber & James M. Poterba, 1993. "Tax Incentives and the Decision to Purchase Health Insurance: Evidence from the Self-Employed," NBER Working Papers 4435, National Bureau of Economic Research, Inc.
    5. Christian Pfeifer, 2013. "Cyclical Absenteeism Among Private Sector, Public Sector And Self‐Employed Workers," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 366-370, March.
    6. Jonathan Gruber & James Poterba, 1994. "Tax Incentives and the Decision to Purchase Health Insurance: Evidence from the Self-Employed," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 109(3), pages 701-733.
    7. Maarten Lindeboom & Marcel Kerkhofs, 2009. "Health and work of the elderly: subjective health measures, reporting errors and endogeneity in the relationship between health and work," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 24(6), pages 1024-1046.
    8. Florence Jusot & Sandy Tubeuf & Alain Trannoy, 2013. "Circumstances And Efforts: How Important Is Their Correlation For The Measurement Of Inequality Of Opportunity In Health?," Health Economics, John Wiley & Sons, Ltd., vol. 22(12), pages 1470-1495, December.
    9. Gerrie‐Cor Herber & Maarten Schipper & Marc Koopmanschap & Karin Proper & Fons van der Lucht & Hendriek Boshuizen & Johan Polder & Ellen Uiters, 2020. "Health expenditure of employees versus self‐employed individuals; a 5 year study," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1606-1619, December.
    10. Black, Nicole & Johnston, David W. & Shields, Michael A. & Suziedelyte, Agne, 2017. "Who provides inconsistent reports of their health status? The importance of age, cognitive ability and socioeconomic status," Social Science & Medicine, Elsevier, vol. 191(C), pages 9-18.
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    Keywords

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy

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