Academic journal article Economic Perspectives

Obesity, Disability, and the Labor Force

Academic journal article Economic Perspectives

Obesity, Disability, and the Labor Force

Article excerpt

Introduction and summary

In this article, we investigate how the rise in obesity over the past three decades is related to non-employment. In recent years, unemployment rate figures-joblessness among those actively seeking work--have been low by historical standards. At the same time, however, there has been a rise in the fraction of men who are not actively seeking work. (1) The labor force participation of men of prime working age is low by historical standards, and this has coincided with an expansion in the Social Security Disability Insurance (SSDI) program.

A number of researchers studying the increase in men's non-employment have pointed out that it takes place against a backdrop of improving health (Juhn, Murphy, and Topel, 2002; and Autor and Duggan, 2003). However, these improvements in health are typically measured by mortality rates, which have been declining over time (Cutler and Ricbardson, 1997). Obesity rates, on the other hand, have climbed dramatically during the past 30 years. To put the increase in perspective, the median male in 2002 would have been heavier than 75 percent of the male population in 1976, using a body mass index (BMI) distribution.

There are a number of reasons that increases in obesity might be linked to decreases in employment. Increases in obesity might affect the ability to work--for example, obese people are more likely than others to have health problems--or the willingness to work, depending on the availability of alternatives to working. We call these "supply side" factors--those factors that affect whether or not an individual is willing and able to take a job. There may also be "demand side" factors at play. If employers think that obese workers are likely to be less productive or likely to be more expensive to employ because of health care costs, then obese workers may have a more difficult time finding a job than similarly qualified workers who are not obese.

In this article, we examine both self-reported health and disability outcomes and employment outcomes to try to distinguish between supply side and demand side explanations. If, for example, there is no change in the relationship between obesity and health outcomes, but there is a change in the relationship between obesity and employment outcomes, that would suggest that demand side factors might play an important role in non-employment among the obese.

We are also interested in whether the changes we observe over time in health and employment outcomes are due to changes in the underlying population characteristics, such as a rising incidence of obesity, or due to an increase in the differences in outcomes between the obese and the nonobese. For example, if in every period the obese are more likely to be in poor health than the nonobese, then an increase in the proportion of the population that is obese will likely lead to a larger proportion of the population that does not work. On the other hand, the propensity to report poor health, disability, or non-employment among the obese compared with the nonobese may also have changed over time. This change in propensities may be due to either supply side or demand side factors that are shaped by changes in health policies and/or labor market policies. For example, in 1984 there was a substantial change in disability insurance (SSDI) criteria that may have made it more likely that someone with obesity-related health conditions could qualify for SSDI. This change, combined with subsequent changes in the wage structure that made SSDI benefits more generous relative to low-wage jobs, may have made some obese people more likely to opt out of the labor market. Thus, an increase in the number of obese people in the population would have a different effect on outcomes, depending on the period in which the change is evaluated.


We find that, although those who are heavier have always had worse self-reported health outcomes and employment outcomes, there is not much evidence that the propensity for the obese to have poor outcomes has changed over time. …

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