Work Disability, Work,
and Justification
Bias in Europe and the US
Arie Kapteyn (RAND)
James P. Smith (RAND)
Arthur van Soest (Netspar, Tilburg University,
RAND)
Motivation
 Labor force participation of older workers is policy
relevant
 Health is a main reason for not participating
 Self-reported work disability is a summary measure
of work-related health…
 But has problems:
 Comparability across countries
 Justification bias
 Anchoring vignettes can be used to tackle these
problems
Washington 2 8/11/09
Self report of work disability
“Do you have any impairment or health problem that
limits the kind or amount of work you can do?”
Response categories:
1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot Do
Washington 3 8/11/09
Vignettes
Example (affect):
Henriette generally enjoys her work. She gets depressed
every 3 weeks for a day or two and loses interest in
what she usually enjoys but is able to carry on with
her day-to-day activities on the job.
Does Henriette have any impairment or health problem
that limits the kind or amount of work she can do?”
None, Mild, Moderate, Severe, or Extreme/Cannot Do?
Washington 4 8/11/09
More examples
Pain Vignette:
Catherine suffers from back pain that causes stiffness in
her back especially at work but is relieved with low
doses of medication. She does not have any pains
other than this generalized discomfort.
Cardio Vascular Disease Vignette:
Norbert has had heart problems in the past and he has
been told to watch his cholesterol level. Sometimes if
he feels stressed at work he feels pain in his chest
and occasionally in his arms.
We work with nine vignettes: three on pain, three on
affect, three on CVD
Washington 5 8/11/09
How Do Vignettes Work?
None
John 1
Mary 1
Resp. 1
Liam 1
Extreme
Washington 6 8/11/09
How Do Vignettes Work: Differential Item
Functioning (DIF)
None
None
John 1
Mary 1
Resp. 1
John 2
Resp. 2
Liam 1
Extreme
Mary 2
Liam 2
Extreme
Washington 7 8/11/09
How Do Vignettes Work: Adjusting for DIF
None
None
None
John 1
John 2
Resp. 2
Mary 1
Mary 2
Resp. 1
John 2
Resp. 2
Liam 1
Extreme
Extreme
Mary 2
Liam 2
Liam 2
Extreme
Washington 8 8/11/09
The data
For a subset of countries that agreed to participate,
SHARE wave 1 in 2004 included a set of vignette
questions on general health status and on work limiting
disabilities as part of a drop-off questionnaire for a
random subsample of the 50+ population.
The eight SHARE countries that agreed to participate in
the drop-off containing vignette questions were
Germany, France, Spain, Belgium, Greece, Italy, the
Netherlands, and Sweden.
HRS 2004 administered the same vignettes, in an
experimental module administered to a random
subsample of the 50+ population in the US
Washington 9 8/11/09
Example: pain vignette 1 [Catherine]
100%
80%
extreme
severe
60%
moderate
mild
40%
none
20%
US
To
ta
lE
U
um
be
lg
i
fra
nc
e
n
sw
ed
e
ne
th
er
la
n
it a
ly
gr
ee
ce
sp
ai
n
ge
rm
an
y
0%
Washington 10 8/11/09
We can combine the responses to the
vignettes and rank countries by “toughness”
Grand Average Rank
9
8
7
6
5
Grand Average Rank
4
3
2
1
sp
ai
n
n
sw
ed
e
gr
ee
ce
an
y
ge
rm
fra
nc
e
um
be
lg
i
ne
th
er
la
nd
s
it a
ly
US
0
Washington 11 8/11/09
Toughness and the law
The OECD has constructed various measures of
employment protection by country.
We have calculated the correlation between “toughness”
and some employment protection measures.
We find correlations between .52 and .56
Washington 12 8/11/09
We estimate a model explaining work disability from
demographics and health conditions, and using
vignettes to correct for response scale differences
We find that:
 Work disability increases with age and with the
presence of health conditions; the latter have a
stronger effect in Europe than in the US
 Work disability is more prevalent among lower
education groups in the US, but that is much less the
case in Europe
 Prevalence of work disability is about equal in the US
and in Europe, however that is the result of two
opposing factors:
Washington 13 8/11/09
Why is work disability the same?
 US: more health conditions
 EU: stronger effect of health conditions on work
disability
However, if we were to give Europeans US scales, then
the percent reporting none or only mild limitations would
increase from 50% to 80%.
Washington 14 8/11/09
Work Disability and Employment
Washington 15 8/11/09
Estimation results
There is evidence of justification bias in the US, but not
in the EU (non-working Americans use “softer” scales
than working Americans).
Work disability has a substantially stronger effect on the
probability of employment in the US than in Europe
(interpretation: also without health limitations,
Europeans over 50 are much less likely to be working
than in the US).
Washington 16 8/11/09
Example
Employment and disability
70.0%
60.0%
50.0%
40.0%
EU-data EU-dis US-work US-scale
30.0%
EU-data EU-dis EU-work US-scale
20.0%
10.0%
0.0%
None
Mild
Moderate
Severe
Extreme
Only the employment equation is different.
When disabilities get severe, they reduce
Employment about equally on both continents
Washington 17 8/11/09
Conclusions
Norms about what constitutes a work disability vary
considerably across countries
Norms appear consistent with legal employment
protection
Differences in self-reports are at least partly a
reflection of social norms, rather than of “true”
disability differences
The relation between work disability and work is
much stronger in the US than in the EU
Washington 18 8/11/09