Because the public and private sectors often operate with different goals, individuals employed by the two sectors may receive different levels of welfare. This can potentially lead to different health status. As such, employment sector offers an important perspective for understanding labor market outcomes. Using micro-level data from a recent Chinese household survey, this study empirically evaluated the impact of employment sector on health and within-sector health inequalities. It found that public sector employment generated better health outcomes than private sector employment, controlling for individual characteristics. The provision of more job security explained an important part of the association between public sector employment and better health. The study also found less health inequality by social class within the public sector. These findings suggest that policymakers should think critically about the “conventional wisdom” that private ownership is almost always superior, and should adjust their labor market policies accordingly.
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References
1.
HyderA., and ReillyB.The public and private sector pay gap in Pakistan: A quantile regression analysis. Pakistan Dev. Rev.44: 271–306, 2005.
2.
DisneyR., and GoslingA.Does it pay to work in the public sector?Fiscal Stud. 19: 347–374, 1998.
3.
BorlandJ.HirschbergJ., and LyeJ.Earnings of public sector and private sector employees in Australia: Is there a difference?Econ. Record.74: 36–53, 1998.
4.
Postel-VinayF., and TuronH.The public pay gap in Britain: Small differences that (don't?) matter. Econ. J.117: 1460–1503, 2007.
5.
LuciforaC., and MeursD.The public sector pay gap in France, Great Britain and Italy. Rev. Income Wealth52: 43–59, 2006.
6.
GornickJ. C., and JacobsJ. A.Gender, the welfare state, and public employment: A comparative study of seven industrialized countries. Am. Sociol. Rev.63: 688–710, 1998.
7.
FreemanR. B.Contraction and expansion: The divergence of private sector and public sector unionism in the United States. J. Econ. Perspect.2: 63–88, 1988.
8.
BlochF. E., and SmithS. P.Human capital and labor market employment: Errata and extension. J. Hum. Resour.14: 267–269, 1979.
9.
HallR. E.GordonA., and HoltC.Turnover in the labor force. Brookings Papers on Economic Activity3: 709–764, 1972.
10.
DeSantisV. S., and DurstS. L.Comparing job satisfaction among public- and private-sector employees. Am. Rev. Public Adm. 26: 327–343, 1996.
11.
DemoussisM., and GiannakopoulosN.Exploring job satisfaction in private and public employment: Empirical evidence from Greece. Labour21: 333–359, 2007.
12.
Jiménez-MartínS.LabeagaJ. M., and Martínez-GranadoM.An empirical analysis of the demand for physician services across the European Union. Eur. J. Health Econ. 5: 150–165, 2004.
13.
HendersonG.Equity and the utilization of health services: Report of an eight-province survey in China. Soc. Sci. Med.39: 687–699, 1994.
14.
ChenM., and ChanA.Occupational health and safety in China: The case of state-managed enterprises. Int. J. Health Serv. 40: 43–60, 2010.
15.
SolingerD. J.Job categories and employment channels among the “floating population.” In Adjusting to Capitalism: Chinese Workers and the State, ed. O'LearyG., pp. 3–47. M. E. Sharpe, Armonk, NY, 1998.
16.
WestonT. B., and JensenL. M. (eds.). China beyond the Headlines. Rowman & Littlefield, Lanham, MD, 2000.
17.
TsuiA. S.BianY., and ChengL. (eds). China's Domestic Private Firms: Multidisciplinary Perspectives on Management and Performance. M. E. Sharpe, Armonk, NY, 2006.
18.
BrennerM. H., and MooneyA.Unemployment and health in the context of economic change. Soc. Sci. Med.17: 1125–1138, 1983.
19.
RuhmC. J.Healthy living in hard times. J. Health Econ. 24: 341–363, 2005.
20.
HammarströmA., and JanlertU.An agenda for unemployment research: A challenge for public health. Int. J. Health Serv. 35: 765–777, 2005.
21.
ScheidT. L.An investigation of work and unemployment among psychiatric clients. Int. J. Health Serv. 23: 763–782, 1993.
22.
JinR. L.ShahC. P., and SvobodaT. J.The impact of unemployment on health: A review of the evidence. CMAJ153: 529–540, 1995.
23.
SchmitzH.Why are the unemployed in worse health? The causal effect of unemployment on health. Labour Econ. 18: 71–78, 2010.
24.
BlakelyT.Unemployment and mortality: Learning from the past in times of resurging unemployment. J. Epidemiol. Community Health64: 3–4, 2010.
25.
GiattiL.BarretoS. M., and CésarC. C.Household context and self-rated health: The effect of unemployment and informal work. J. Epidemiol. Community Health62: 1079–1085, 2008.
26.
LudermirA. B., and LewisG.Informal work and common mental disorders. Soc. Psychiatry Psychiatr. Epidemiol.38: 485–489, 2003.
27.
SantanaV. S., and LoomisD.Informal jobs and non-fatal occupational injuries. Ann. Occup. Hyg.48: 147–157, 2004.
28.
GiattiL.BarretoS. M., and CésarC. C.Household context and self-rated health: The effect of unemployment and informal work. BMJ62: 1079–1085, 2008.
29.
VirtanenP.The working conditions and health of non-permanent employees: Are there differences between private and public labour markets?Econ. Ind. Democracy.27: 39–65, 2006.
30.
VirtanenM.Temporary employment and health: A review. Int. J. Epidemiol.34: 610–622, 2005.
31.
BenachJ.A new occupational health agenda for a new work environment. Scand. J. Work Environ. Health.28: 191–196, 2002.
32.
SillaI.GraciaF. J., and PeiróJ. M.Job insecurity and health-related outcomes among different types of temporary workers. Econ. Ind. Democracy.26: 89–117, 2005.
33.
GuestD.Flexible employment contracts, the psychological contract and employee outcomes: An analysis and review of the evidence. Int. J. Manage. Rev.5: 1–19, 2004.
34.
RichardsonD.Fatal agricultural injuries in North Carolina by race and occupation, 1977–1991. Am. J. Ind. Med.31: 452–458, 1997.
35.
LoomisD. P., and WolfS. H.Mortality of workers at a nuclear materials production plant at Oak Ridge, Tennessee, 1947–1990. Am. J. Ind. Med.29: 131–141, 1996.
36.
RobinsonJ. C.Trends in racial inequality and exposure to work-related hazards, 1968–1986. Milbank Q.65: 404–420, 1987.
37.
QuinlanM.MayhewC., and BohleP.The global expansion of precarious employment, work disorganization, and consequences for occupational health: A review of recent research. Int. J. Health Serv. 31: 335–414, 2001.
38.
BenachJ., and MuntanerC.Precarious employment and health: Developing a research agenda. BMJ61: 276–277, 2007.
39.
SverkeM.HellgrenJ., and NäswallK.No security: A meta-analysis and review of job insecurity and its consequences. J. Occup. Health Psychol. 7: 242–264, 2002.
40.
RobinsonJ. C.The rising long-term trend in occupational injury rates. Am. J. Public Health78: 276–281, 1988.
41.
LoomisD.Political economy of US states and rates of fatal occupational injury. Am. J. Public Health99: 1400–1408, 2009.
42.
MorseT.The relationship of unions to prevalence and claim filing for work-related upper-extremity musculoskeletal disorders. Am. J. Ind. Med.44: 83–93, 2003.
43.
TrinkoffA. M.Staffing and worker injury in nursing homes. Am. J. Public Health95: 1220–1225, 2005.
44.
MuntanerC.Work or place? Assessing the concurrent effects of workplace exploitation and area-of-residence economic inequality on individual health. Int. J. Health Serv. 41: 27–50, 2011.
45.
BenachJ.Introduction to the WHO Commission on Social Determinants of Health Employment Conditions Network (EMCONET) study, with a glossary on employment relations. Int. J. Health Serv. 40: 195–207, 2010.
46.
LipscombH. J.A conceptual model of work and health disparities in the United States. Int. J. Health Serv. 36: 25–50, 2006.
47.
BenachJ.Methods for the study of employment relations and health inequalities in a global context. Int. J. Health Serv. 40: 209–213, 2010.
48.
MuntanerC.A macro-level model of employment relations and health inequalities. Int. J. Health Serv. 40: 215–221, 2010.
49.
BenachJ.A micro-level model of employment relations and health inequalities. Int. J. Health Serv. 40: 223–227, 2010.
50.
ChungH.MuntanerC., and BenachJ.Employment relations and global health: A typological study of world labor markets. Int. J. Health Serv. 40: 229–253, 2010.
51.
KimI. H.Case studies on employment-related health inequalities in countries representing different types of labor markets. Int. J. Health Serv. 40: 255–267, 2010.
52.
BenachJ.Six employment conditions and health inequalities: A descriptive overview. Int. J. Health Serv. 40: 269–280, 2010.
53.
MuntanerC.Unemployment, informal work, precarious employment, child labor, slavery, and health inequalities: Pathways and mechanisms. Int. J. Health Serv. 40: 281–295, 2010.
54.
QuinlanM.Policies and interventions on employment relations and health inequalities. Int. J. Health Serv. 40: 297–307, 2010.
55.
MuntanerC.The solution space: Developing research and policy agendas to eliminate employment-related health inequalities. Int. J. Health Serv. 40: 309–314, 2010.
56.
BenachJ.Conclusions and recommendations for the study of employment relations and health inequalities. Int. J. Health Serv. 40: 315–322, 2010.
57.
WrightE. O.Classes. Verso, London, 1985.
58.
ChenM., and ChanA.Employee and union inputs into occupational health and safety measures in Chinese factories. Soc. Sci. Med.58: 1231–1245, 2004.
59.
SuZ.Occupational health and safety legislation and implementation in China. Int. J. Occup. Environ. Health.9: 302–308, 2003.
60.
ChanA., and ZhuX.Disciplinary labor regimes in Chinese factories. Crit. Asian Stud. 35: 559–584, 2003.
61.
ChenL., and HouB.The employment flexibility and security under the context of globalization in China. In Globalization and Changes in Employment Conditions in Asia and the Pacific, ed. LeeS. and HurJ., pp. 217–272. Korea Labor Institute, Seoul, 2007.
62.
KaplanG. A., and CamachoT.Perceived health and mortality: A nine-year follow-up of the human population laboratory cohort. Am. J. Epidemiol.117: 292–304, 1983.
63.
StrawbridgeW. J., and WallhagenM. I.Self-rated health and mortality over three decades: Results from a time-dependent covariate analysis. Res. Aging.21: 402–416, 1999.
64.
JylhäM.VolpatoS., and GuralnikJ. M.Self-rated health showed a graded association with frequently used biomarkers in a large population sample. J. Clin. Epidemiol.59: 465–471, 2006.
65.
CumminsS.Neighbourhood environment and its association with self rated health: Evidence from Scotland and England. J. Epidemiol. Community Health59: 207–213, 2005.
66.
CummingsJ. R.RiceT., and HanochY.Who thinks that part D is too complicated? Survey results on the Medicare prescription drug benefit. Med. Care Res. Rev.66: 97–115, 2009.
67.
LuoY., and WenM.Can we afford better health? A study of the health differentials in China. Health6: 471–500, 2002.
68.
HouseJ. S.Excess mortality among urban residents: How much, for whom, and why?Am. J. Public Health90: 1898–1904, 2000.
69.
HeywoodJ. S., and GreenC.Performance Pay, Sorting, and the Dimensions of Job Satisfaction. Working Papers No. 4731. Lancaster University Management School, Economics Department, Lancaster, UK, 2007.
70.
ForthJ.BewleyH., and BrysonA.Small and Medium-Sized Enterprises: Findings from the 2004 Workplace Employee Relations Survey. Report to the Department of Trade and Industry. London, 2006.
71.
TsaiC. J.SenguptaS., and EdwardsP.When and why is small beautiful? The experience of work in the small firm. Hum. Relations.60: 1779–1807, 2007.
72.
FaragherE. B.CassM., and CooperC. L.The relationship between job satisfaction and health: A meta-analysis. Occup. Environ. Med.62: 105–112, 2005.
73.
De WitteH.Job insecurity and psychological well-being: Review of the literature and exploration of some unresolved issues. Eur. J. Work Organ. Psychol.8: 155–177, 1999.
74.
ZhaoZ.Health demand and health determinants in China. J. Chinese Econ. Business Stud. 6: 77–98, 2008.
75.
LiangK.Rural-Urban Differences in the Shape of the Socioeconomic Gradients in Health in China. Paper presented at the American Sociological Association Annual Meeting, Boston, 2008.
76.
NavarroV.Inequalities are unhealthy. Monthly Rev. 56: 26–30, 2004.
77.
MarmotM. G.The Status Syndrome: How Social Standing Affects Our Health and Longevity. Times Books/Henry Holt, New York, 2004.
78.
KawachiI.KennedyB. P., and WilkinsonR. G.The Society and Population Health Reader: Income Inequality and Health. New Press, New York, 1999.
79.
TangM.ChenY., and KrewskiD.Gender-related differences in the association between socioeconomic status and self-reported diabetes. Int. J. Epidemiol.32: 381–385, 2003.
80.
RathmannW.Sex differences in the associations of socioeconomic status with undiagnosed diabetes mellitus and impaired glucose tolerance in the elderly population: The KORA Survey 2000. Eur. J. Public Health15: 627–633, 2005.
81.
MutchlerJ. E., and BurrJ. A.Racial differences in health and health care service utilization in later life: The effect of socioeconomic status. J. Health Soc. Behav.32: 342–356, 1991.
82.
VukoviæD.BjegoviæV., and VukoviæG.Prevalence of chronic diseases according to socioeconomic status measured by wealth index: Health survey in Serbia. Croat. Med. J.49: 832–841, 2008.
83.
ZimmerZ., and KwongJ.Socioeconomic status and health among older adults in rural and urban China. J. Aging Health16: 44–70, 2004.
84.
ZimmerZ.How indicators of socioeconomic status relate to physical functioning of older adults in three Asian societies. Res. Aging.26: 224–258, 2004.
85.
SantosA. C.EbrahimS., and BarrosH.Gender, socio-economic status and metabolic syndrome in middle-aged and old adults. BMC Public Health8: 62, 2008.
86.
WangY.Cross-national comparison of childhood obesity: The epidemic and the relationship between obesity and socioeconomic status. Int. J. Epidemiol.30: 1129–1136, 2001.
87.
SubramanianS. V., and SmithG. D.Patterns, distribution, and determinants of under- and overnutrition: A population-based study of women in India. Am. J. Clin. Nutr.84: 633–640, 2006.
88.
FernaldL. C. H.Socio-economic status and body mass index in low-income Mexican adults. Soc. Sci. Med.64: 2030–2042, 2007.
89.
MonteiroC. A.Obesity and inequities in health in the developing world. Int. J. Obes.28: 1181–1186, 2004.
90.
FernaldL., and AdlerN.Blood pressure and socioeconomic status in low-income women in Mexico: Areverse gradient?J. Epidemiol. Community Health62: e8, 2008.
91.
BravemanP. A.Socioeconomic status in health research: One size does not fit all. JAMA294: 2879–2888, 2005.
92.
KaplanG. A., and KeilJ. E.Socioeconomic factors and cardiovascular disease: A review of the literature. Circulation88: 1973–1998, 1993.
93.
HendersonG.Trends in health services utilization in eight provinces in China, 1989–1993. Soc. Sci. Med.47: 1957–1971, 1998.
94.
WagstaffA., and LindelowM.Can insurance increase financial risk?: The curious case of health insurance in China. J. Health Econ. 27: 990–1005, 2008.
95.
RosenbaumP. R., and RubinD. B.The central role of the propensity score in observational studies for causal effects. Biometrika70: 41–55, 1983.
