The Impact of Mental Problems on Mortality and How it is Moderated by Education

50 Pages Posted: 2 Jul 2018

See all articles by Govert E. Bijwaard

Govert E. Bijwaard

Netherlands Interdisciplinary Demographic Institute (NIDI); IZA Institute of Labor Economics

Mikko Myrskylä

London School of Economics & Political Science (LSE)

Per Tynelius

Karolinska Institutet

Abstract

Mental disorders have a large impact on invalidity and mortality. Poor mental health is associated with low education, which is also associated with poor health and higher mortality. The association between mental health and mortality may, therefore, be partly explained by the increased incidence of mental problems of the low educated. An important issue is that mental health problems, education attainment and mortality may all depend on the same observed and unobserved individual factors. We account for both the selective incidence of mental health problems and selective educational attainment by using a correlated multistate model for the mental health (hospitalization) process (both admittance an discharge) and mortality with a re-weighting technique (inverse propensity weighting) based on the probability to attain higher education. We use Swedish Military Conscription Data (1951-1960), linked to the administrative Swedish death and National Hospital Discharge registers. We estimate the effect of mental hospitalization and education on the morality rate and how the effect of mental hospitalization is moderated by education. Our empirical results indicate a strong effect of both mental hospitalization and education on mortality. Mental hospitalization affects mortality due to external causes of death in particular. Only for the low educated improving education moderates the impact of mental hospitalization on mortality. We also found that ignoring confounding would overestimate the impact of mental hospitalization on mortality. Accounting for confounding in mental hospitalization seems to be more important than accounting for selective educational attainment.

Keywords: mental health, education, mortality, timing-of-events, inverse propensity weighting

JEL Classification: C41, I14, I24

Suggested Citation

Bijwaard, Govert and Myrskylä, Mikko and Tynelius, Per, The Impact of Mental Problems on Mortality and How it is Moderated by Education. IZA Discussion Paper No. 11591, Available at SSRN: https://ssrn.com/abstract=3205878 or http://dx.doi.org/10.2139/ssrn.3205878

Govert Bijwaard (Contact Author)

Netherlands Interdisciplinary Demographic Institute (NIDI) ( email )

P.O. Box 11650
NL-2502 AR The Hague
Netherlands
+31 70 3565224 (Phone)

IZA Institute of Labor Economics

P.O. Box 7240
Bonn, D-53072
Germany

Mikko Myrskylä

London School of Economics & Political Science (LSE) ( email )

Houghton Street
London, WC2A 2AE
United Kingdom

Per Tynelius

Karolinska Institutet ( email )

Granits väg 4
Section for Integrative Physiology
Solna, 17171
Sweden

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