Applied Economics, 1983, 15, 715-729

Health and youth employment

DA VID LYNN PASSMORE, UNAL A Y, SHERYL ROCKEL,
BARBARA WADE and JAMES WISE
The Pennsylvania State University, University Park, Pennsylvania, USA

The employment of 6.4 %ofUnited States teenagers and young adults is limited by their health.
These young people are less likely to have jobs than youths without health problems. Also, they
work fewer hours per week than the youth average, although they earn as much per hour as
youths without health limitations. The differences in satisfaction and prestige that youths enjoy
from their jobs are not related to the presence of health conditions. Youths who reported health
conditions lasting their entire lives are more likely to have jobs than young people recently
acquiring their conditions. These relationships are derived from analyses of responses of 11 412
civilian noninstitutionalized youths to the 1979 Youth Survey of the National Longitudinal
Surveys of Labor Force Behavior.

1. INTRODUCTION

The education and employment needs of handicapped and disabled people received con-
siderable attention from legislators and policy-makers in the United States during the 1960s and
1970s. For instance, the Education Amendments of 1976 (Public Law 94-482) earmark 10 %of
the allotment of federal money for vocational education to pay for 50 %of the costs of training
handicapped students. Affirmative action in employment of handicapped people is emphasized
in the Rehabilitation Act of 1973 (Public Law 93-112, Section 503). Amendments to the 1973
Act provide incentives for employers to train and to hire disabled people. President Kennedy
established the President's Committee on Employment of the Handicapped in 1962, extending
presidential efforts since the mid-1940s to highlight employment needs of handicapped
Americans.
Although much of this attention centres on education and employment of handicapped and
disabled young people, systematic and comprehensive estimates of the influence of health
conditions on youth employment are not available to guide policy-making and legislation.
Previous studies focused on adults (e.g., Levitan and Taggart, 1977; Wolfe, 1980) and on
disabilities that are defined strictly for determining who receives Social Security Disability
Insurance benefits in the United States (e.g., Berkowitz et aI., 1976). Moreover, data that address
health and employment simultaneously are scarce (Rones, 1981, footnote 2).
In this paper we report a study of the relationships between employment and the incidence,
type and duration of health conditions that limit work of young people. Our data are from a
0003-6846j83 $03.00 + .12 © 1983 Chapman and Hall Ltd. 715
716 David Lynn Passmore, Unal Ay, Sheryl Rockel, Barbara Wade and James Wise

1979 survey of a sample of teenagers and young adults in the United States. Labour force data,
demographic characteristics and health information are merged in this survey. In addition, the
definition of health applied in this survey is broader than the Social Security definition of
disability. Acute and chronic health conditions are included as well as a variety of conditions
that affect employment, such as pregnancy.
In brief, we find that 6.4 % of youths in the United States believed during 1979 that their
health limited the amount or kind of work they could do. These youths are less likely to
participate in the labour force and to be employed than youths without health problems.
However, perceived health status is not related to job satisfaction, occupational prestige or
hourly rate of pay among employed youths. Employed youths with health problems work fewer
hours each week than the working youth average.
In the next section of this paper we describe the target population, sample, variables and
analyses used in this study. Then, results of our analyses are tabulated and discussed. Also, there
is a brief statistical appendix that follows the summary and reference citations.

II. METHOD

Target population and sample

We analyse data collected by the 1979 Youth Survey of the National Longitudinal Surveys of
Labor Force Behavior that was administered by the National Opinion Research Center at the
University of Chicago and the Center for Human Resource Research at The Ohio State
University (Borus et al., 1980, 'Questionnaire', p. 395 if). The data represent civilian
non institutionalized youths in the continental United States. These young people were 16 to 21
years old in January 1979.
Two multi-stage probability samples cover the youth population through a cross-sectional
sample and a supplemental sample (Borus et ai., 1980, Appendix A). The cross-sectional sample
yields an equal number of males and females who represent various racial, ethnic and income
groups in their proper population proportions. Proportional samples often contain inadequate
numbers of minority group members for analysis. The supplemental sample produces
additional Hispanics, Blacks and poor non-Hispanics and non-Blacks.
The full sample contains 1269314- to 21-year-olds. However, we analyse data from 1141216-
to 21-year-olds who are not enrolled in the active armed forces. We estimate population values
by multiplying each survey response by a unique number called a sampling weight. This weight
reflects the probability of being included in the sample. In addition, it corrects oversampling of
minorities, biases in sampling and inconsistencies with independent census population counts
(Borus et al., 1980, pp. 387-92). As a result, sample members' data are adjusted to represent
members of the youth population.
Estimates of error and bias created by this sampling scheme are unavailable currently
However, for at least two reasons employment estimates from the 1979 Youth Survey may differ
from estimates from the Current Population Survey (CPS) (US Department of Commerce,
1978), the source of the United States government's monthly labour force data. First, the CPS
uses, when necesSary, proxy respondents (sister ... granny ... a responsible adult) even though I
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Health and youth employment 717

they might be unable to recall or report accurately a youth's employment activity (see Borus et
al., 1978 for evidence of the effects of different respondents on labour force data). Second, the
1979 Youth Survey was administered from January to August 1979, a period of varying
employment conditions. The CPS refers to employment activity during the wee..k containing the
19th day ofany month. In addition, the 1979 Youth Survey, by omitting institutionalized youths
(as does the CPS), probably underestimates the number of youths with health problems who
neither work nor look for work.

Variables
Criterion variables. We examine six aspects of youth employment: labour force status;
weekly hours worked; incidence of employment; job satisfaction; occupational prestige; and
hourly rate of pay.
The definition of labour force status we apply is also used in the CPS, the United States
Census of the Population and Housing, and many American government and private statistical
operations. Youths are classified as employed, unemployed, or out of the labour force.
Employed youths worked for pay at least one hour, or worked unpaid for at least 15 hours in a
family business, during the week prior to the administration of the 1979 Youth Survey.
Unemployed youths did not hold jobs, but they made specific attempts to find work during four
weeks before the survey. Youths out of the labour force were neither employed nor unemployed.
The labour force participation rate equals the number of 16- to 21-year-olds employed and
unemployed (called the youth labour force) divided by the number of civilian non-
institutionalized youths. The employment-population ratio equals the number employed
divided by the number in the population. The unemployment rate represents the percentage of
unemployed youths in the youth labour force.
Weekly hours worked represents the number of hours youths work at all jobs during the
week. Values for this variable include zero hours for youths who are not working. The incidence
of employment indicates whether youths are employed during the week. These variables, and
those remaining to be described, are analysed only for youths not enrolled in school. This
restriction on the sample eliminates youths who are unavailable for serious commitment to
work.
Job satisfaction is defined as a simple sum of responses to ten 1979 Youth Survey items. These
items contain statements about job advancement opportunities, safety, environment, pay,
security, co-workers and supervision. Youths rate these statements using a four-point scale
(4 = statement very true; 3 = somewhat true; 2 = not too true; 1 = not true at all).
Occupational prestige is determined by assigning values of the Duncan Occupational Status
Index (Duncan, 1961) to occupations in which youths are employed. This index is a weighted
combination of median income, median educational attainment, and the percentage of females
in each of the occupations listed in the United States Census occupational classification system.
The Duncan Index is stable over time (Hodge et al., 1966) and settings (Siegel, 1970).
Youths' before-tax pay (by day, week, month, year) is converted to cents received per hour.
Youths paid less than 50 cents or more than $15 per hour are excluded from our analyses.
Predictor variables. We study relationships between aspects of youth employment and the
incidence, type and duration of health limitations to work. Many variables are related to youth
718 David Lynn Passmore, Unal Ay, Sheryl Rockel, Barbara Wade and James Wise

employability in addition to health. We apply some ofthese variables as controls to obtain better
estimates of the net relationship between youth employment and reported health. These
controls include gender, ethnic origin, age, marital status, high school completion, responsibility
for the support of dependents, location of current residence and the local unemployment rate.
Definitions of control variables appear in tables that contain the results of our study.
The incidence of health limitations to work is measured by youths' reports of whether their
health limits the amount or kind of their employment. Alternate measurement methods could
lead to different assessments of these limitations. For instance, medical examinations are not
used to corroborate these self-reports, as done in the 1971-74 Health and Nutrition Surveys
conducted by the United States Center for Health Statistics (see Rones, 1981, footnote 2). Wolfe
(1981) observed, though, that medical evaluations do not necessarily reduce uncertainty about
whether functional work limitations are caused by health (see Haber (1967) for a review of these
measurement problems). At best, the measure of health obtained for our study represents beliefs
about the effects of conditions on employment; at worst, it may represent a lame excuse for a
poor work history.
The availability of data from only a small number of youths in the sample with health
conditions that affect work prevents employment comparisons among detailed categories of
health conditions. Conditions cited include, among others, acne, asthma, fractured bones,
circulatory problems, cancer and pregnancy. These types of health conditions are classified
under three variables. One variable represents whether the health limitation is due to a
pregnancy or a normal delivery. Another variable denotes that an accident or injury caused the
health limitation. The third variable shows that the health limitation is a developmental
disability or disease.
The duration of the health condition in months measures the persistence of the health
condition. On the one hand, long durations may indicate reduced opportunities for creating,
maintaining or improving job knowledge, skills and attitudes. On the other hand, young people
with long durations may have opportunities to adjust psychologically, medically and
occupationally to their conditions. Previous research is unavailable which might enable us to
determine the expected direction of the relationship between the duration measure and youth
employment.

Analyses
We apply in our analyses simple tabulation and varieties of multiple regression. Not only do
regression equations include health limitation variables, but also control variables are entered in
equations to allow estimation of net relationships between criterion variables and health
limitation variables.
Labour force status is cross-tabulated by the incidence of health limitations to work. Job
satisfaction, occupational prestige and hourly rate of pay are related to incidence of health
limitations and control variables by using ordinary least squares regression methods. Actually,
the natural logarithm of hourly rate of pay is the criterion variable specified, but results are
expressed iIi cents per hour.
Zero weekly hours are recorded for 31 % of the youths in the sample because they are not
working. Tobit ·regression methods (Tobin, 1958) are applied to examine the relationships
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 Health and youth employment 719
between the weekly hours worked, the incidence of health limitations and the control variables.
Tobit methods are appropriate when cases are clustered at some limiting value on the criterion
variable. The Tobit regression coefficient is parsed in two ways: first, if health limitations are
reported, the probability of working is computed; second, for working youths, the change in
weekly hours worked associated with; the incidence of health limitations is calculated. A
statistical appendix to this paper displays the mathematics of this decomposition of the Tobit
regression coefficient.
The probability of working is decomposed further by relating the incidence ofemployment to
types of health limitations and control variables by using logistic regression methods (Amemiya,
1981, p. 1486). These methods are appropriate when a categorical criterion variable is analysed.
Predicted values from the logistic equation are restricted within the range zero to + 1, which is a
convenient property for expressing the probability of working as a function of types of health
limitations to work.
Using logistic regression methods, relationships are examined among the incidence of
employment, control variables and the duration of the health limitation in months. Youths
experiencing their health condition their entire lives are assigned the highest value for the
duration variable.

III. RESULTS

Labour force status

As shown in Table 1, 6.4 %of youths in the United States believed during 1979 that their health
limited the amount or kind of work they could do. Youths with health limitations to work
participate in the labour force about 16 % less frequently than other young people. Their
employment-population ratio is about 17 %lower, and their unemployment rate is 7.5 %higher.

Weekly hours worked

Table 2 contains regression coefficient estimates from a T.obit analysis of weekly hours worked,
incidence of health limitations and control variables. The directions of the signs of the control
variables' coefficients are consistent with previous research on youth labour markets. The
coefficient for the health limitation variable differs statistically from zero and is negative.
Using mathematics developed in the statistical appendix to this paper, the health limitation
variable is divided into two pieces of information. First, the probability of being employed (that
is, of having worked any hours) for youths reporting limitations is 20% lower than for those
without health limitations to work. Among youths employed and not in school, health
limitations are associated with 14.27 fewer work hours during the week pt:eceding the
administration of the 1979 Youth Survey.

Incidence of employment
By type of health limitation. The Tobit analysis of hours worked reveals that young people
with health limitations have a lower probability of being employed. Also shown in Table 2 are

1.
720 David Lynn Passmore, Unal Ay, Sheryl Rockel, Barbara Wade and James Wise
Table 1. Labour force status by incidence of health limitations to work, reported by civilian
noninstitutionalized 16-21·year-olds during 1979 (numbers in thousands)

Reported health limits to work

Status Total Yes No

Population 25550 1634 23916

In the labour force 18234 920 17314
Laboqr force participation rate [(In
the labour force/population) x 100J 71.4% 56.3% 72.4%
Employed 14854 682 14172
Employment-population ratio
(employed/population) 0.581 0.417 0.592
Unemployed 3380 238 3142
Unemployment rate
[(Unemployed/in the labour force)
x l00J 18.5% 25.9% 18.1 %
Out of the labour force 7316 714 6602

Source: Estimated from responses to the 1979 Youth Survey of the National Longitudinal
Surveys of Labor Force Behavior by a multi-stage probability sample of 11 412 youths from the
civilian noninstitutional population of the continental United States between 16 and 21 years
old in January 1979.

Table 2. Relationships ofweekly hours worked and incidence ofemployment to incidence and type ofhealth
limitations to work and characteristics ofcivilian noninstitutionalized 16-21-year-olds not enroned in school
during 1979 (N = 3619)

Incidence of employment

Tobit
regression q
Estimate of coefficient Logistic "1
j
population for weekly regression Chances of employment
mean hours worked coefficient associated with '1

(standard characteristic, holding ,j

(standard (standard
Characteristic deviation) . error) error) others constant at mean a .~
~
t

Health status
Health limit due to 0.03 -1.87
I
l

pregnancy or delivery
Health limit due to
(0.17)
0.02
(0.28)
-0.36
Than
those
f9 of 100 less ~
:!

accident or injury (0.14) (0.27) without 8 of 100 less ~

Health limit due to 0.04 -0.60 health i
disease or develop- (0.20) (0.19) limits 13 of 100 less
mental disability t
Total

Any health limit ~

to work .
0.09
(0.29)
0.09
(0.29)
-18.06
(0.07)
Il
No health limit 0.91 rc rc rc
to work (0.29)
 Health and youth employment 721

Table 2. (Cont.)

Incidence of employment
Tobit
regression
Estimate of coefficient Logistic
population for weekly regression Chances of employment
mean hours worked coefficient associated with
(standard (standard (standard characteristic. holding
Characteristic deviation) error) error) others constant at mean a

Gender
Male 0.47 16.44 1.05 22 of 100 greater
(0.50) (0.04) (0.08) than females
Female 0.53 rc rc rc
(0.50)
Ethnic origin
Black 0.14 -14.49 -1.01 { 22 of 100 less
(0.35) (0.04) (0.10) Than
whites 6 of 100 less
Hispanic 0.07 -2.74 -0.27
(0.26) (0.05) (0.11)
White 0.79 rc rc rc
(0.41)

Age
In integer years 19.60 2.20
as of January 1979 (1.43) (0.01)
Between 16-17 0.08 -0.65 Than { 14 of 100 less
(0.27) (0.23) 20-21
Between 18-19 0.37 -0.14 year
(0.48) (0.08) olds 3 of 100 less
Between 20-21 0.55 rc rc
(0.50)
Marital status
Ever married 0.29 -4.46 -0.24 5 of 100 less than
(0.45) (0.04) (0.09) those never
married
Never married 0.71 rc rc rc
(0.45)
High school completion
Received diploma 0.69 17.12 1.27 27 of 100 greater
or equivalent (0.46) (0.04) (0.08) than those without
diplOma
Not received 0.31 rc rc rc
(0.46)
Dependents
At least one 0.10 4.29 0.21 4 of 100 greater
(OJO) (0.53) (0.11) than those without
dependents
None 0.90 rc rc rc
(OJO)

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722 David Lynn Passmore, Unal Ay, Sheryl Rockel, Barbara Wade and James Wise
Table 2. (Cont.)

Incidents of employment

Tobit
regression
Estimate of coefficient Logistic
population for weekly regression Chances of employment
mean hours worked coefficient associated with
(standard (standard (standard characteristic, holding
Characteristic'It:
deviation) error) error) others constant at mean 8

Current residence
Urban 0.77 1.00 0.054 Logistic coefficient
(0.42) (0.04) (0.09) not statistically
significant
Rural 0.23 rc rc rc
(0.42)

Local unemployment 2.58 -0.23 5 of 100 less

rate category (0.72) (0.05) for each higher
(1 = < 3%; unemployed
2 3.0-5.9%; category
3 = 6.0-8.9 %;
4 = 9.0-11.9 %;
5 = 12.0-14.9%;
6=15+%)
Criterion 26.3 0.69
variable mean (18.4) (0.46)
(standard (includes
deviation) zeros)
Intercept -40.40 0.42
Goodness- Model Model
of-fit test X2 = 874 X2 = 712
(see Tobin, (see Harrell,
1958, 1980, p. 83)
Section 4) with 13 dJ.,
with 9 dJ., P < 0.001
P < 0.001

Source: See Table 1; sample members with missing data deleted from analyses.
Note: Approximately 11.5 million youths were not enrolled in school during 1979; rc = reference category;
- means variable not used in equation.
8First partial derivative, evaluated at the mean, of the likelihood function maximized to estimate logistic
regression coefficients. Equal to

[exp (~+ L XJj)/(1 +exp (~+ L Xj~j))2J ~j'

j j •
a
where is the estima,te of intercept; ~j the estimate of logistic coefficient for variable j; ~j' the estimate of
logistic coefficient for characteristic of interest, and Xj the estimate of population mean for variable j.
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Health and youth employment 723
the chances of being employed for three types of health limitations to work and a number of
control variables. These results are derived from a logistic regression analysis of the incidence of
employment, types of health limitations and control variables. Differences in chances of being
employed for values of each control variable are in expected directions. Chances of being
employed for youths with each type of health limitation are based on logistic regression
coefficients that differ statistically from zero.
One-third of youths who are not enrolled in school and who report health limitations are
pregnant or post partum females. These young women are 39 %less likely to be employed than
youths not reporting any health limitations to work. Developmental disabilities or diseases
afflict 45 %of youths who report health limitations to work. These young people experience
13 %less chance of being employed than youths not reporting health problems. Youths who are
limited because of accidents or injuries are 8 %less likely to be employed than youths without
any limitations. They comprise 22 % of youths who are not in school and who report health
limitations to work.
By duration of health condition. The longer out-of-school youths have their health
conditions, the more likely they are to be employed. Based on predicted values from the
equation shown in Table 3, youths experiencing their health conqitions for seven months (the
shortest duration observed) have a 0.35 probability of being employed. For youths with health
conditions for 63 months (the arithmetic mean), the probability of being employed is 0.40. The
.probability of being employed for youths who report health conditions lasting their entire lives
is 0.54.

Table 3. Relationship of incidence of employment to duration of health conditions and charac-

teristics of civilian noninstitutionalized 16-21-year-olds not enrolled in school and reporting health
limitations to work during 1979 (N = 303)

Chances of
Estimate of Logistic employment associated
population mean regression with characteristic,
(standard coefficient holding others
Characteris tic deviation) (standard error) constant at mean a

Duration of 1.15 of 100 greater

health limit 63.37 0.004 for each 12 months
in months (71.89) (0.002) longer duration
Gender
Male 0.21 1.60 38 of 100 greater than
(0.44) (0.36) females
Female (0.79) rc rc
(0.44)
Ethnic origin
Black 0.13 -1.23 30 of 100 less than·
(0.34) (0.37) whites
Hispanic 0.05 -0.43 ns
(0.21) (0.47)
White 0.82 rc rc
(0.30)
724 David Lynn Passmore, Unal Ay, Sheryl Rockel, Barbara Wade and James Wise

Table 3. (Com.)

Chances of
Estimate of Logistic employment associated
population mean regression with characteristic,
(standard coefficient holding others
Characteristic deviation) (standard error) constant at mean a
Age
Between 16-17 0.10 -0.81 ns
(0.30) (1.12)
Between 18-19 0.34 -0.16 ns
(0.47) (0.30)
Between 2(}-21 0.56 rc rc
(0.50)
Marital status
Ever married 0.48 -0.48 12 of 100 less than those
(0.50) (0.31) never married
Never married 0.52 rc rc
(0.50)
High school completion
Received diploma 0.65 1.95 47 of 100 greater than
or equivalent (0.48) (0.35) those without diploma
Not received 0.35 rc rc
(0.48)
Dependents
At least one 0.14 0.95 23 of 100 greater than
(0.34) (0.41) those without dependents
None 0.86 rc rc
(0.34)
Current residence
Urban 0.79 0.08 ns
(0.41) (0.35)
Rural 0.21 rc rc
(0.41)
Local unemployment 2.59 -0.12 ns
category (see Table 2) (0.81) (0.18)
Criterion variable 0.46
Mean (standard (0.21)
deviation)
Intercept -1.60
Goodness-of-fit test Model Xl = 92
(see Harrell, 1980,
p. 83) with 11 d.f.,
P < 0.001.

Source: See Table 1; sample members with missing data deleted from analysis.
Note: Approximately 985 000 youths not enrolled in school had health limitations to work during
1979; rc = reference category; ns = regression coefficient not statistically significant.
aSee footnote a in Table 2 . ' I
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Health and youth employment 725

Among youths who are not enrolled in school and who report health limitations to work,
males, youths not responsible for supporting dependents and high school completers are more
likely to be employed than females, youths with dependents, and those who did not complete
high school (see Table 3). Blacks and youths who are married, divorced, separated or widowed
are less likely to be employed than whites and those never married. These' relationships are
uniformly larger in magnitude than those observed from the analysis of employment youths
with and without limitations (cf. entries for each characteristic in Tables 2 and 3).

Job satisfaction, prestige and pay

Summarized in Table 4 are ordinary least squares regressions of job satisfaction, occupational
prestige and hourly rate of pay with the incidence of health limitations and control variables.
Small mean differences in satisfaction, prestige and pay are observed by incidence of health
limitations. These results remain unchanged when the differences are adjusted by including

Table 4. Distribution ofjob satisfaction, occupational prestige and pay by incidence ofhealth limitations to
work reported by civilian non institutionalized 16-21-year-olds not enrolled in school during 1979
(N= 2524)

Estimate of popUlation mean

(standard deviation)

Reported health limits to

work Difference Regression adjusted
Criterion between (1) difference between
variable Total Yes (1) No (2) and (2) means '(1) and (2) means a

Job satisfaction
score 21.2 20.9 21.2 -0.3 -0.4
(0-40 range) (4.7) (5.1) (4.7)
Duncan Occupat-
ional Status Index 28.4 30.6 28.3 2.3 -1.0
(0-100 range) (18.3) (17.8) (18.3)
Hourly rate
of pay (cents/hr) 368c 358c 369c llc lc
(>$0.50, <S15) (168c) (178c) (164c)

Source: See Table 1.

Note: Approximately 8 million youths were not enrolled in school and employed during 1979; 5.6 %of
these youths reported a health limitation to work. ..
aHealth limitations coefficient based on regression of data weighted by sampling fractions. Job
satisfaction and occupational prestige regressions included the incidence of health limitations, gender,
ethnic origin, age, marital status, high school completion, presence of dependents and location of current
residence. The hourly rate of pay regression also included the local unemployment rate category as a
control for the local demand for labour. The natural logarithm of hourly rate ofpay actually was used,and
results were transformed to cents per hour.
726 David Lynn Passmore, Unal Ay, Sheryl Rockel, Barbara Wade and James Wise
control variables in regression equations. Because the average youth who reports health
limitations works about 14 fewer hours per week, a youth with a helath limitation could receive
less gross annual personal income from wages and salaries than a youth not reporting a health
limitation.

IV. DISCUSSION

The results <1f this status study generate more questions than answers about the factors causing
the relationships observed. According to our 1979 estimates, the employment of a small portion
of the civilian noninstitutionalized youth population is limited by health. If institutionalized
youths had been included in the 1979 Youth Survey these estimates might differ in two ways.
First, the incidence of youths reporting health limitations would probably be higher. Second, the
employment-popUlation ratio and the labour force participation rate for youths who report
health conditions would be lower because institutionalized youths are tallied as out of the
labour force in most surveys. The unemployment rate would probably not change because most
institutionalized youths are neither available nor looking for work.
Why are youths who report health limitations to work less likely to be employed and to work
fewer hours than youths without health problems? A number of explanations can be offered.
First, employers might decline to hire these youths because they believe that these youths'
potential productivity might be low. Second, government transfer payments received by youths
who report health limitations might encourage these young people not to work. Third, health
conditions might have a genuine effect on their ability to acquire useful skills, to conduct a
productive job search or to perform adequately on the job. Data from the 1979 Youth Survey
allow some of these explanations to be weighed. Data are available that would enable
researchers to study labour supply as a function of government transfer payments and to
determine the nature of human capital investment and quality of job search of youths who
report health limitations to work.
Do health limitations create lasting effects on the employability of youths? At least two
contrary and qualified answers can be offered. A first answer is no because some of the
conditions cited, for example pregnancy, trauma from accidents and some diseases, might
decrease employment prospects when these conditions are acquired; but, these conditions might
be temporary and might not have any consequences for long-term employability. The positive
relationship between the probability of employment and duration of health conditions suggests
that this explanation merits investigation.
A second answer to the question is: yes, health problems exact a lasting employment effect.
Even if most of the health conditions youths cite are eliminated over time, studies by Stephenson
1978), Stevenson (1979) and others reveal that adult employability and earnings are related
positively to opportunities for youths to gain work experience. The scarring effects of
employment problems of youths with health limitations can be investigated directly by using
longitudinal data from Youth Surveys planned for subsequent years for the National
Longitudinal Surveys of Labor Force Behavior. '
Youths who rePort health limitations to work are less likely to work than other youths. When

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Health and youth employment 727

working, however, these youths are as satisfied with aspects of their jobs as other employed
youths. On the average, youths hold jobs that occupy the lower quarter of the occupational
status hierarchy in the United States economy. Employed youths who report health limitations
to work are no exception.
Youths who report health limitations to work earn about as much per hour as other youths.
Similarity in pay might reflect rigidities (union agreements, perceptions of fairness, minimum
wage laws, wage standards) that reduce employers' flexibility in making wage offers. Or perhaps
the comparable productivity ofyouths who report health problems is shown through their equal
pay. More detailed studies of wage determinants for youths with health limitations can include
information about type and quality of schooling, family conditions, spouses' employment and
employer characteristics. The reduction in weekly hours worked can also be studied with these
variables. A major policy question is whether income supplements from government transfer
payments reduce the Willingness of youths with health problems to work additional hours, even
though they may be as productive as other youths. Or are reductions in work hours and income
the result of inability of these young people to complete a full work week?

V. SUMMARY

During 1979, about 6.4 %of teenagers and young adults in the United States reported that their
health limited their employment. These youths participate in the labour force 16 % less
frequently and suffer a 7.5 %higher unemployment rate than youths without health limitations.
Youths not enrolled in school have 20 %fewer chances of being employed if they believe that
their health limits their employment. Pregnant or post partum females are 39 %less likely to have
jobs than youths without health limitations. Youths afflicted by diseases and accidents are 13
and 8 % less likely, respectively, to be employed than those not reporting health limitations.
Youths having health problems their entire lives are about 19 %more likely to be employed than
youths who recently acquired their conditions. Also, young people who report health
limitations, who are employed and who are not enrolled in school, work about 14 fewer hours
per week than the working youth average. Perceived health status is not related to job
satisfaction, occupational prestige or hourly rate of pay. These relationships between youth
employment and health limitations to work are derived from analyses of responses of 11412
civilian noninstitutionalized 16- to 21-year-olds in the United States to the 1979 Youth Survey
of the National Longitudinal Surveys of Labor Force Behavior.

ACKNOWLEDGEMENTS

The advice and assistance of our following Pennsylvania State University colleagues are
appreciated: D. Anderson, H. Flexner, M. Hallberg, E. Herr, T. Long, 1. Rodgers, M. Scofield, 1.
Selzer, D. Shapiro, S. Stephenson and F. Welch. The Penn State College of Education provided
generous computing assistance for the completion of research reported in this paper.
728 David Lynn Passmore, Unal Ay, Sheryl Rockel, Barbara Wade and James Wise

STATISTICAL APPENDIX

The decomposition Qf the regression coefficient for the incidence of health limitations in the
To bit analysis of weekly hours worked is a straightforward application of the decomposition of
effects of participating in an income maintenance experiment on family earnings shown by
Stephenson and McDonald (1979). Their approach uses methods provided by Tobin (1958) and
extended by Amemiya (1973) for handling criterion variables that are clustered at some limiting
value. In our study, 31 % of the sample members worked zero hours.
In Table 2, the Tobit regression coefficient for the incidence of health limitation variable, H L,
estimates the'thange in the expected value of weekly hours worked, E[lt1:la for person i for a
unit change in H L. A unit change in H L is the difference between youths with and without health
limitations to work. Expressed in another way, the coefficient is the first derivative of the Tobit
equation with respect to HL. Dropping subscripts, the derivative is decomposed as follows:

oE[lt1:lJ = E[lt1:l*J of(z) F() oE[lt1:l*J

oHL oHL + z oHL

where z = lt1:l /SE(lt1:l), the number of standard deviations a youth with the average hours
worked is above zero lt1:l [SE(lt1:l) is the standard error of the Tobit regression equationJ; F(z)
is the probability that person with WH is above zero WH; E[WH*J the expected value of WH,
given that person i is working; of(z)/oHL the change in probability of working, given that
person i reports a health limitation to work; and oE[lt1:l*J/oHL the change in lt1:l, given that
person i has a health limitation and is working. of(z)/oHL and oE[lt1:l*J/oHL of the
decomposition are evaluated at lt1:l in our study.
Using data from the Tobit equation reported in Table 2, z = 26.3/28.8 = 0.91; F (z) = 0.81
from normal probability table; and, because E[lt1:lJ = E[lt1:l* J F(z), E[lt1:l*J = 26.3/0.81
= 32.5. Therefore, of(z)/oHL = F( (lt1:l - oE[lt1:lJ/oHL)/SE(lt1:l» F(z) = F[(26.3
oE[lt1:lJ of(z)
~ 18.06)/28.8J -0.81 = -0.20. Because F(z) oE[lt1:l*J/oHL = oHL -E[lt1:l*J oHL =
-18.06-[( -0.20)(32.51)] = -11.56; therefore, oE[WH*J/oHL = -11.56/(0.81) = -14.27.
The probability of having no hours worked (not havirtg a job) is 0.20 greater if a youth
reported a health limitation to work. Among employed youths, the report ofa health limitation
is associated with 14.27 fewer hours worked per week.

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