Employed - Les données sur le cancer

EARNINGS AND EMPLOYMENTUNEMPLOYMENT SPELLS FOR
SALARIED AND SELF-EMPLOYED
WORKERS SURVIVING CANCER
Aurélia Tison, Alain
Paraponaris and Bruno
Ventelou
INTRODUCTION
 More cancer survivors are working age adults (Ferlay et al 2013) (Hoffman 2005)
 A growing number of self-employed workers in France thanks to new
reforms (RSI 2011)
 Very few studies on them (Paraponaris et al 2004) (Eischenbaum voline et al 2008) (Sauze 2011)
 What are their financial and professional situations two years after cancer
in comparison to those of employees and to the general population ?
1) Transitions on the labor market
2) Absenteeism and Return to Work
3) Wage losses
FRENCH CONTEXT
Three sickness funds
CNAMTS • Employees
RSI
MSA
• Self-employed
workers
• Farmers
Days’ allowances are not the same
 Employees: 50% to 80% of their wage
with a maximum of 42.77€ per day
(57.03€ if 3 children and more).
 Self-employed workers: 50% of their
annual wage during the last three years
with a maximum per day of 49.82€.
 Waiting days differ which could impact
the length of absenteeism (Pollack).
DATA
CANCER
survey
SelfEmployed
Workers
Professional situation 18
months after in %
Profession
Not
al situation Employed
Employed
in 2010
Employed 88 [84-91] 12 [9-17]
Not
6 [0.8-35] 94 [65-99]
Employed
CANCER
survey
Employed
Workers
Total
100
100
General
survey
SelfEmployed
Workers
Professional situation 18
months after in %
Profession
Not
al situation Employed
Employed
in 2010
Employed 97 [95-98]
3 [2-5]
Not
32 [20-50] 68 [50-80]
Employed
Professional situation 18 months
after in %
Professiona
l situation Employed
in 2010
Not
Employed
Total
Total
General
survey
Employed
Workers
100
100
Professional situation 18
months after in %
Profession
Not
al situation Employed
Employed
in 2010
94.5 [9495]
Employed
88 [86-89]
12 [11-14]
100
Employed
4.5 [5-6]
Not
Employed
2 [1-4]
98 [96-99]
100
Not
28 [25-30] 72 [70-75]
Employed
Total
100
100
ABSENTEEISM
 Significant t test (p = 0.02) : 58 days before taking a sick leave for selfemployed workers in comparison to 41 days for employees.
 Significant chi2 test (p = 0.00) : 41% self-employed workers do not take
any sickness days against 16% employees.
 Cox model
 Significant Hazard ratios less than 1 = self-employed (ref:no), survival>80%(ref:<80%), age
 Significant Hazard ratios more than 1 = diminished working hours (ref:no), reorganization of
work (ref:no), after-effects (ref:no).
RETURN TO WORK
1.00
Kaplan-Meier survival estimates
Significant t test (p=0.00)
0.00
0.25
0.50
0.75
In mean self-employed workers are
135 days on sick leave before
returning to work in comparison to
203 days for employees.
0
500
1000
analysis time
self_employed = 0
self_employed = 1
1500
RTW is a distinct process for selfemployed workers and employees.
WAGE LOSSES
 Significant t test for the variation of wages between 2012 and 2010
(p = 0.00): -183€ for self-employed against – 31€ for employed workers.
 Linear regression (outcome = wage in 2012 – wage in 2010)
 Significant and positive results:
 high level of study (ref: <bac) 83.61€
 Sigificant and negative results:
 self-employed (ref: salaried) -160€
 participation in the households’earnings (from -221.8€ to -528.9€)
 different job in 2012 (ref: same job)-123.4€
 diminished working hours (ref:no) -243.2€
 chemotherapy (ref:no) -145.6€
ALL
Outcome
variable
(wage)
Mean
Std Error
t
P(t)
Base Line
Control
(2660)
Treated
(1438)
Diff(BL)
Control
(2660)
Treated
(1438)
Diff (FU)
2213.147 1846.785
34.034
29.179
65.03
63.29
0.000
0.000
-366.362
44.829
-8.17
0.000***
2337.583
34.034
68.68
0.000
1798.876
29.179
61.65
0.000
-538.707
44.829
-12.02
0.000***
SE
DID
Follow up
Base Line
Control
Treated
Diff(BL)
Control
Treated
Diff (FU)
Mean
Std Error
t
P(t)
2630.640
232.041
11.34
0.000
1843.237
193.962
9.50
0.000
-787.403
302.430
-2.60
0.010***
2878.721
232.041
12.41
0.000
1659.500
193.962
8.56
0.000
-1.2e+03
302.430
-4.03
0.000***
Mean
Std Error
t
P(t)
Base Line
Control
(2660)
-172.345
63.398
-2.72
0.007***
Follow up
Outcome
variable
(wage)
E
Outcome
variable
(wage)
Diff in diff
Diff in diff
-431.818
427.701
-1.01
0.313
Follow up
Treated
(1438)
Diff(BL)
Control
(2660)
Treated
(1438)
Diff (FU)
2213.147 1846.785
34.034
29.179
65.03
63.29
0.000
0.000
-366.362
44.829
-8.17
0.000***
2337.583
34.034
68.68
0.000
1798.876
29.179
61.65
0.000
-538.707
44.829
-12.02
0.000***
Diff in diff
-172.345
63.398
-2.72
0.007***
CONCLUSION & DISCUSSION
 The employment rate from 2010 to eighteen months after is smaller for cancer survivors than for
the general population but no difference between self-employed and employed workers surviving
cancer.
 A difficulty for non-employed workers to find a job after a cancer persists (see Joutard et al 2014).
 Our control group from the labor force survey could contain individuals affected by a chronic
disease.
 Self-employed workers take a longer time to put themselves on sick leave compared to
employees.
 Return to work not only differs by gender as shown in the literature (Marino el al 2013; Malavolti 2004)
but also between self-employed and employed workers.
 Wage losses after cancer are significant and result in a high financial burden for self-employed
cancer survivors (see also Lauzier et al 2008).
 Stratification of the variable self-employed by type of job impossible due to few observations.
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