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Job market paper: Beyond "The Change": How menopause impacts health and employment
Abstract: Despite the vast medical literature on the health effects of menopause, its economic implications remain understudied. During women's reproductive years, hormones like estrogen are protective of health. Menopause, associated with a gradual yet pronounced decrease in estrogen, induces a distinct change in women’s health trajectory that may have an impact on employment. This paper uses detailed data on the reported natural age of menopause for women in the Health and Retirement Study (HRS) to estimate the impact of menopause on health and employment. To address issues in identification that arise when analyzing menopause, such as confounding factors and measurement error, this paper uses the genetic predisposition for the timing of menopause, specifically the associated polygenic risk score (PGS), as an instrument for the reported age of natural menopause. There are three principal findings. First, consistent with the medical literature, crossing the menopause threshold there is an economically substantive and statistically significant acceleration in health conditions. The decline in health is more than triple that for pre-menopause years. Second, menopause is associated with a substantial reduction in the likelihood of working for pay by just under 2 percentage points every year after menopause, which accumulates to an 18 percentage point reduction in ten years. Combining these estimates, the associated IV estimate of the impact of health on employment indicates that the diagnosis of an additional medical condition reduces the likelihood of working for pay by between 49 to 77 percentage points depending on the exact specification. This is a substantial effect given that 78% of women work for pay prior to menopause. The key take-away is that essentially an additional diagnosis of a medical condition results in exit from employment for middle age to older women.
Working papers:
The impact of menopause on health and OASDI claims
Abstract: Menopause induces a distinct change in women’s health trajectory that may have an impact on social insurance systems like the Old-Age, Survivors, and Disability Insurance (OASDI). This paper uses detailed data on the reported natural age of menopause for women in the Health and Retirement Study (HRS) to estimate the impact of menopause on health and the collection of Social Security and disability benefits. To address issues in identification that arise when analyzing menopause, such as confounding factors and measurement error, this paper uses the genetic predisposition for the timing of menopause, specifically the associated polygenic risk score (PGS), as an instrument for the reported age of natural menopause. There are three principal findings. First, consistent with the medical literature, crossing the menopause threshold there is an economically substantive and statistically significant acceleration in health conditions. The decline in health is more than triple that for pre-menopause years. Second, menopause is associated with a substantial increment in the likelihood of receiving Social Security or disability benefits by 0.5 percentage points every year after menopause. Over a decade, this effect accumulates to a 5 percentage point increase, on average, before reaching the early retirement age. Combining these estimates, the IV analysis reveals that the diagnosis of an additional medical condition increases the probability of receiving Social Security or disability benefits by 25.5 percentage points. This effect is substantial, given that only 5% of women receive such benefits before menopause. The key takeaway is that an additional medical diagnosis due to menopause considerably accelerates the timeline for accessing Social Security and disability benefits among middle-aged and older women.
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