The unequal impact of ill health: Earnings, employment, and mental health among breast cancer survivors in Finland

I study the impact of breast cancer on earnings, employment, and mental health among Finnish women, specifically examining whether there is a heterogeneous impact according to socioeconomic status. In addition, the contribution of the article lies in investigating the extent to which mental health problems mediate the impact on earnings and employment, and how efficiently social insurance system protects individuals from income loss due to sickness. The empirical analyses are based on unique register data including the total population of Finland from 2000 to 2016. As an identification strategy, the exact timing of cancer diagnosis is used. The results are based on difference-in-differences estimations. Breast cancer has an overall impact of -5.1 percent on annual earnings with significant differences between earnings quintiles: the negative impact in the second earnings quintile is the largest, -8.9 percent. Results hold when using other socioeconomic variables, while the impact is bigger when we include women with weaker labor market attachment to the analysis. Mental health problems mediate the impact only modestly. The negative effect is smaller when looking at total income highlighting the importance of the Finnish welfare state to buffer effects of ill health on economic well-being.

Automated summary

The study found significant negative impact of breast cancer on the annual earnings of Finnish women, especially in the second earnings quintile where the negative impact is largest; Mental health problems have a relatively small mediating effect on income and employment impacts; The Finnish welfare state plays an important role in buffering the economic well-being effects of illness.