Cross-border Mobility in European Countries: Associations between Cross-border Worker Status and Health Outcomes
Background. Mobility of workers living in one country and working in a different country has increased in the European Union. Exposed to commuting factors, cross-border workers (CBWs) constitute a potential high-risk population. But the relationships between health and commuting abroad are under-documented. Our aims were to: (1) measure the prevalence of the perceived health status and the physical health outcomes (activity limitation, chronic diseases, disability and no leisure activities), (2) analyse their associations with commuting status and countries of destination, and (3) confirm the positive association between wage and health index for both CBWs and non-cross border workers (NCBWs).
Methods. Based on the ‘Enquête Emploi’, the French cross-sectional survey segment of the European Labour Force Survey (EU LFS), the population was composed of 2,546,802 workers. Inclusion criteria for the samples were aged between 20 and 60 years and living in the French cross-border departments of Germany, Belgium, Switzerland and Luxembourg. The Health Index is an additional measure obtained with five health variables. A logistic model was used to estimate the odds ratios of each group of CBWs, taking NCBWs as the reference group, controlling by demographic background and labour status variables.
Results. A sample of 34,362 observations (3,453 CBWs vs. 30,909 NCBWs) was retained. The CBW status is positively associated with a better perceived health, activity limitation, chronic diseases and disability. A marginal improvement of the health index is correlated with a wage premium for both NCBWs and CBWs. Commuters to Switzerland have the higher health outcomes among all CBWs. Commuters to Germany report lower disability and more leisure activities.
Conclusion. CBWs are healthier and have more income. This main finding suggests (1) a healthy cross-border phenomenon steming from a social selection and a positive association between income and the health index is confirmed; (2) the existence of major health disparities among CBWs; and (3) the rejection of the spillover phenomenon assumption for CBWs. The newly founded European Labour Authority (ELA) should take into account health policies as a promising way to support the cross-border mobility within the European Union.
Figure 1
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Posted 21 Sep, 2020
Received 02 Jan, 2021
On 26 Dec, 2020
On 24 Dec, 2020
Received 22 Dec, 2020
On 04 Dec, 2020
Received 23 Oct, 2020
On 30 Sep, 2020
Invitations sent on 21 Sep, 2020
On 18 Sep, 2020
On 16 Sep, 2020
On 16 Sep, 2020
Cross-border Mobility in European Countries: Associations between Cross-border Worker Status and Health Outcomes
Posted 21 Sep, 2020
Received 02 Jan, 2021
On 26 Dec, 2020
On 24 Dec, 2020
Received 22 Dec, 2020
On 04 Dec, 2020
Received 23 Oct, 2020
On 30 Sep, 2020
Invitations sent on 21 Sep, 2020
On 18 Sep, 2020
On 16 Sep, 2020
On 16 Sep, 2020
Background. Mobility of workers living in one country and working in a different country has increased in the European Union. Exposed to commuting factors, cross-border workers (CBWs) constitute a potential high-risk population. But the relationships between health and commuting abroad are under-documented. Our aims were to: (1) measure the prevalence of the perceived health status and the physical health outcomes (activity limitation, chronic diseases, disability and no leisure activities), (2) analyse their associations with commuting status and countries of destination, and (3) confirm the positive association between wage and health index for both CBWs and non-cross border workers (NCBWs).
Methods. Based on the ‘Enquête Emploi’, the French cross-sectional survey segment of the European Labour Force Survey (EU LFS), the population was composed of 2,546,802 workers. Inclusion criteria for the samples were aged between 20 and 60 years and living in the French cross-border departments of Germany, Belgium, Switzerland and Luxembourg. The Health Index is an additional measure obtained with five health variables. A logistic model was used to estimate the odds ratios of each group of CBWs, taking NCBWs as the reference group, controlling by demographic background and labour status variables.
Results. A sample of 34,362 observations (3,453 CBWs vs. 30,909 NCBWs) was retained. The CBW status is positively associated with a better perceived health, activity limitation, chronic diseases and disability. A marginal improvement of the health index is correlated with a wage premium for both NCBWs and CBWs. Commuters to Switzerland have the higher health outcomes among all CBWs. Commuters to Germany report lower disability and more leisure activities.
Conclusion. CBWs are healthier and have more income. This main finding suggests (1) a healthy cross-border phenomenon steming from a social selection and a positive association between income and the health index is confirmed; (2) the existence of major health disparities among CBWs; and (3) the rejection of the spillover phenomenon assumption for CBWs. The newly founded European Labour Authority (ELA) should take into account health policies as a promising way to support the cross-border mobility within the European Union.
Figure 1