Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 8;25(1):1045.
doi: 10.1186/s12913-025-13183-w.

Valuation of health losses among Japanese workers with children during the COVID-19 pandemic

Narimasa Kumagai  1 , Aran Tajika  2 , Mihajlo Jakovljevic  3   4   5
Affiliations

Valuation of health losses among Japanese workers with children during the COVID-19 pandemic

Narimasa Kumagai et al. BMC Health Serv Res. .

Abstract

Background: Women experienced a larger decline in well-being than men did during the COVID-19 pandemic. This loss was greater for parents with childcare responsibilities living in Europe. However, little is known regarding the monetary value of health losses among Japanese workers with children during this time. This study filled this gap by attaching monetary values to poor self-assessed health (PSAH) due to a lower household income among middle-aged Japanese men and women.

Methods: This study used data on four waves from the Japan Household Panel Survey (JHPS) COVID-19 Special Survey conducted by Keio University to examine the impact of health conditions on life satisfaction among Japanese workers. It used the dichotomous variable PSAH to measure the value lost in moving from good, very good, or excellent health to fair or poor health. To select the explanatory variables for the estimation function measuring the impact of PSAH on life satisfaction, the determinants of PSAH were investigated using the random forest model. Considering the endogeneity between PSAH and life satisfaction, we used the two-stage residual inclusion approach with generalized residuals.

Results: The results show a significant difference in the monetary value of the loss of life satisfaction due to poor health between adults with children and adults without children. The results support the hypothesis that adults with children experience greater health losses than adults without children do. The health losses of adults with children were approximately 3.49 million Japanese yen (JPY) (7.3 times the average monthly household income), that is, 1.04 million JPY more than that of adults without children. The direct impact of PSAH and severe mental distress on life satisfaction was greater for adults with children than for adults without children.

Discussion: Adults with children were more likely to experience mental ill-health in the two lowest income classes; thus, the magnitude of the monetary value of the loss of well-being due to poor health during the pandemic increased.

Conclusions: Higher levels of mental health distress are associated with poorer health; therefore, attention must be paid to changes in income, sleep duration, and job insecurity among adults with children.

Keywords: Fixed-effects logit model; Health loss; Japan; Monetary valuation; Random forest; Two-stage residual inclusion.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The present study falls under (1) to (3) below. In medical research in Japan, the Ethical Guidelines for Life Sciences and Medical Research Involving Human Subjects (2021), which are the standard ethical guidelines based on the Declaration of Helsinki, have been established. It defines research that meets the following conditions as not subject to the ethical guidelines. (1) Samples and information that have established academic value, are widely used for research purposes, and are generally available to the public. (2) Existing information that does not fall under the category of information on individuals. (3) Anonymized processed information that has already been created. Consent for publication: Not applicable. Generative AI and AI-assisted technologies in the writing process: None. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Determinants of PSAH
Fig. 2
Fig. 2
Distribution of LS by presence of children
See this image and copyright information in PMC

References

    1. Adams-Prassl A, Boneva T, Golin M, Rauh C. The impact of the coronavirus lockdown on mental health: evidence from the united States. Econ Policy. 2022;37:139–55. 10.1093/epolic/eiac002.
    1. Davillas A, Jones AM. The first wave of the COVID-19 pandemic and its impact on socioeconomic inequality in psychological distress in the UK. Health Econ. 2021;30:1668–83. 10.1002/hec.4275. - PMC - PubMed
    1. Gao X, Davillas A, Jones AM. The Covid-19 pandemic and its impact on socioeconomic inequality in psychological distress in the united kingdom: an update. Health Econ. 2022;31:912–20. 10.1002/hec.4480. - PubMed
    1. Pedraza P, Marin G, Kea T. Life dissatisfaction and anxiety in COVID-19 pandemic. MUNI econ working Paper, No. 2020-03. MUNI ECON WP. 2020;(3). 10.5817/WP_MUNI_ECON_2020-03
    1. Etheridge B, Spantig L. The gender gap in mental well-being at the onset of the Covid-19 pandemic: evidence from the UK. Eur Econ Rev. 2022;145:104114. 10.1016/j.euroecorev.2022.104114. - PMC - PubMed

Supplementary concepts

LinkOut - more resources