Journal of Public Health Policy

, Volume 32, Issue 2, pp 234–250 | Cite as

Social security and mortality: The role of income support policies and population health in the United States

  • Peter S Arno
  • James S House
  • Deborah Viola
  • Clyde Schechter
Original Article

Abstract

Social Security is the most important and effective income support program ever introduced in the United States, alleviating the burden of poverty for millions of elderly Americans. We explored the possible role of Social Security in reducing mortality among the elderly. In support of this hypothesis, we found that declines in mortality among the elderly exceeded those among younger age groups following the initial implementation of Social Security in 1940, and also in the periods following marked improvements in Social Security benefits via legislation and indexing of benefits that occurred between the mid-1960s and the early 1970s. A better understanding of the link between Social Security and health status among the elderly would add a significant and missing dimension to the public discourse over the future of Social Security, and the potential role of income support programs in reducing health-related socioeconomic disparities and improving population health.

Keywords

Social Security income support social epidemiology health policy 

References

  1. Adler, N.E. and Rehkopf, D.H. (2008) U.S. disparities in health: Descriptions, causes, and mechanisms. Annual Review of Public Health 29: 235–252.CrossRefGoogle Scholar
  2. Marmot, M. and Wilkinson, R.G. (2006) Social Determinants of Health, 2nd edn. Oxford: UK Oxford University Press.Google Scholar
  3. Lantz, P.M., House, J.S., Lepkowski, L.M., Williams, D.R., Mero, R.P. and Chen, J. (1998) Socioeconomic factors, health behaviors, and mortality. Journal of the American Medical Association 279: 1703–1708.CrossRefGoogle Scholar
  4. Pappas, G., Queen, S., Hadden, W. and Fisher, G. (1993) The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. New England Journal of Medicine 329: 103–109.CrossRefGoogle Scholar
  5. Balan-Cohen, A. (2009) The effect of income on elderly mortality: Evidence from the Old Age Assistance Program in the United States. American Economic Association Conference Papers. http://www.aeaweb.org/assa/2009/author_papers.php?author_ID=6557, accessed 1 January 2009.
  6. Herd, P., Schoeni, R.F. and House, J.S. (2008) Upstream solutions: Does the supplemental security income program reduce disability in the elderly? The Milbank Quarterly 86: 5–45.CrossRefGoogle Scholar
  7. Connor, J., Rodgers, A. and Priest, P. (1999) Randomized studies of income supplementation: A lost opportunity to assess health outcomes. Journal of Epidemiology and Community Health 53: 725–730.CrossRefGoogle Scholar
  8. Englehardt, G.V. and Gruber, J. (2004) Social Security and the Evolution of Elderly Poverty. Working Paper 10466. Cambridge MA: National Bureau of Economic Research.Google Scholar
  9. Romig, K. (2008) Social Security Reform: Possible Effects on the Elderly Poor and Mitigation Options. Congressional Research Service Report to Congress. www.globalaging.org/elderrights/us/2008/socreform.pdf, accessed 6 January 2011.
  10. National Commission on Fiscal Responsibility and Reform. (2010) The Moment of Truth: Report of the National Commission on Fiscal Responsibility and Reform. 1 December 2010. http://www.fiscalcommission.gov/news/moment-truth-report-national-commission-fiscal-responsibility-and-reform, accessed 18 December 2010.
  11. H.R.4529: Roadmap for America's Future Act of 2010. http://www.govtrack.us/congress/bill.xpd?bill=h111-4529, accessed 12 July 2010.
  12. Wright, J.D. and Devine, J.A. (1995) Poverty among the elderly. Journal of Long-Term Home Health Care 13 (1): 5–16.Google Scholar
  13. Radner, D.B. (1995) Incomes of the elderly and nonelderly, 1967–92. Social Security Bulletin 58 (4): 82–101.Google Scholar
  14. Ross, C.M., Danziger, S. and Smolensky, E. (1987) Interpreting changes in the economic status of the elderly, 1949–1979. Contemporary Policy Issues 5 (2): 98–112.CrossRefGoogle Scholar
  15. DeNavas-Walt, C., Proctor, B.D. and Smith, J.C. (2009) U.S. Census Bureau, Current Population Reports, P60-236. Income, Poverty, and Health Insurance Coverage in the United States: 2008. Washington DC: Government Printing Office.Google Scholar
  16. Kollman, G. (1996) Summary of Major Changes in the Social Security Cash Benefits Program: 1935–1996. Congressional Research Service Report to Congress. http://www.ssa.gov/history/pdf/crs9436.pdf, accessed 5 January 2011.
  17. Shearon, M. (1938) Economic status of the aged. Social Security Bulletin 1 (1): 5–17.Google Scholar
  18. Upp, M 1982 A look at the economic status of the aged then and now. Social Security Bulletin 45 (3): 16–22.Google Scholar
  19. Social Security Administration. (2008) Annual statistical supplement, 2008 to the Social Security Bulletin. Office of Policy, Office of Research, Evaluation and Statistics, SSA Publication No. 13-11700.Google Scholar
  20. Social Security Administration. (2008) Office of retirement and disability policy. Income of the Aged Chartbook, 2008 http://www.socialsecurity.gov/policy/docs/chartbooks/income_aged/2008/iac08.html#definitions, accessed 10 July 2010.
  21. Social Security Administration. (2006) Defined Contribution Pension Plans and the Supplemental Security Income Program, Policy Brief No. 2006-01 http://www.ssa.gov/policy/docs/policybriefs/pb2006-01.pdf, accessed 22 December 2010.
  22. Purcell, P. (2009) Older Workers: Employment and Retirement Trends. Congressional Research Service Report to Congress. http://digitalcommons.ilr.cornell.edu/key_workplace/655, accessed 6 January 2011.
  23. U.S. Census Bureau. (1945) Current Population Survey. Current Population Reports, Series P-50, No. 2.Google Scholar
  24. Robert, S.A. and House, J.S. (1994) Socioeconomic status and health over the life course. In: R.P. Abeles, H.C. Gift and M.G. Ory (eds.) Aging and Quality of Life. New York: Springer-Verlag, pp. 253–274.Google Scholar
  25. Beckett, M. (2000) Converging health inequalities in later life: An artifact of mortality selection? Journal of Health and Social Behavior 41 (1): 106–119.CrossRefGoogle Scholar
  26. Behrman, J.C., Sickles, R. and Taubman, P. (1998) Causes, Correlates and Consequences of Death among Older Adults: Some Methodological Approaches and Substantive Analyses. Boston, MA: Kluwer Academic Publishers, pp. 109–129.CrossRefGoogle Scholar
  27. Snyder, S. and Evans, W. (2006) The effect of income on mortality: Evidence from the social security notch. Review of Economics and Statistics 88 (3): 482–495.CrossRefGoogle Scholar
  28. Handwerker, E.W. (2007) Empirical essays in the economics of aging. Unpublished doctoral dissertation, University of California, Berkeley.Google Scholar
  29. Case, A. (2004) Does money protect health status? Evidence from South African pensions. In: D.A. Wise (ed.) Perspectives on the Economics of Aging. Chicago, IL: University of Chicago Press, pp. 287–312.CrossRefGoogle Scholar
  30. Jensen, R.T. and Richter, K. (2003) The health implications of social security failure: Evidence from the Russian pension crisis. Journal of Public Economics 88: 209–236.CrossRefGoogle Scholar
  31. Feng, J., He, L. and Sato, H. (2009) Public Pension and Household Saving: Evidence from China. Bank of Finland, Institute for Economies in Transition, BOTIT Discussion Papers, No 2009/02.Google Scholar
  32. Norström, T. and Palme, J. (2010) Public pension institutions and old-age mortality in a comparative perspective. International Journal of Social Welfare 19: s121–s130.CrossRefGoogle Scholar
  33. Andersson, K., Petzold, M.G., Sonesson, C., Lonnroth, K. and Carlsten, A. (2006) Do policy changes in the pharmaceutical reimbursement schedule affect drug expenditures? Interrupted time series analysis of cost, volume and cost per volume trends in Sweden 1986–2002. Health Policy 79 (2–3): 231–243.CrossRefGoogle Scholar
  34. French, B. and Heagerty, P.J. (2008) Analysis of longitudinal data to evaluate a policy change. Statistics in Medicine 27 (24): 5005–5025.CrossRefGoogle Scholar
  35. Cutler, D. and Meara, E. (2004) Changes in the age distribution of mortality over the 20th century. In: D.A. Wise (ed.) Perspectives on the Economics of Aging. Chicago, IL: University of Chicago Press, pp. 333–366.CrossRefGoogle Scholar
  36. Armstrong, G.L., Conn, L.A. and Pinner, R.W. (1999) Trends in infectious disease mortality in the United States during the 20th century. Journal of the American Medical Association 281: 61–66.CrossRefGoogle Scholar
  37. Manning, W.G. and Mullahy, J. (2001) Estimating log models: To transform or not to transform? Journal of Health Economics 20: 461–494.CrossRefGoogle Scholar
  38. CDC. (1999) Achievements in public health, 1900–1999: Decline in deaths from heart disease and stroke: United States, 1900–1999. MMWR 48: 649–656.Google Scholar
  39. National Center for Health Statistics. (1978) Chartbook for the conference on the decline in coronary heart disease mortality. U.S. Department of Health, Education, and Welfare. www.cdc.gov/nchs/data/misc/corltrtacc.pdf, accessed 12 December 2010.
  40. Card, D., Dobkin, C. and Maestas, N. (2009) Does Medicare save lives? The Quarterly Journal of Economics 124 (2): 597–636.CrossRefGoogle Scholar
  41. Kaplan, G.A, Ranjit, N. and Burgard, S.A. (2008) Lifting gates, lengthening lives: Did civil rights policies improve the health of African American women in the 1960s and 1970s? In: R.F. Schoeni, J.S. House, G.A. Kaplan and H. Pollack (eds.) Making Americans Healthier. New York: Russell Sage Foundation, pp. 145–169.Google Scholar

Copyright information

© Palgrave Macmillan, a division of Macmillan Publishers Ltd 2011

Authors and Affiliations

  • Peter S Arno
    • 1
  • James S House
    • 2
  • Deborah Viola
    • 1
  • Clyde Schechter
    • 3
  1. 1.Department of Health Policy & ManagementSchool of Health Sciences and Practice, New York Medical CollegeValhallaUSA
  2. 2.Survey Research Center, University of MichiganAnn ArborUSA
  3. 3.Department of Family and Social MedicineAlbert Einstein College of MedicineBronxUSA

Personalised recommendations