Shorter lives in stingier states: Social policy shortcomings help explain the US mortality disadvantage
Shorter lives in stingier states: Social policy shortcomings help explain the US mortality disadvantage
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DOI：
10.1016/j.socscimed.2016.10.017
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发表时间：
2016-12-01
影响因子：
5.4
通讯作者：
Bambra, Clare
中科院分区：
文献类型：
--
作者：
Beckfield, Jason;Bambra, Clare
相对于其他富裕民主国家的政治和经济同行，美国在死亡率上处于劣势。最近有人提出，社会政策可能在解释这种不利条件方面发挥作用。在本文中，我们通过对1970年至2010年美国和其他17个高收入国家的福利国家慷慨（失业保险，疾病津贴和养老金）与预期寿命之间的关系进行时间序列横截面分析来检验这一“社会政策假设”。固定效应估计与自相关校正的标准误差（鲁棒的不可测量的国家间差异和重复测量的序列自相关）发现福利慷慨和预期寿命之间的强关联。整体福利慷慨度每增加一个单位，出生时预期寿命就会增加0.17岁（p < 0.001），65岁时预期寿命就会增加0.07岁（p < 0.001）。福利国家的影响最大的领域是养老金福利（出生时预期寿命B = 0.439，p < 0.001; 65岁时预期寿命B = 0.199，p < 0.001）。将社会政策措施滞后10年的模型也会产生类似的结果，这表明这些结果不是由内生偏见驱动的。有证据表明，美国的死亡率劣势在一定程度上是福利国家的劣势。我们估计，如果美国有其他17个经合组织国家的平均社会政策慷慨度，美国的预期寿命将延长约3.77年。(C)2016年6月，作者。爱思唯尔有限公司出版
The United States has a mortality disadvantage relative to its political and economic peer group of other rich democracies. Recently it has been suggested that there could be a role for social policy in explaining this disadvantage. In this paper, we test this "social policy hypothesis" by presenting a time-series crosssection analysis from 1970 to 2010 of the association between welfare state generosity (for unemployment insurance, sickness benefits, and pensions) and life expectancy, for the US and 17 other high income countries. Fixed-effects estimation with autocorrelation-corrected standard errors (robust to unmeasured between-country differences and serial autocorrelation of repeated measures) found strong associations between welfare generosity and life expectancy. A unit increase in overall welfare generosity yields a 0.17 year increase in life expectancy at birth (p < 0.001), and a 0.07 year increase in life expectancy at age 65 (p < 0.001). The strongest effects of the welfare state are in the domain of pension benefits (b = 0.439 for life expectancy at birth, p < 0.001; b = 0.199 for life expectancy at age 65, p < 0.001). Models that lag the measures of social policy by ten years produce similar results, suggesting that the results are not driven by endogeneity bias. There is evidence that the US mortality disadvantage is, in part, a welfare-state disadvantage. We estimate that life expectancy in the US would be approximately 3.77 years longer, if it had just the average social policy generosity of the other 17 OECD nations. (C) 2016 The Authors. Published by Elsevier Ltd.