Assessing the impact of benefit sanctions on health

点击翻译按钮获取中文摘要

The aim of this research is to examine whether benefit sanctions lead to claimants having worse physical or mental health, or making greater use of health services. It also seeks to add to our knowledge on whether sanctions encourage claimants to return to employment more quickly. The proposal is innovative in using a database of individuals' benefits, employment and health histories constructed from administrative records which have not previously been linked. BackgroundPeople who claim some benefits, especially Jobseeker's Allowance (JSA) and Employment & Support Allowance claimants in the Work-Related Activity Group (ESA WRAG), have conditions placed on them. With JSA, for example, claimants must sign on at the Jobcentre Plus office regularly and take certain steps to find work. If they fail to meet these conditions, they can be sanctioned, i.e. their benefits are stopped for a period. There have always been conditions on unemployment benefits but they have increased in recent years, with the number of sanctions and maximum length rising. The introduction of Universal Credit has seen conditions extended to those in work as well as higher sanction rates for early cases. Sanctions are meant to ensure that people return to work as soon as they can. This is good for public finances as it keeps claims down, good for the economy as it keeps labour supply up and, arguably at least, good for claimants since unemployment tends to be bad for our health. However, critics argue that sanctions may have unintended side-effects: harming claimant health, increasing homelessness, or putting stress on families which affects child welfare. Health effects may arise from restricted spending on food or heating but also from the psychological stresses of trying to cope without income. These unintended impacts could lead to greater expenditure on public services, off-setting savings from reduced benefit claims. There has been very little research on these unintended impacts associated with sanctions, and almost none which can provide convincing evidence that sanctions cause harm. Proposed researchWe will construct a database of individuals' benefit, work and health histories by combining information held in the administrative records of the Department for Work and Pensions (DWP) and NHS Scotland. The data are sensitive, personal information so we need special permissions to access them which we are in the final stages of securing. The database will cover people who claimed JSA or ESA WRAG in Scotland for 2010-17. We focus on Scotland because the health data are currently only available here. From DWP, we get records of claim spells and whether people were sanctioned. From NHS Scotland, we get information on: the prescribing of medicines which can indicate various physical and mental health conditions; use of Accident & Emergency or unplanned hospital admissions which can indicate incidents arising from risky behaviours such as alcohol abuse or the worsening of chronic conditions due to poor diet, stress, etc.; and mortality data, including suicides. We will also examine missed appointments since these are a significant concern for the health services. From Oct 2013 on, DWP can provide data on employment spells so we can look at the labour market impact of sanctions in this period, and hence whether any health effects depend on whether people find paid work or not. The main challenge for our analysis is to show whether sanctions cause a change in health. To do this, we have to rule out the possibility that there are other factors which mean that the people who are more likely to get sanctioned also tend to have worse health; examples might include a drug or alcohol problem, or a domestic crisis such as a bereavement. There are various techniques which let us do this. The results of the research will feed into academic debates about the recent changes to welfare but are also intended to have an influence policy in this area.