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Assessing the impact of benefit sanctions on health

评估福利制裁对健康的影响

基本信息

批准号：
ES/R005729/1
负责人：
Nick Bailey
金额：
$ 20.54万
依托单位：
University of Glasgow
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2018
资助国家：
英国
起止时间：
2018 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=ES%2FR005729%2F1
关键词：
Assessing impact benefit sanctions health

项目摘要

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.

这项研究的目的是检查福利制裁是否会导致索赔人的身体或精神健康状况变差，或者更多地使用医疗服务。它还试图增加我们对制裁是否鼓励索赔人更快重返工作岗位的了解。该提案在使用个人福利、就业和健康历史数据库方面具有创新性，该数据库是由以前没有关联的行政记录构建的。背景申请某些福利的人，特别是工作相关活动小组(ESA WRAG)中的求职者津贴(JSA)和就业与支持津贴申领人(ESA WRAG)，是有条件的。例如，在JSA，申领人必须定期在Jobcenter Plus办公室签约，并采取某些步骤找到工作。如果他们不符合这些条件，他们可以受到制裁，即他们的福利在一段时间内被停止。失业救济金一直是有条件的，但近年来有所增加，制裁的次数和最长期限都有所增加。引入普遍信贷后，条件扩大到那些正在工作的人，以及对早期案件的更高处罚率。制裁旨在确保人们尽快重返工作岗位。这有利于公共财政，因为它降低了申领失业救济金人数，有利于经济，因为它保持了劳动力供应的增加，而且可以说，至少对申领失业救济金的人有利，因为失业往往对我们的健康不利。然而，批评人士认为，制裁可能会产生意想不到的副作用：损害索赔人的健康，增加无家可归者，或者给影响儿童福利的家庭带来压力。对健康的影响可能来自食品或取暖支出的限制，但也可能来自试图在没有收入的情况下应对的心理压力。这些意想不到的影响可能会导致公共服务支出增加，抵消福利申领减少带来的节省。关于制裁带来的这些意想不到的影响的研究很少，几乎没有能够提供令人信服的证据证明制裁造成伤害的研究。建议研究我们将结合工作和养老金部门(DWP)和苏格兰国民健康保险制度(NHS)行政记录中的信息，建立一个关于个人福利、工作和健康历史的数据库。这些数据是敏感的个人信息，因此我们需要特殊权限才能访问它们，而我们正处于保护的最后阶段。该数据库将涵盖2010-17年度在苏格兰申请JSA或ESA WRAG的人。我们把重点放在苏格兰，因为健康数据目前只能在这里获得。从DWP，我们可以获得索赔期限的记录，以及人们是否受到制裁。从苏格兰国民健康保险制度，我们得到以下信息：开药可表明各种身心健康状况；使用急诊或非计划住院可表明危险行为引起的事件，如酗酒或由于不良饮食、压力等造成的慢性疾病恶化；以及死亡数据，包括自杀。我们还将审查错过的预约，因为这是医疗服务的一个重要问题。从2013年10月开始，DWP可以提供就业时间的数据，这样我们就可以研究这段时间内制裁对劳动力市场的影响，因此是否会对健康造成任何影响，取决于人们是否找到了有偿工作。我们的分析面临的主要挑战是，展示制裁是否会导致健康状况发生变化。要做到这一点，我们必须排除其他因素的可能性，这些因素意味着更有可能受到制裁的人往往健康状况更差；例如，可能包括毒品或酒精问题，或者家庭危机，如丧亲。有各种技术可以让我们做到这一点。这项研究的结果将进入关于最近福利变化的学术辩论，但也旨在对这一领域的政策产生影响。