Income Support Policies and the Health of the Elderly

项目描述（由申请人提供）：本项目旨在评估收入支持政策对健康的影响。越来越多的证据表明，医疗保健只占人口健康差异的有限部分。社会和经济因素与生物医学因素一起，在解释个人健康差异方面发挥着重要作用。然而，对于社会和经济政策如何影响健康，甚至是否影响健康，人们知之甚少。因此，本研究的重点是老年人的收入支持政策，即目前的补充安全收入（SSI）和1974年以前的老年援助（OAA），是否会影响美国老年人的健康。该提案有三个目的：1)评估州内最高OAA和SSI福利的变化是否会影响州内老年人死亡率的变化；2)评估1940年至1960年州内OAA福利的变化是否导致65至70岁老年人与60至65岁老年人的死亡率在州内发生变化。65岁以下的人没有资格领取OAA，但与65至70岁的人比较相似，因此可以作为对照组；3)评估从OAA过渡到SSI是否降低了黑人和白人之间的死亡率差异。在南方的许多州，OAA的福利少得可怜。南方的政客们限制南方黑人获得福利。但SSI的实施迫使所有州都有一个标准的最低福利水平和标准化的资格。因此，黑人比白人更有可能从OAA到SSI的转变中受益，从而缩小了他们之间的死亡率差距。总而言之，为了实现这三个目标，一般的经验策略涉及州和年份固定模型，以评估州内最大OAA和SSI福利随时间的变化是否会影响州内变化的老年人死亡率。使用最大状态OAA和SSI福利是因为它们似乎与个人健康无关。所有模型都将通过利用当前人口调查、十年一次的美国人口普查和年度人口普查统计摘要的数据来控制州内人口和经济趋势的变化。总体和个人死亡率数据可从国家卫生统计中心获得。

DESCRIPTION (provided by applicant): The goal of this project is to evaluate whether income support policies affect health. There is increasing evidence that medical care accounts for only a limited portion of the variance in population health. Social and economic factors play a significant role, alongside biomedical factors, in explaining differences in health among individuals. Yet little is known about how, or even whether, social and economic policies affect health. Thus, this study focuses on whether the means tested income support policy for the elderly, which is currently Supplemental Security Income (SSI) and was Old Age Assistance (OAA) previous to 1974, affects elderly American's health. The proposal has three aims: 1) Evaluate whether within state changes in maximum state OAA and SSI benefits impacted within state changes in elderly mortality rates; 2) Evaluate whether within state changes in OAA benefits between 1940 and 1960 produced within state changes in mortality rates among the elderly for those aged 65 to 70 as compared to those aged 60 to 65. Individuals below age 65 were not eligible for OAA, but are relatively similar to those aged 65 to 70, thus can act as a control group; 3) evaluate whether the transition to SSI from OAA reduced the differences in mortality rates between blacks and whites. In many southern states OAA benefits were miserly. Southern politicians restricted black southerner's access to the benefits. But the implementation of SSI forced all states to have a standard minimum benefit level and standardized eligibility. Thus, blacks would be more likely than whites to benefit from the transition from OAA to SSI, thus reducing the mortality gap between them. In sum, the general empirical strategy, for all three aims, involves state and year fixed models to evaluate whether within state variation in maximum OAA and SSI benefits over time affects within state changes is elderly mortality. Maximum state OAA and SSI benefits are used because they are not plausibly endogenous with individual health. All models will control for within state changes in demographic and economic trends by drawing on the Current Population Survey, the decennial U.S. Census, and data from the annual Census statistical abstracts. Mortality data, both aggregate and individual level, is available from the National Center for Health Statistics.