The Short and Long Term Effects of Job and EArnings Losses on Health Outcomes

描述（由申请人提供）：正常的经济活动使工人的收入，就业和职业发展受到意想不到的冲击。例如，每年有超过10%的美国工人被解雇。虽然对许多工人来说，这些冲击可能是短暂的，但越来越多的文献表明，短期的职业冲击-如非自愿失业-可能对某些工人群体产生巨大和持久的影响。例如，成熟的失业工人往往会经历长期的收入损失，就业可能性降低，提前退休，工作不稳定性增加，以及消费减少和医疗保险覆盖范围的损失。大量文献表明，收入与就业和健康之间有着密切的联系。此外，越来越多的文献将经济不确定性和不快乐带来的压力与健康结果联系起来。然而，目前还没有对失业的影响、经济结果以及短期和长期健康的全面研究，部分原因是缺乏大量工人样本的详细纵向职业和健康信息数据。这是公共政策特别关注的问题，因为许多失业者可能有资格享受残疾保险，而且大多数最终有资格享受医疗保险。因此，社会通过增加保健开支承担了失业成本的一个重要部分。我们建议研究在大规模裁员和公司关闭期间失业对短期和长期健康结果的影响，使用几个大型管理数据集，通过社会保障局通过持续的合作访问。该数据包含有关收入，残疾，死亡和医疗保险支出的信息，非常适合此目的，因为它提供了1978年至2005年10%美国人样本的收入和健康结果以及雇主的纵向信息。我们还使用收入和计划参与调查中详细的健康相关和人口统计数据作为我们数据的子样本。这些数据使我们能够在公司层面隔离触发失业的事件，这些事件与工人先前的健康状况和收入无关。因此，我们可以隔离工人受到真正外部负面事件影响的情况，并在失业后15至20年内跟踪对收入，残疾保险和死亡率的影响。当工人领取残疾保险或年满65岁时，我们还可以分析失业对医疗保险支出的影响。我们的研究设计使我们能够（1）评估在大规模裁员或公司关闭期间失业对短期和长期健康结果和健康支出的影响;（2）研究失业影响健康结果和健康支出的渠道;以及（3）评估失业和收入分散的社会成本，通过医疗保险和社会保障残疾增加支出保险为了回应评论者的评论，我们还使用调查数据来评估失业前的工人健康状况，研究失业对健康的影响，而不是死亡率，并直接检查健康保险或配偶收入等关键渠道。公共卫生相关性我们使用了来自社会保障管理局的一个大型新数据集，涵盖了25年的数据，以研究在大规模裁员或公司关闭期间失业对死亡率，发病率和长期医疗支出的影响。因此，我们获得了一个更完整的画面的个人工人的成本失去工作，以及成本的社会承担通过增加支出的联邦残疾保险和医疗保险。

DESCRIPTION (provided by applicant): Regular economic activity exposes workers to unexpected shocks to their earnings, employment, and career development. For example, more than 10 percent of American workers are laid off every year. While for many workers these shocks may be short-lived, a growing literature shows that short-term career shocks - such as involuntary job losses - can have large and persistent effects for certain groups of workers. For example, mature displaced workers tend to experience long-term earnings losses, reduced employment probabilities, early retirement, increased job instability, as well as reductions in consumption and a loss in health insurance coverage. A long literature has demonstrated a strong correlation between earnings and employment and health. Moreover, a growing literature link stress from economic uncertainty and unhappiness to health outcomes. However, at present no comprehensive study of the effect of job loss, economic outcomes, and short and long-term health exists, partly due to a lack of data on detailed longitudinal career and health information for a large sample of workers. This is a particular concern for public policy, since many job losers may be eligible for disability insurance and most eventually become eligible for Medicare. Thus, an important part of the cost of job loss is borne by society through higher health expenditures. We propose to study the effects of job losses during mass-layoffs and firm closings on short and long term health outcomes using several large administrative data sets accessed through the Social Security Administration through an ongoing cooperation. The data contains information on earnings, disability, death, and Medicare expenditures and is ideal for this purpose, since it provides longitudinal information on earnings and health outcomes and employers for a 10 percent sample of Americans ranging from 1978 to 2005. We also use detailed health-related and demographic data from the Survey of Income and Program Participation available for a sub-sample of our data. The data allows us to isolate events at the firm level triggering job loss that are not correlated with workers' prior health status and earnings. Thereby, we can isolate situations in which workers are affected by truly external negative events, and follow the effect on earnings, entry into disability insurance, and mortality over 15 to 20 years after a job loss. As workers receive disability insurance or turn 65, we can also analyze the effect of job loss on Medicare expenditures. Our research design allows us to (1) evaluate the effects of job loss during mass-layoffs or firm closings on short- and long-term health outcomes and health expenditures; (2) to study the channels through which job loss affects health outcomes and health expenditures; and (3) to assess the social costs of job loss and earnings dispersion in terms of increased expenditures through Medicare and Social Security Disability Insurance. In response to reviewers' comments, we also use the survey data to assess workers' health prior to job loss, to study health effects of job loss other than mortality, and to directly examine key channels such as presence of health insurance or spousal income. PUBLIC HEALTH RELEVANCE We use a large new data set from the Social Security Administration spanning over 25 years of data to study the effects of job loss during mass-layoffs or firm closures on mortality, morbidity, and long-term health expenditures. Thereby, we obtain a more complete picture of the individual worker's costs of job loss, as well as of the costs society bears through increased expenditures for federal disability insurance and Medicare.