Income Support Policies and the Health of the Elderly

描述（由申请人提供）：本项目的目标是评估收入支持政策是否影响健康。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。除了生物医学因素外，社会和经济因素在解释个人健康差异方面发挥着重要作用。然而，人们对社会和经济政策如何、甚至是否影响健康知之甚少。因此，本研究的重点是是否手段测试的收入支持政策的老年人，这是目前的补充保障收入（SSI）和老年援助（OAA）在1974年之前，影响美国老年人的健康。该提案有三个目标：1）评估最大州高龄津贴和SSI福利的州内变化是否影响了老年人死亡率的州内变化; 2）评估1940年至1960年期间高龄津贴福利的州内变化是否导致65岁至70岁老年人与60岁至65岁老年人的死亡率发生变化。65岁以下的人不符合OAA的条件，但与65至70岁的人相对相似，因此可以作为对照组; 3）评估从OAA过渡到SSI是否减少了黑人和白人之间死亡率的差异。在许多南方州，高龄津贴的福利少得可怜。南方的政客们限制南方黑人享受这些福利。但是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，黑人将比白人更有可能从从高龄津贴向SSI的过渡中受益，从而缩小他们之间的死亡率差距。总而言之，对于所有三个目标，一般的经验策略涉及州和年固定模型，以评估随着时间的推移，最大高龄津贴和SSI福利的州内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，因为它们与个人健康无关。所有模型都将通过利用当前人口调查、十年一度的美国人口普查以及年度人口普查统计摘要中的数据来控制州内人口和经济趋势的变化。国家卫生统计中心提供了总体和个人死亡率数据。

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.