Income Support Policies and the Health of the Elderly

描述(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体之间的健康差异方面发挥着重要作用。然而，关于社会和经济政策如何影响健康，甚至是否会影响健康，人们知之甚少。因此，本研究的重点是老年人的经济状况调查收入支持政策，目前是补充保障收入(SSI)，1974年以前是老年援助(OAA)，是否影响美国老年人的健康。该提案有三个目的：1)评估州内最高州高龄津贴和社会保障援助福利的变化是否影响到州内老年人死亡率的变化；2)评估1940年至1960年期间高龄津贴福利的变化是否在州内产生变化，65岁至70岁的老年人的死亡率与60岁至65岁的老年人相比是否发生变化。65岁以下的人没有资格领取高龄津贴，但与65岁至70岁的人相对相似，因此可以作为对照组；3)评估从高龄津贴过渡到SSI是否减少了黑人和白人之间的死亡率差异。在美国南部的许多州，高龄津贴福利非常吝啬。南方政客限制南方黑人享受福利。但SSI的实施迫使所有州都有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高龄津贴过渡到SSI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，总体经验策略包括州和年固定模型，以评估在州内随时间变化的最大OAA和SSI收益是否影响州内的老年死亡率。之所以使用最大的州高龄津贴和SSI福利，是因为它们与个人健康并不是内生性的。所有模型都将利用当前人口调查、十年一次的美国人口普查和年度人口普查统计摘要中的数据，控制州内人口和经济趋势的变化。死亡率数据，包括总体和个人层面，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.