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Cited by 68Retirement, Disability, and EmploymentHealth disparities and outcomesAging, Health, and Disability

Upstream Solutions: Does the Supplemental Security Income Program Reduce Disability in the Elderly?

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HERD, PAMELA, SCHOENI, ROBERT F., HOUSE, JAMES S.·2008·The Milbank Quarterly
DOI 10.1111/j.1468-0009.2007.00512.xPMC PMC2690339
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Abstract

Context:The robust relationship between socioeconomic factors and health suggests that social and economic policies might substantially affect health, while other evidence suggests that medical care, the main focus of current health policy, may not be the primary determinant of population health. Income support policies are one promising avenue to improve population health. This study examines whether the federal cash transfer program to poor elderly, the Supplemental Security Income (SSI) program, affects old‐age disability. Methods:This study uses the 1990 and 2000 censuses, employing state and year fixed‐effect models, to test whether within‐state changes in maximum SSI benefits over time lead to changes in disability among people aged sixty‐five and older. Findings:Higher benefits are linked to lower disability rates. Among all single elderly individuals, 30 percent have mobility limitations, and an increase of $100 per month in the maximum SSI benefit caused the rate of mobility limitations to fall by 0.46 percentage points. The findings were robust to sensitivity analyses. First, analyses limited to those most likely to receive SSI produced larger effects, but analyses limited to those least likely to receive SSI produced no measurable effect. Second, varying the disability measure did not meaningfully alter the findings. Third, excluding the institutionalized, immigrants, individuals living in states with exceptionally large benefit changes, and individuals living in states with no SSI supplements did not change the substantive conclusions. Fourth, Medicaid did not confound the effects. Finally, these results were robust for married individuals. Conclusions:Income support policy may be a significant new lever for improving population health, especially that of lower‐income persons. Even though the findings are robust, further analyses are needed to confirm their reliability. Future research should examine a variety of different income support policies, as well as whether a broader range of social and economic policies affect health.

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  • Higher SSI benefit levels reduced disability among beneficiaries aged 65 and older, robust across disability measures and Medicaid receipt.

    “They conclude that higher SSI benefit levels reduced disability in this group and their results remained robust regardless of the disability measure used (self-reported health condition or census Activities of Daily living (ADL) measure) and whether or not beneficiaries also received Medicaid (state programs to pay for medical care used by the indigent) payments for medical services.”

    From Social security and mortality: The role of income support policies and population health in the United States (2011) · cites this paper as [6]

    The Results and Summary and Discussion link higher state SSI benefit maximums to lower disability among adults aged 65 and older, and report broadly similar findings using a census ADL measure. But the analysis did not estimate the effect specifically among SSI beneficiaries; it studied broader populations, including a low-income subgroup. The Medicaid analyses tested whether Medicaid participation or spending confounded the finding, not whether it held separately for beneficiaries who did and did not receive Medicaid. No page numbers are available in our copy. (LLM, conf=0.88)

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Research works printed but not linked: 7

  1. [3]3. Adler, N., T. Boyce, M. Chesney, S. Folkman, and S.L. Syme. 1994. SES and Health. American Psychologist 49(1):15-24.
  2. [4]4. Alaimo, K., C.M. Olson, E.A. Frongillo, and R.R. Briefel. 2001. Food Insufficiency, Family Income, and Health in US Children. American Journal of Public Health 91(5):781-86.
  3. [33]33. Graham, H. 2004. Social Determinants and Their Unequal Distribution. Milbank Quarterly 82(1):101-24.
  4. [38]38. Hayward, M., A. Pienta, and D. McLaughlin. 1997. Inequality in Men's Mortality. Journal of Health and Social Behavior 38(4):313-30.
  5. [49]49. Kington, R., and J. Smith. 1997. Socioeconomic Status and Racial and Ethnic Differences in Functional Status. American Journal of Public Health 87(5):805-10.
  6. [52]52. Lantz, P., J.S. House, J. Lepkowski, D. Williams, R. Mero, and J. Chen. 1998. Socioeconomic Factors, Health Behaviors, and Mortality. Jour- nal of the American Medical Association 279(21):1703-8.
  7. [71]71. Mulatu, M.S., and C. Schooler. 2002. Causal Connections between Socioeconomic Status and Health: Reciprocal Effects and Medi- ating Mechanisms. Journal of Health and Social Behavior 43(2):22- 41.

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Authors
HERD, P., SCHOENI, R. F., & HOUSE, J. S.
Affiliations
University of Wisconsin–Madison (US)
Corresponding author
HERD, PAMELA
ORCID
Venue
The Milbank Quarterly
Publisher
Wiley
Published
2008-02-27
Volume
86
Issue
1
Pages
5-45
ISSN
  • 0887-378X (ISSN-L)
  • 1468-0009
DOI
10.1111/j.1468-0009.2007.00512.x
PMC
PMC2690339
OpenAlex
W2020382470
Cited by
68
References
105
Citations by year
2026: 1 · 2025: 7 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 3 · 2016: 3 · 2015: 5 · 2014: 4 · 2013: 3 · 2012: 2
FWCI
17.70
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Milbank Quarterly (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
Funders
National Institute on Aging (R03 AG0276611)
Topics
  • Social Sciences › Demography › Retirement, Disability, and Employment
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
Keywords
Supplemental Security Income, cash transfers, income support policy, mobility limitations, elderly health, elderly living alone, Medicaid, population health, low-income populations
MeSH terms
Activities of Daily Living, Aged, Aged, 80 and over, Female, Persons with Disabilities, Humans, Income, Male, Medicaid, Policy Making, Social Security, United States, Models, Econometric, Censuses

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