Squared Away Blog

Research

March 10, 2022

Employers have learned over the years that understanding employee psychology is critical to getting them to save for retirement. Researchers have landed on a novel idea along those lines: explain to employees that they have an opportunity to save in a 401(k) or increase their 401(k) saving on a future date that represents a fresh start, such as a birthday or the first day of spring.

In a 2021 study in the journal Organizational Behavior and Human Decision Processes, this “fresh start framing” during an experiment increased the percentage of workers who agreed to contribute to their employer retirement plans and increased the share of pay contributed to the plans. In both cases, the increases were well in excess of 25 percent in a comparison with employees who were presented with less salient future dates.

Add this technique to a well-established one that growing numbers of employers already use with some success: automatically enrolling workers in the 401(k), and sometimes automatically increasing their contributions, which research has shown can work better than waiting for them to do it themselves. Most of the retirement plans in the study did not have any automatic features, and the fresh start dates proved another way to elicit better saving habits – voluntarily.

The option to delay a commitment to save is based on an assumption that people are more willing to make a change that involves sacrifice if it can be postponed – smokers often try to quit this way. One theory for using a fresh start date is that it imbues a feeling of optimism, giving employees permission to set aside past failures. …Learn More

March 1, 2022

When workers develop disabilities on the job, it often has some connection to where they live.

Musculoskeletal conditions like arthritis and tendinitis can happen anywhere but are especially prevalent in a swath surrounding the Kentucky-West Virginia border and running south to Alabama. Intellectual disabilities and mood disorders like autism and depression are common in Vermont, New Hampshire, Massachusetts, and Rhode Island.

The hot spots, described in new research, represent areas that fall in the top 10 percent of all the areas with awards for the specific condition in many of the years studied, 2005 through 2018.

New Hampshire is a dramatic example: all 10 designated areas of the state were identified as hot spots for awards based on mental disorders in all 14 years.

In addition to mental and musculoskeletal conditions, the researchers from Mathematica found a third major hot spot for circulatory and respiratory disorders like heart disease and asthma. These disorders are prevalent in an area that starts in Indiana and Illinois and flows down the Mississippi River to Mississippi.

The explanations for the hot spots are myriad and complex. Musculoskeletal disabilities constitute the largest single type of benefit award – a third of the U.S. total – and hot spots in the Southeast, where coal mining, agriculture and manufacturing are dominant, tend to have older, less educated populations and more veterans. …Learn More

Research

February 17, 2022

Paying off the mortgage frees up a lot of money for other things. The homeowners in one study splurged on big-ticket items.

Older homeowners, however, are adding another priority: medications.

After a mortgage payoff, workers and retirees ages 50 to 64 spent 50 percent more on prescription drugs in a comparison with households who had no major changes in their monthly housing costs, according to a new study by Harvard’s Joint Center for Housing Studies and funded by the U.S Social Security Administration.

The mortgage is typically a homeowner’s largest monthly expense. If medication spending rises when this big bill is eliminated, it supports the argument that some aging homeowners who are still carrying a mortgage may be choosing housing over necessary medical care.

This research is particularly relevant at a time older Americans are entering retirement with more debt. In 2016, four in 10 retirees had a mortgage – double the share in the late 1980s.

Not surprisingly, the researchers found some indication that lower-income workers and early retirees benefited more from eliminating their monthly payments. They have difficulty paying even for essential expenses, and the increase in their prescription purchases after paying off the home loan appeared to be larger than for higher-income groups with fewer constraints.

The researchers split the homeowners into two age groups – under and over 65. While homeowners under 65 sharply increased their drug spending after the mortgage payments ended, the Medicare beneficiaries did not.

The level spending after Medicare eligibility indicates that the program relieves some of the pressure on the family budget, the researchers said. Medicare also provides an average $5,000 annually to subsidize low-income retirees’ medications under the Low Income Subsidy program.

But for older homeowners who are too young to get Medicare but are still paying a mortgage, the study “raises serious concerns for health care quality and the costs to treat poorly managed conditions,” the researchers said.

To read this study, authored by Christopher Herbert, Jennifer Molinsky, Samara Scheckler, and Kacie Dragan, see “Older Adult Out-of-Pocket Pharmaceutical Spending after Home Mortgage Payoff.”

A blog post last year featured a similar study – this one about the older Americans’ adherence to medications after …Learn More

Research

February 3, 2022

One in five babies born in U.S. cities is in poor health, with profound and lasting impacts on their own and their mother’s lives.

Researchers reached this conclusion after following nearly 3,700 infants and their mothers through Princeton’s Fragile Families Survey, which checked in on the families six times between the child’s birth and age 15. The survey was fielded in cities with a 200,000-plus population, and the babies’ most common medical conditions were low birth weight, premature birth, and genetic or other abnormalities, such as difficulty breathing.

A body of research on the long-run prospects for children with disadvantages – whether medical or socioeconomic – has established that they have far more problems as adults. Consistent with other prior research, a study by Dara Lee Luca and Purvi Sevak at Mathematica also found an immediate consequence for newborns in poor neonatal health: a greater likelihood of having a disability such as a motor or speech disorder or neurodevelopmental problems such as ADHD and autism.

Within their first year, the infants often qualified for federal cash payments to their mothers under Supplemental Security Income for Children (SSI).

The inordinate amount of time spent caring for babies in poor neonatal health takes an enormous toll on the mothers, the researchers found. While caregiving didn’t seem to impact their mental health, their ability to hold down a job was significantly compromised. The mothers of babies in poor health worked fewer hours, especially when the children were very young, and were more likely to drop out of the labor force entirely. …Learn More

Research

January 6, 2022

Opioids fueled a record of nearly 100,000 drug overdose deaths in the United States last year.

The biggest cause of overdose deaths was dangerous synthetic opioids, such as fentanyl. But the epidemic involving illegal chemicals grew out of the abuse of highly addictive prescription opioids. A spate of new research reveals that the use and abuse of these prescription drugs have plagued people with disabilities, who often start taking them to treat painful musculoskeletal conditions such as arthritis or a bad back.

A 2017 analysis featured in this blog provided the first estimate of opioid use among people who have disabilities that limit their ability to work. The researchers found that about one in four people applying for federal disability benefits used the medications – a much higher rate than in the U.S. population overall.

Painkillers often do more harm than good because they can increase society’s dependence on disability benefits by impairing lung function, aggravating existing conditions like rheumatoid arthritis, or causing addiction. According to 2021 research by RAND that followed older workers over several years, the opioid users in the study were much more likely to wind up on disability than their counterparts who did not take them.

“Although the pain relief is an important health goal,” the researchers concluded, “the consequences to workers and social programs of powerful prescription painkillers are substantial and long-lasting.”

The isolation and stresses caused by the pandemic are believed to have fueled the dramatic rise in overdose deaths last year. But a long-running cause, prior to COVID, was the decline in U.S. manufacturing employment. Research reported in this blog directly tied the movement of robots onto factory floors to the rise in deaths of despair – from drug addiction, alcoholism, and suicide – among men between ages 30 and 54. The study found that automation accounts for nearly one in five overdose deaths in manufacturing counties, which are concentrated in the heavily industrialized Midwest. The researchers said the rate of applications for disability benefits is also higher in these counties.

Opioid abuse in the disability community is happening for the same reason it is pervasive in society: an ample supply of the addictive drugs. …Learn More

Research

December 16, 2021

Two previous studies on long-term care reported in this blog estimated how many of today’s 65-year-olds today will require care for minimal, moderate, or severe levels of need as they age and how many have the financial resources to cover each level of care that might be required.

In the third and final study in this series, the Center for Retirement Research matched the specific levels of need each retiree is projected to have in the future with their resources to determine how many of them will fall short.

Among all retirees, 22 percent are expected to have minimal needs for care and 9 percent will lack the family and financial resources to cover it – in other words, just under half of the people in this group will fall short. The shortfall among people with moderate needs will be larger: the comparable figures are 38 percent of all retirees will be at this level and 21 percent of retirees will fall short. Finally, 24 percent of retirees are expected to have severe care needs – for at least five years – and 16 percent will fall short.

But there is another critical source of support: Medicaid. The researchers find that the joint federal-state program dramatically reduces the share of retirees with insufficient resources to cover their care.

Not everyone qualifies for Medicaid, however. Older Americans can get the funding if they meet two conditions. First, they must have a serious health issue, such as dementia or a physical or medical condition that limits their activity. Second, the program covers nursing homes only for retirees with little in the way of financial resources, either because they had lower-paying jobs and didn’t save or because they exhausted most of the retirement savings they had scraped together.

When Medicaid is added to the picture, the program makes a significant dent. Among the 65-year-olds who will need moderate care, the share of all retirees who lack the resources to cover it drops from 21 percent to 14 percent when Medicaid funding is included. Medicaid also reduces the burden on boomers who will need high levels of care: the share lacking adequate resources drops from 16 percent to 11 percent.

The researchers didn’t include Medicaid in the resources available to the 9 percent of retirees who will need only minimal help with chores like cleaning or grocery shopping. The program typically doesn’t pay for these services, though there has been movement in a handful of states and at the federal level to loosen the restrictions around housekeeping. …Learn More

Research

November 18, 2021

The federal minimum wage is $7.25 an hour and hasn’t budged since 2009. But many states and some municipalities have raised their minimum wages. Today, more than half of the state minimums exceed the federal minimum.

Now a new trend has emerged: 19 states have enacted or approved automatic yearly increases in their minimum wages to protect their residents from inflation. These adjustments just went into effect this year in Arizona, Colorado, Maine, and Washington D.C.

How might higher minimum wages affect applications for disability insurance? On the one hand, the higher pay could prevent some people with mild disabilities from resorting to the fallback option: applying for disability benefits. But if small employers lay people off to cut costs or feel they can’t afford to hire workers at the new higher minimum wage, applications could go up. Facing fewer job opportunities, more low-wage workers might apply for benefits from a program that currently covers some 16 million Americans.

A new study finds that a rising minimum wage does, indeed, increase disability applications to the U.S. Social Security Administration. But the researchers stress that this impact is minimal compared with the increase driven by an economic downturn that throws more people out of work.

In their analysis of nearly 3,000 counties from 2000 through 2015, a one-dollar increase in the minimum wage added some 80,000 more applications to the disability program and its companion, the Supplemental Security Income program for the poor, elderly, and adults with disabilities. That represents a 2 percent increase.

Contrast that to the impact of a rising unemployment rate, which was about three times larger. …Learn More