September 10, 2020
Why the Mix of Disabilities is Changing
The mix of disabilities for people receiving federal disability insurance has changed in important ways that often reflect trends in the health of the population as a whole.
Two disabling conditions that have become a growing share of Social Security’s benefit awards in recent decades are mood disorders and various musculoskeletal problems, which include arthritis and back pain.
First, consider mood disorders. They range from depression and bipolar disorder to irritability and seasonal affective disorder, and they can hamper someone’s ability to work. Mirroring the rising share of awards for mood disorders, their prevalence in the population has edged up from 54.6 percent of adults in 1997 to 56.2 percent in 2017, according to a study by Mathematica, a research organization.
Second, disability awards to people with musculoskeletal problems like arthritis and back pain have increased dramatically. These conditions are often aggravated by carrying excess weight, so the rise in cases aligns with the researchers’ estimate that the adult obesity rate has surged from about 20 percent to 31 percent.
But a related finding about musculoskeletal conditions is more difficult to explain. Despite the growth in disability awards involving these conditions, the share of the population afflicted by them – about a third – hasn’t changed much, according to the study, which was conducted for the Retirement and Disability Research Consortium.
The researchers found one clue to this apparent contradiction in a separate analysis indicating that this population’s ability to work may be deteriorating over time. …Learn More
August 11, 2020
Same Arthritis. But Some Feel More Pain
The X-rays look very similar for two 60-year-old women with arthritic knees.
But the less-educated woman has more severe pain than the person who graduated college.
A new study of men and women finds that the degree of knee-joint deterioration visible in an X-ray isn’t the primary reason one person experiences more knee pain than someone else. Instead, the overwhelming reason is knee strain caused by obesity and the toll taken by physically demanding jobs – both of which are more common among less-educated workers.
The researchers focused on knee arthritis, because musculoskeletal pain is one of the leading causes of Social Security benefit payments to people who develop a disability and can no longer work.
Understanding what’s behind the pain differences is important, because the need for workers in certain jobs requiring physical strength – home health aides, janitors, and construction workers are examples – is expected to increase in the future.
Given this growing demand and predictions of a continued rise in obesity, the researchers conclude that “pain is expected to contribute to an increase” over time in the percentage of the population who will be impaired by their pain.
The people in the study fell into three educational groups: a high school degree or less; some college; or a four-year college degree. The researchers also had information about their occupations, as well as several data sources that gauge the severity of their knee pain, including the ability to do things like walking a quarter of a mile.
Knee arthritis worsens with age. However, a surge in reports of severe knee pain came about a decade earlier for people with no more than a high school degree than the surge for college graduates. …Learn More
April 30, 2020
Unexpected Retirement Costs Can be Big
Resourceful retirees usually weather the financial surprises that come their way. But a handful of unexpected health events can really hurt.
The death of a spouse is at the top of the list. Net worth drops by more than $30,000 over a couple of years as retirees pay for the extraordinary medical and other expenses surrounding a spouse’s death.
Two serious health conditions also deplete retirees’ assets: strokes and lung disease, which strike about one in five older Americans during their lifetimes, according to a National Bureau of Economic Research study funded by the U.S. Social Security Administration that tracked changes in the finances of people 65 and over.
Despite the presence of Medicare, a first-time stroke reduces a retired household’s average wealth by more than $25,000 – or 6 percent – and lung disease reduces it by about $29,000.
Net worth in this study includes financial assets and home equity minus debts.
These estimates of the cost of various events provide new information about a few of the many unknowns that go into retirement planning. Workers who may think they are saving enough to cover their routine retirement expenses don’t necessarily factor in medical and related costs that are difficult or impossible to predict.
Taken together, single and married retirees will use anywhere from 3 percent to 14 percent of their wealth to pay these unpredictable expenses. But wealthy retirees, who can afford first-rate care, spend much more than the average, while poor people, who have Medicaid to supplement their Medicare, spend very little. …Learn More
April 7, 2020
Our Parents Were Healthier at Ages 54-60
Baby boomers aren’t as healthy as their parents were at the same age.
This sobering finding comes out of a RAND study that took a series of snapshots over a 24-year period of the health status of Americans when they were between the ages of 54 and 60.
The researchers found that overall health has deteriorated in this age group, and they identified the specific conditions that are getting worse, including diabetes, pain levels, and difficulty performing routine daily activities.
Obesity is an overarching problem: the share of people in this age group with class II obesity, which puts them at very high risk of diabetes, tripled to 15 percent between 1992 and 2016.
In addition to declining health, the study for the Retirement and Disability Research Consortium uncovered strong evidence of growing health disparities among 54 to 60-year-olds: the poorest people are getting sicker faster than people with more wealth.
The increase in women’s pain levels has been starkest over the past 24 years. The wealthiest women have seen an increase of 6 percentage points in the share experiencing moderate to severe pain from conditions like joint or back pain. But the poorest women saw a 21-point leap. The disparity for men was also large: up 7 points for the wealthiest men versus 15 points for the poorest men.
The bottom line: today’s 54 to 60-year-olds are not as healthy as their parents were, and the study suggests that the disparities between rich and poor will continue to grow.
To read this study, authored by Peter Hudomiet, Michael D. Hurd, and Susann Rohwedder, see “Trends in Health and Mortality in the United States.”Learn More
March 10, 2020
Hypertension, Arthritis? Keep Working!
The growing list of effective medications available for managing a variety of chronic conditions seem to be changing the way we work and retire.
For example, older workers at one company who suffer from arthritis and high blood pressure – two relatively easy conditions to treat – are able to keep working just like their healthier co-workers, according to a new study from a research consortium funded by the U.S. Social Security Administration.
In fact, the two specific groups in this study – employees with hypertension or a combination of arthritis and hypertension – actually worked an average of four to 10 months longer, respectively, than the healthy workers. This counterintuitive finding might owe to the fact that people with chronic conditions are motivated to work longer to maintain their employer health insurance. Another possibility is that, because of their condition, they pay closer attention to their overall health and take better care of themselves.
The researchers, who are from Stanford University’s Medical School and Princeton University, had the advantage of access to nearly 4,700 employees’ detailed medical records, which allowed them to track how their health progressed over an 18-year period, until they retired.
A limitation of the study is that the employees aren’t representative of the general working population. They were mainly white men employed in Alcoa smelters and fabrication plants around the country. And because it was very common for them to join the company in their 20s and qualify for a 30-year pension, their average retirement age was only 58.
But older workers in a wide variety of professions are reckoning with the need to work longer than they might have planned so they can afford to retire.
A chronic medical condition doesn’t have to be a barrier to working as long – or even longer – than everyone else. …Learn More
October 24, 2019
Part D Cost for Brand Name Drugs Rising
Reforms to Medicare Part D under the Affordable Care Act brought significant relief to retirees by reducing the share of medication costs they must pay out of their own pockets.
But with the healthcare reform now nearly a decade old, other developments have taken over that will drive up drug costs for the most vulnerable retirees – the biggest users of expensive brand name drugs. Although only a few million people will be affected, they are already saddled with the highest spending burden.
This vulnerable group could get some help from Congress. There is bipartisan support for placing an absolute limit on how much Part D policyholders must pay in total for their prescriptions, said Juliette Cubanski, associate director of the Medicare policy program at the Kaiser Family Foundation.
“That’s a positive development,” she said, “but there are also several areas of disagreement in the legislation being considered on the House and Senate sides.”
Under the Affordable Care Act (ACA), retirees are required to pay 25 percent of their total drug costs up to the annual threshold that qualifies them for catastrophic coverage – this dollar threshold is the total of their own payments plus the price discounts from manufacturers of brand name drugs. The upshot in 2020 for retirees is that those with the highest need could spend about $375 more out of their own pockets before they enter Part D’s less-onerous catastrophic coverage phase, according to a Kaiser analysis. And that’s just the increase for next year – their outlays will rise over the next decade.
Once retirees enter the catastrophic phase, they are protected, because Medicare begins picking up the vast majority of the tab. But out-of-pocket costs are rising because the ACA’s controls on the spending threshold they must cross to qualify for catastrophic coverage have ended. …Learn More