Posts Tagged "depression"

Two workers loading a truck

Who Applies for Disability – and Who Gets it

Blue-collar workers who end up applying for federal disability benefits find themselves in that position for a variety of interrelated reasons.

A dangerous or physically demanding job can either cause an injury or exacerbate a medical condition that could lead to a disability. And people with limited resources in childhood often develop health problems earlier in life, and their circumstances can limit their access to job opportunities, making them more likely to end up in dangerous or physically demanding jobs.

A new NBER study untangles all these factors to clarify who applies for disability and which applicants ultimately receive benefits through Social Security’s rigorous approval process.

Researchers at Stanford and the University of Wisconsin linked a survey of Americans 50 and older to occupational data describing the level of environmental and physical hazards they’ve faced during decades of working. Next, socioeconomic measures of their upbringing – the adults’ descriptions of their childhood health, education, and parents’ financial resources – were layered into the analysis. Finally, the researchers repeated the process, replacing childhood health with genetic data on their predispositions to various disabling illnesses.

Blue-collar and service workers are known to apply for federal disability benefits at higher rates than white-collar workers. But the researchers showed that low socioeconomic status in childhood – by limiting the options for less strenuous jobs – played an even bigger role than workplace demands in whether the workers applied for the benefits.

However, when it comes to who is approved for benefits, physical and mental job requirements were key – and socioeconomic status plays no role. This makes sense because the heart of Social Security’s approval process is a determination that a disabled person is unable to do his previous job or another job appropriate to his age and experience.

An applicants’ health is, by definition, always central to whether he qualifies for disability. The final step in the researchers’ analysis used genetic data to get a picture of the applicants’ underlying health – as distinct from the health problems originating from a disadvantaged childhood. …Learn More

House roof illustrations

Boomers Repairing their Mortgage Finances

The housing market collapse more than a decade ago inflicted a lot of financial damage on baby boomers nearing retirement. But a new study finds that some have been trying to make up for lost time by rapidly reducing their mortgage debt.

Since the Great Recession, the boomers who were born in the 1950s – they are now in their 60s – have paid down more than 40 percent of their remaining mortgages and home equity loans, on average – a much faster pace than their parents did at that age.

Not all the damage from the Great Recession can be repaired, however, because many people lost their homes in the wave of foreclosures. For example, the homeownership rate for the boomers born in the early 1950s quickly dropped slightly more than 10 percentage points after the housing crisis, to 67 percent, where it remained until 2016, the last year of data in the study.

Since then, the U.S. homeownership rate has increased but is still below the pre-recession peak.

The impact of the housing crisis was far less dramatic for Americans born in the early 1930s. Their homeownership rate dipped 2 percentage points right after the crisis, to a relatively high 76 percent, according to Jason Fichtner of Johns Hopkins University.

The decline in boomers’ homeownership leaves fewer of them with housing wealth to fall back on when they retire.

They have also fallen behind in fully paying off their mortgages, which would eliminate their monthly payments and make the house a low-cost place to live. Just half of the boomers born in the early 1950s who held onto their homes during the Great Recession own them outright – two-thirds of the people born in the early 1930s had paid off their mortgages by that age. …Learn More

Isolated birds

Isolation May Worsen Impact of Disability

A danger for working-age people with disabilities is that they become socially isolated, which can cause a further deterioration in their health and ability to function.

A good example of this vicious cycle is people with severe arthritis. If joint pain makes walking more difficult, it can limit one’s ability to do things with friends or be out in public, which means more social isolation and less exercise to ease the pain’s disabling effects.

A new Mathematica study connects this phenomenon to the sharp rise in the share of Social Security disability awards going to people with arthritis, back pain, and other musculoskeletal conditions.

Between 1997 and 2017, there was a slight increase, to 13.4 percent, in the share of Americans with musculoskeletal conditions who reported being socially isolated, according to the study, which was conducted for the Retirement and Disability Research Consortium.

Discomfort in social settings is also present in the general population – but at about half the rate, or 6 percent of adults.

Another contributor to social isolation is cognitive impairment, which includes confusion and poor memory. Cognitive impairments are also on the rise among people with arthritis and related conditions. The increase can’t solely be attributed to the aging of the U.S. population either, because the analysis controlled for age in order to eliminate its effects.

To understand the role of social isolation in disability, the researchers point to the vicious cycle between the two.

“Whether social isolation is exacerbating disability or disability is exacerbating social isolation,” they said, “the contributing limitations are risk factors” that will worsen a disability that already exists. …Learn More

Silhouettes of people

2020 Disability Blogs Tackle Myriad Issues

Squared Away has featured numerous articles this year – the 30th anniversary of the Americans with Disabilities Act – about the challenges that people with disabilities must deal with.

One in four adults in this country has some type of disability. What becomes clear when looking back at this collection of articles is the importance of ensuring that those who are capable of working get the support they need to overcome their unique challenges.

Employment rates, which are lower for people with disabilities, can be improved greatly if they receive support. One recent blog examined a program to assist people with severe intellectual or learning disabilities. The federal-state Vocational Rehabilitation program supplies coaches who help their clients find appropriate work and then smooth the bumps in the employer-employee relationship.

Another program that provides day care to children with disabilities has been effective in keeping their mothers – often single, low-income workers – in the labor force.

The logistical barriers to working are inherently higher for people with disabilities. Yet they are more likely than others to hold low-paying jobs with just-in-time scheduling or shifts that aren’t the same from week to week, according to research covered in an August blog. Imagine arranging special transportation or child care to accommodate these unpredictable schedules.

Economic factors also affect whether people find work or wind up on Social Security disability insurance. Amid the COVID-19 recession, researchers are concerned about the long-term impact of workers with disabilities losing their jobs. During the Great Recession, applications for Social Security disability benefits surged. Once people apply for disability benefits, the odds of ever going back to work decline.

Recessions are also an obstacle for people from low-income families trying to move up the economic ladder. Yet a researcher found that if they can manage to earn more than their parents, they will have more success staying off the disability rolls. One big reason: workers with good jobs and higher incomes are healthier because they can afford better medical care.

Our disability blogs cover research being funded by the U.S. Social Security Administration, which also supports this blog. Here is the complete list of the 2020 headlines:

Work:

Same Disability: Some Have Tougher Jobs

Same Arthritis but Some Feel More Pain

Disabilities and the Toll of Irregular Hours


Economy:
Learn More

Depressed woman

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

Woman with mental health problems

Recessions Hit Depressed Workers Hard

Anyone who’s suffered through depression knows it can be difficult to get out of bed, much less find the energy to go to work. Mental illness has been on the rise, and depression and myriad other symptoms get in the way of being a productive employee.

So it’s not surprising that men and women with mental illness are much less likely to be employed than people who have no symptoms. But the problem gets worse in a recession.

In 2008, the first year of the Great Recession, the economy slowed sharply as 2.6 million workers lost their jobs. During that time, people who suffered from mental illness left the labor force at a much faster pace than everyone else, according to a new study from the Retirement and Disability Research Consortium.

The researchers compared average labor force participation, as reported in the National Health Interview Survey, for three periods. Two periods of consistent economic growth bracketed a period that included the onset of the Great Recession: 1997-1999, 2006-2008, and 2015-2017.

Labor force participation for people with no mental illness dipped less than 1 percent between the late 1990s and the period that included the recession. By 2015-2017, roughly three out of four of them were still in the labor force – only slightly below pre-recession levels.

Contrast this relative stability to large declines in activity for people with mental illness – the more severe the condition, the steeper the drop. Participation fell 17 percent among people with the most severe forms of mental illness between the late 1990s and the period that included the recession. By 2015-2017, only 38 percent of them remained in the labor force – well below pre-recession levels. …Learn More

Photo of pills

Opioid Abuse Tied to Where People Live

In 2019, the U.S. Attorney’s Office in northern Oklahoma detained one doctor charged with operating a pill mill that prescribed opioids to addicts for the simple reason that he presented “a danger to our community.”

While mental illness and unemployment are familiar culprits in the opioid crisis sweeping the country, the environment that people live in – including the prevalence of unscrupulous doctors – is actually important as well.

That’s one conclusion in a new study that found that people are more likely to become addicts if they move from an area with a relatively low level of prescription opioid abuse to a high-abuse area.

The research looked at more than 3 million people on federal disability insurance (DI) – a group that uses opioids at much higher rates than the general population. More than half of DI recipients are prescribed opioids in a given year. And since they are covered by Medicare, the researchers had access to the prescription records for Oxycontin, Vicodin, and morphine.

To gauge the impact of moving to a new location, the researchers created an index that estimated the extent of prescription opioid abuse in each U.S. county. The index took into account several factors, including the amount of opioids prescribed to patients and their use of multiple prescribers.

When DI recipients moved from a county at the low end of this index – the 25th percentile – to the high end – the 75th percentile – their rate of prescription opioid use increased nearly 5 percent, according to the study conducted for the Retirement and Disability Research Consortium.

People with a prior history of prescription opioid use were at particularly high risk of prescription opioid abuse if they moved to a high-use area. …Learn More