Research

July 27, 2021

With the nation still in the midst of an opioid crisis, a new study provides the first estimate of opioid use among people who apply for disability.

One out of every four applicants used opioids in 2017 – below the peak in 2012 but still significantly more than in the general population, according to researchers at Mathematica and the U.S. Social Security Administration.

And the researchers may be underestimating the extent of opioid use. Their data come from Social Security’s disability application forms. The forms ask applicants to list their prescriptions, including opioids taken for musculoskeletal pain such as a bad back, as well as their non-prescription drug use, and the stigma around use and abuse may encourage underreporting.

To estimate opioid use required creating a database because none existed. The researchers mined the text fields in each disability application using machine learning to find information about opioid use and then entered the information into the database.

Some interesting demographic trends emerged from the study. Opioid use is most prevalent in middle age, at around 30 percent of disability applicants in their 40s and 50s. “This is notable,” the researchers said, because if Social Security grants their requests for benefits, they “may remain on the [disability rolls] for 25 years.”

In a breakdown by education levels, the biggest opioid users had attended college but didn’t get a degree. Women’s use exceeded men’s throughout the study’s 10-year period, mirroring the population as a whole. And a state-by-state breakdown shows that applicants’ opioid use fell across the nation during that time. But Alabama, Arkansas, Michigan, and Nevada still had particularly high rates in 2017. …Learn More

Behavior

November 3, 2020

It’s often true that men in their 50s who’ve done physically demanding jobs for decades develop debilitating conditions. But they’re not old enough to retire and collect Social Security.

Particularly during economic downturns, many of these workers have turned to a fallback option: federal disability benefits.

While economic conditions and policy changes are primarily responsible for the year-to-year changes in applications for disability, there is growing evidence of worsening health and functioning among men in their 50s and 60s. A new study has found that these trends have also increased the number of older workers who may qualify for disability benefits.

The researchers first confirmed past studies showing that this population’s health has gotten worse since the 1990s. More of them are suffering from various debilitating conditions, including asthma, hypertension, diabetes, and cancer.

The older workers also increasingly reported having trouble carrying out some basic activities required to do their jobs, such as reaching overhead, kneeling, and standing for two hours. Evidence of the older workers’ deteriorating condition over time was confirmed in separate analyses of two different surveys: the Health and Retirement Study and the National Health Interview Survey.

The heart of the study was to measure the potential impact of declining health and work capacity on the Social Security disability program.

The analysis finds that the deterioration in men’s health is likely to have increased the share of these men who could qualify for disability benefits by more than 15 percent between the mid-1990s and mid-2010s. The rise in potential demand for benefits was unrelated to the aging of the baby boom population, which the researchers accounted for.

Economic downturns like the Great Recession increase disability applications and awards. But those increases are usually temporary. …Learn More

Research

September 10, 2020

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