April 21, 2022

The connection between Americans’ socioeconomic status (SES) and their health was established long ago and the evidence keeps piling up.

Less-educated, lower-income workers suffer more medical conditions ranging from arthritis to obesity and diabetes. And the increase in life expectancy for less-educated 50-year-olds was, in most cases, roughly 40 percent of the gains for people with higher socioeconomic status between 2006 and 2018.

More recently researchers have connected SES and mental health. The foundations are laid in childhood. In one study, the children and teenagers of parents with more financial stresses – job losses, large debts, divorce, or serious illness – have worse mental health. And COVID has only aggravated the nation’s mental health crisis.

In a new book, Dr. Thomas Insel, former director of the National Institute of Mental Health, is concerned about the impact of inequality.

Mental health in disadvantaged communities “is worse because of the world outside of health care. It’s our housing crisis, our poverty crisis, our racial crisis, our increasing social disparities that weigh heaviest on those in need,” he writes in “Healing: Our Path from Mental Illness to Mental Health.” …Learn More

Research

March 2, 2021

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

Behavior

March 17, 2020

I appreciate how privileged my husband and I are that we are able to remain in our home, where we feel fairly safe.

He is a retired Boston high school teacher. I have a good job that also provides me with some degree of flexibility when needed, and my boss didn’t resist, because of my autoimmune condition, when I asked to work at home early last week.

A young couple in my condo building with a new baby fled last weekend to a relative’s house in rural Connecticut, where the husband will be able to telecommute to his high-paying job in Boston.

Yes, our 401(k)s are getting pummeled. But this national crisis is immediate and far more consequential for the millions of Americans who must work even in a pandemic. Workers have two concerns, and they are intertwined: health and money.

Think about the first responders, service-industry workers, or post office employees who are in contact with the public, constantly exposing themselves and, as a result, their families to the coronavirus.

Low-income people are also very vulnerable. Research shows that they are less healthy for reasons ranging from less access to employer health insurance to higher rates of smoking and obesity. Diabetes is more pervasive in low-income populations too.

Yet public health officials tell us that people with underlying conditions are far more vulnerable to getting seriously ill if they contract the virus – and these are the same people who usually don’t have the luxury to telecommute. Many low-income workers also live in crowded conditions, often with older relatives in fragile health.

Many workers are grappling with the realization that the economy is starting to slow down – and they will be the first to feel it. Consider the cleaning ladies or dog walkers whose clients are asking them not to come to the house this week or the servers at the restaurants shutting down in Manhattan, Massachusetts, Illinois, and across the nation. …Learn More