文章基本信息

标题：Effects of Macroeconomic Trends on Social Security Spending Due to Sickness and Disability
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作者：Jahangir Khan ; Ulf-G. Gerdtham ; Bjarne Jansson 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2004
卷号：94
期号：11
页码：2004-2009
语种：English
出版社：American Public Health Association
摘要：Objectives. We analyzed the relationship between macroeconomic conditions, measured as unemployment rate and social security spending, from 4 social security schemes and total spending due to sickness and disability. Methods. We obtained aggregated panel data from 13 Organization for Economic Cooperation and Development member countries for 1980–1996. We used regression analysis and fixed effect models to examine spending on sickness benefits, disability pensions, occupational-injury benefits, survivor’s pensions, and total spending. Results. A decline in unemployment increased sickness benefits spending and reduced disability pension spending. These effects reversed direction after 4 years of unemployment. Inclusion of mortality rate as an additional variable in the analysis did not affect the findings. Conclusions. Macroeconomic conditions influence some reimbursements from social security schemes but not total spending. Research into the determinants of social security spending has produced a large body of literature documenting a procyclical pattern in sickness absenteeism. 1– 3 This pattern is generally believed to result from negative selection of employment during good times (i.e., sicker individuals have an easier time finding jobs when the economy is robust) or increased “shirking” because of reduced fear of job loss. 4– 6 However, such a pattern is also consistent with deteriorating health when labor markets strengthen. 7– 9 Hazardous work conditions, the physical exertion of employment, and job-related stress can have negative health effects, especially when job hours are extended during short-lived economic expansions. 10, 11 Cyclically sensitive sectors, such as construction, also have high accident rates, and some byproducts of economic activity, such as pollution and traffic congestion, clearly present health risks. Gerdtham and Ruhm 8 recently used aggregate data for 23 Organization for Economic Cooperation and Development (OECD) countries over the period 1960–1997 to study the relationship between macroeconomic conditions (unemployment) and fatalities. Their main finding, as well as findings from Ruhm and Neumayer, was that there is strong evidence that mortality increases when unemployment is low. 7– 9 Our principal objective was to analyze the relationship between macroeconomic conditions, as measured by unemployment rate and social security spending due to sickness and disability on the basis of information from 13 member nations of the OECD over the period 1980–1996. We analyzed social security spending on sickness benefits, disability pension, occupational injury benefits, survivor’s pension, and their aggregates. Knowledge about how spending by different social security programs changes through economic business cycles can affect social security policymaking and help to establish new social security rules that effectively address cost containment.