SeaTE: Subjective ex ante Treatment Effect of Health on Retirement by Pamela Giustinelli, Matthew D. Shapiro :: SSRN

January 2, 2019

This paper develops an innovative approach to measuring the effect of health on retirement. The approach elicits subjective probabilities of working at specified time horizons fixing health level. Using a treatment-effect framework, within-individual differences in elicited probabilities of working given health yield individual-level estimates of the causal effect of health (the treatment) on working (the outcome). We call this effect the Subjective ex ante Treatment Effect (SeaTE). The paper then develops a dynamic programming framework for the SeaTE. This framework allows measurement of individual-level value functions that map directly into the dynamic programming model commonly used in structural microeconometric analysis of retirement. The paper analyzes conditional probabilities elicited in the Vanguard Research Initiative (VRI)—a survey of older Americans with positive assets. Among workers 58 and older, a shift from high to low health would on average reduce the odds of working by 28.5 percentage points at a two-year horizon and 25.7 percentage points at a four-year horizon. There is substantial variability across individuals around these average SeaTEs, so there is substantial heterogeneity in taste for work or returns to work. This heterogeneity would be normally unobservable and hard to disentangle from other determinants of retirement in data on realized labor supply decisions and health states. The paper’s approach can overcome the problem that estimates of the effect of health on labor supply based on behavioral (realizations) data can easily overstate the effect of health on retirement whenever less healthy workers tend to retire earlier for reasons other than health.

via SeaTE: Subjective ex ante Treatment Effect of Health on Retirement by Pamela Giustinelli, Matthew D. Shapiro :: SSRN


Hunger Pains? SNAP Timing, and Emergency Room Visits by Chad D. Cotti, John Gordanier, Orgul D. Ozturk :: SSRN

January 2, 2019

The impact of poor nutrition has been established as an important determinant of health. It has also been demonstrated that the single monthly treatment of SNAP benefits leaves meaningful nutritional deficiencies in recipient households during the final weeks of the benefits cycle. Further, health related behaviors have been documented to be altered on the date of food stamp receipt. This project exploits highly detailed and linked administrative data on health care utilization of food stamp recipients and randomized food stamp receipt dates to allow us to measure the impact of food stamp treatment days and the low nutritional periods created by the SNAP benefits cycle on the likelihood of emergency department (ER) utilization among the Medicaid population. Our main finding is that among SNAP receiving individuals in the ER on a particular day, the share that received benefits on that day is 3.5% lower than would be expected. This effect is present across all age groups, although the magnitude is smallest for young children. Further, we find that for individuals 55 and over, the share of ER visits that comes from individuals that are past the third week of their SNAP benefit month, i.e. received benefits more than 21 days ago, is 1.5% larger than would be expected. This suggests that these older individuals are more likely to visit the ER late in the SNAP benefit cycle, which is consistent with increased food insecurity as a possible mechanism linking the food stamp benefits cycle to emergency care utilization. We find no such effect for younger individuals.

via Hunger Pains? SNAP Timing, and Emergency Room Visits by Chad D. Cotti, John Gordanier, Orgul D. Ozturk :: SSRN


Medical-Legal Partnerships and Mental Health: Qualitative Evidence that Integrating Legal Services and Health Care Improves Family Well-Being by Dayna Bowen Matthew :: SSRN

January 2, 2019

Medical-Legal partnerships are an innovative health care delivery model that integrates lawyers into primary care clinical settings. The objective is to preventively address patients’ legal needs that also have an adverse impact on their health outcomes. Since the first medical-legal partnership formally opened at the Boston Medical Center in 1993, nearly 300 of these entities have formed around the country. The empirical evidence that they improve health, however, is still emerging. This essay contributes results of interviews conducted among families who received medical legal partnership help as an intervention in Colorado. The evidence supports the conclusion that addressing patients’ legal stressors improves their mental health and family well-being.

via Medical-Legal Partnerships and Mental Health: Qualitative Evidence that Integrating Legal Services and Health Care Improves Family Well-Being by Dayna Bowen Matthew :: SSRN


Social Security Administration Payments to State Vocational Rehabilitation Agencies for Disability Program Beneficiaries Who Work: Evidence from Linked Administrative Data by Jody Schimmel, Paul O’Leary :: SSRN

January 2, 2019

This article’s authors use linked administrative data from the Social Security Administration (SSA) and the Department of Education’s Rehabilitation Services Administration to evaluate SSA’s investment in services provided by the federal-state Vocational Rehabilitation (VR) program. A unique data resource permits a comparison of the value of SSA payments to state VR agencies for services provided to disability program beneficiaries who find and maintain a substantial level of work with the value of the cash benefits those beneficiaries forgo because of work. The authors find that the value of cash benefits forgone by beneficiaries after applying for VR services is substantially greater than the value of SSA payments to state VR agencies for those services.

via Social Security Administration Payments to State Vocational Rehabilitation Agencies for Disability Program Beneficiaries Who Work: Evidence from Linked Administrative Data by Jody Schimmel, Paul O’Leary :: SSRN


The Unintended Consequences of Flexicurity: The Health Consequences of Flexible Employment by Keith A. Bender, Ioannis Theodossiou :: SSRN

January 2, 2019

While atypical employment contracts offer flexibility in the labor market, these kinds of contracts are inherently insecure and may generate stress among affected workers. This study examines the impact of atypical forms of employment (specifically seasonal or temporary jobs or a fixed time contracts) on workers’ health. Survival analysis shows that, other things equal, the longer percent of time spent in flexible employment contracts increases the odds of falling into ill health for a variety of health conditions. The results are robust to controlling for the endogeneity in the relationship.

via The Unintended Consequences of Flexicurity: The Health Consequences of Flexible Employment by Keith A. Bender, Ioannis Theodossiou :: SSRN


Informal Bankruptcy: Health Expenditure Shocks and Financial Distress Avoidance by G. Nathan Dong :: SSRN

October 19, 2018

This article studies the financial decision-making behavior of U.S. families that have difficulties paying for their medical bills and investigate what alternatives they have to avoid filing for formal bankruptcy and what influence their motivation to do so. Using household financial and demographic information from the Health Tracking Household Survey in 2007 and 2010, this article finds that families with younger age members, minority ethnic background, more doctor visits, and without insurance made more diverse and severe choices to finance the payments before resorting to personal bankruptcy. Interestingly, households with better education seek more diverse but easier financing methods, suggesting that financial literacy may play a dual role in undertaking financial planning—strategic default and bankruptcy avoiding.

via Informal Bankruptcy: Health Expenditure Shocks and Financial Distress Avoidance by G. Nathan Dong :: SSRN


The Relationship between Reverse Mortgage Borrowing, Domain and Life Satisfaction by Cäzilia Loibl, Donald R. Haurin, Julia Brown, Stephanie Moulton :: SSRN

October 19, 2018

Objectives: Reverse mortgages allow adults aged 62 and older to borrow against the equity in their homes without incurring monthly loan repayments.

This study examines the relationship of reverse mortgage borrowing with older adults’ satisfaction with their financial situation, housing, health, and daily life/leisure as well as with life as a whole.

Method: A new national data set of 1,088 older adults, comprised of loan data, credit histories, and responses to a phone survey, was created. Our estimation strategy compares reverse mortgage borrowers to older adults who obtained mandatory counseling but not a reverse mortgage.

Results: Reverse mortgage borrowers have significantly higher financial and housing satisfaction compared to non-borrowers; no differences were found for health, daily life/leisure, and general satisfaction. These satisfaction domains contribute differently to general satisfaction for reverse mortgage borrowers relative to non-borrowers: housing satisfaction has a greater influence for borrowers and health a greater influence for non-borrowers.

Discussion: Our study provides new knowledge about the longer-term outcomes of reverse mortgage borrowers. The positive association of reverse mortgage borrowing for housing and financial satisfaction and, in turn, general satisfaction, provides insights regarding borrower experiences with this controversial financial tool.

via The Relationship between Reverse Mortgage Borrowing, Domain and Life Satisfaction by Cäzilia Loibl, Donald R. Haurin, Julia Brown, Stephanie Moulton :: SSRN