Association between Longest Held Occupation and Receiving Social Security Disability Benefit

Tuesday, June 25, 2019
Exhibit Hall C (Marriott Wardman Park Hotel)

Presenter: Rene Pana-Cryan

Co-Authors: Abay Asfaw; Brian Quay

Background: The Social Security Disability Insurance (SSDI) benefits are paid to workers or their family members if they are unable to work because of a medically determinable physical or mental condition that is expected to last at least one year or result in death. The cost of SSDI has been increasing overtime and may outweigh the SSDI trust fund if the current trend continues. There is evidence that economic, policy, demographic, and health factors might affect the rapid growth in the SSDI rolls. However, very few studies have examined the impact of workplace factors on the rising costs of the SSDI program
Objective: This study explored whether occupation was one of the risk factors for the rising number of disabled workers who received SSDI benefits between 1992 and 2014. . Improving our understanding of the potential long-term effects of occupation on government-run safety net programs can help us develop occupation-specific prevention strategies. As to our knowledge, no other studies have examined the association between occupation and the risk of receiving SSDI benefits.
Hypothesis: Workers with high risk longest held occupations are more likely to receive SSDI benefit at an earlier age compared with workers with lower risk longest health occupations.
Data and measurement of variables: We used the Health and Retirement Study (HRS), a longitudinal panel survey of a representative sample of Americans aged 50 and older in specific years or waves. We used a cohort of 16,196 HRS respondents between the age of 51 and 64 years who were followed from the date of entry (at age 51 or older) and until they received SSDI benefits, died, reached full retirement age, or the end of the follow-up period (2014), whichever came first. The outcome variable was receiving SSDI benefit, occurring on and after the first interview year but before or on the last interview year, 2014. Longest-held occupation was our main explanatory variable. We considered sixteen different occupations, and included sex, race and ethnicity, marital status, smoking, alcohol consumption, and obesity as covariates.
Method: We used the extended Cox proportional hazard survival. Because one third of the respondents in our cohort did not report their longest held occupation, we used a multiple imputation method to address the problem of missing observations.
Results: Compared with workers in managerial (reference) occupations, the likelihood of receiving SSDI benefits was more than 1.7 times higher for workers in transportation, health services, machine operators, and food preparation occupations. Workers in mechanics and repair, handlers and helpers, personal services, and construction and extractive occupations were more than 1.5 more likely to receive SSDI benefits than workers in the reference occupation.
Conclusion: Targeted interventions to improve the safety and health of workers in longest held occupations associated with a high risk of receiving SSDI benefits would help reduce the societal burden of occupational injury and illness overall and the burden on the social security system specifically.