History of Income Insurance Benefits and Inequalities in Health and Disability at Older Ages in Canada

• In Event: 3111 - Comparative Perspectives on Inequality in Later Life

Abstract

Background: The interplay between different income insurance programs (e.g. unemployment, disability and social welfare), and particularly benefit substitution between these programs, remains understudied in health research in North America. In this paper, we examine how trajectories of income insurance benefits relate to health and disability in older age in Canada.
Data and methods: Data come from the Longitudinal and International Survey of Adults (LISA), a biennial panel survey began in 2012 by Statistics Canada. The LISA surveys 32,133 respondents about employment, income and well-being, notably using a retrospective administrative data tax records linkage going as far back as 1982. We first constructed detailed government program transfer histories spanning twenty years of the respondents’ life course. Next, we used MPlus to estimate household income trajectories, finding a four-category model (low income, middle-low, middle-high, high) fit the data best. Finally, we estimated binomial logistic models relating these trajectories and income insurance benefit histories to poor self-rated health and disability status among respondents 45 to 64 years old in 2014. All analyses were stratified by sex, but there were no substantive differences in the analytic findings.
Results: Controlling for income trajectories, respondents who experienced only unemployment over the past 20 years did not exhibit higher odds of either poor health or disability relative to respondents who never received any income insurance benefits. In contrast, respondents who had any other combination of benefits (unemployment, and/or disability, and/or welfare) had much higher odds of poor health and disability than those who never received any benefits.
Conclusions: These results suggest important heterogeneity exists in the association between past unemployment and health in older adulthood. For a segment of unemployment recipients, selective processes appear to play an important role, suggesting that other benefits other than unemployment may be indicated to forestall future health declines.  

Authors

• Amelie Quesnel-Vallee, McGill University

• Miles G. Taylor, Florida State University

• Johan Fritzell, Aging Research Center, Karolinska Institutet, Sweden