The personal and national costs of mental health conditions: impacts on income, taxes, government support payments due to lost labour force participation

<p>Abstract</p> <p>Background</p> <p>Mental health conditions have the ability to interrupt an individual's ability to participate in the labour force, and this can have considerable follow on impacts to both the individual and the state.</p> <p>Method</p> <p>Cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' <it>Survey of Disability, Ageing and Carers </it>and STINMOD, an income and savings microsimulation model was used to quantify the personal cost of lost income and the cost to the state from lost income taxation, increased benefits payments and lost GDP as a result of early retirement due to mental health conditions in Australians aged 45-64 in 2009.</p> <p>Results</p> <p>Individuals aged 45 to 64 years who have retired early due to depression personally have 73% lower income then their full time employed counterparts and those retired early due to other mental health conditions have 78% lower incomes. The national aggregate cost to government due to early retirement from these conditions equated to $278 million (£152.9 million) in lost income taxation revenue,$407 million (£223.9 million) in additional transfer payments and around $1.7 billion in GDP in 2009 alone.</p> <p>Conclusions</p> <p>The costs of mental health conditions to the individuals and the state are considerable. While individuals has to bear the economic costs of lost income in addition to the burden of the conditions itself, the impact on the state is loss of productivity from reduced workforce participation, lost income taxation revenue, and increased government support payments - in addition to direct health care costs.</p

Allocating Family Responsibilities for Dependent Older People in Mexico and Peru

This paper applies different analytical frameworks to explore processes of family bargaining about providing care for dependent older people in Mexico and Peru. These frameworks include cultural norms, life course effects and material exchange. The paper is based on 19 in-depth qualitative family case studies, which are linked to a wider set of quantitative survey data. Care arrangements and bargaining processes are revealed to be highly gendered, and largely conform to prevailing cultural norms. Rather than neutral and objective, the self-identified role as main carer is found to be subjective and potentially ambiguous. The few men who self-identify as main carers are more likely to play an indirect, organisational role than engage directly in daily care. As such, bargaining mainly relates to which woman performs the main care role, and large family networks mean that there is usually more than one candidate carer. Bargaining can occur inter-generationally and conjugally, but bargaining between siblings is of particular importance. Bargaining is framed by the uncertain trajectory of older people’s care needs, and arrangements are sometimes reconfigured in response to changing care needs or family circumstances. Taking the narratives at face value, the influence of life course effects on bargaining and care arrangements is more obvious than material exchange. There are, however, indications that economic considerations, particularly inheritance, still play an important behind the scenes role

Introduction

This is an expanded version of comments on the future of the demography of aging at an invited session of the 2008 annual meeting of the Population Association of America. In an introduction, John Haaga offers reasons for a revival of interest in population aging, including greater realization of plasticity in aging trajectories at both individual and societal levels. Linda Martin proposes that population scientists working in aging emulate those studying fertility and family planning in previous decades, learning from interventions (in this case, aimed at increasing retirement savings and reducing disability at older ages). Changes in family structure will increasingly affect new cohorts of the elderly, and Linda Waite speculates on the ways in which changes in the economy, medicine, and the legal environment could affect the social context for aging. Research on mortality at older ages is "alive and well" asserts James Vaupel, who sets out six large questions on mortality trends and differentials over time and across species. Lastly, Wolfgang Lutz expands the scope of projections, showing the considerable uncertainty about the timing and pace of population aging in the developing world and the effects on future elderly of the increases in educational attainment in much of the world during the second half of the twentieth century. Copyright (c) 2009 The Population Council, Inc..