Stronger welfare policies meant that older workers who lost their jobs during the Great Recession were more insulated from mental health issues in Europe than in the U.S.

The old cliché states, “Money doesn’t make you happy”, but is this really true? In new research, Carlos Riumallo-Herl finds that wealth had an insulating effect against depression for older workers who lost their jobs during the Great Recession in the U.S. He finds that in comparison to workers in the U.S., those in Europe with low wealth who were made unemployed at the same time did not suffer from depression. He argues that this can be explained by the greater generosity of European unemployment safety nets which mean that people did not have to draw on their own wealth whilst unemployed, and were thus more financially secure

Better together? Group incentives and the demand for prevention

In a field experiment with 400 groups of informal entrepreneurs in El Salvador, we compare the impact of group incentives (linked to compliance of all members) to equivalent individual ones to encourage cardiovascular check-ups. We test two incentive designs: small rewards and lotteries. Group incentives are as effective as individual ones at increasing demand for prevention, but, unlike individual incentives, they fail to target those with potentially higher health risks. The equal effectiveness of group incentives is linked to more communication, coordination between members and, to some extent, peer pressure. These social dynamics contribute to reduce uncertainty about other group members’ decisions and enhance the perceived net benefit of prevention. Although the preventive check-ups do not induce short-term lifestyle changes, they substantially increase the detection of new risk factors, making all incentives highly cost-effective interventions in this population

El Salvador’s Covid-19 response is storing up health and economic problems for the worse-off

Our new research into the effects of El Salvador’s lockdown shows that those with the lowest incomes and the worst health have been hit the hardest. While many have skipped meals and stopped working, others have even ended treatment for chronic illnesses or taken loans from predatory lenders. These adaptations only make the situation worse, and the state must try to tackle the conditions driving them if the country returns to lockdown, write Mylène Lagarde (LSE Health Policy), Manuel Sánchez Masferrer (ESEN, El Salvador), and Carlos Riumallo Herl (Erasmus University Rotterdam)

Health Inequalities in the South African elderly: The Importance of the Measure of Social-Economic Status

A common approach when studying inequalities in health is to use a wealth index based on household durable goods as a proxy for socio-economic status. We test this approach for elderly health using data from an aging survey in a rural area of South Africa and find much steeper gradients for health with consumption adjusted for household size than with the wealth index. These results highlight the importance of the measure of socioeconomic status used when measuring health gradients, and the need for direct measures of household consumption or income in ageing studies

Pension exposure and health:Evidence from a longitudinal study in South Africa

Social protection schemes have been expanding around the world with the objective of protecting older persons during retirement. While theoretically they have been seen as tools to improve individual wellbeing, there are few studies that evaluate whether social pensions can improve health. In this study, we exploit the change in eligibility criteria for the South African Old Age grant to estimate the association between pension exposure eligibility and health of older persons. For this, we use data from the Health and Aging in Africa: A longitudinal Study of an INDEPTH Community in South Africa (HAALSI) and model pension exposure in terms of its cumulative effect. Our results show that pension exposure is associated with better health as measured by a set of health indices. Disentangling these effects, we find that pension exposure is most likely to improve health through the delayed onset of physical disabilities in the elderly population. Our study highlights the relevance of social protection schemes as a mechanism to protect older persons physical health.</p

Selective Exercise of Discretion in Disability Insurance Awards

Variation in assessor stringency in awarding benefits leaves applicants exposed to uninsured risk that could be systematic if discretion were exercised selectively. We test for this using administrative data on applications to the Dutch disability insurance program. We find that discretion is more often exercised in favor of lower-waged applicants. Pre-disability wages drop discontinuously just above disability thresholds for entitlement to partial benefits. Assessors are more likely to discard the highest-paying algorithm-generated job matches that determine earnings capacity and entitlement when evaluating lower-waged applicants. While these applicants benefit on average, they are exposed to greater risk from between assessor variation

The effect of old-age pensions on health care utilization patterns and insurance uptake in Mexico

Introduction As old-age pensions continue to expand around the world in response to population ageing, policymakers increasingly wish to understand their impact on healthcare demand. In this paper, we examine the effects of supplemental income to older adults on healthcare use patterns, expenditures and insurance uptake in Yucatan, Mexico. Method We use a longitudinal survey for individuals aged 70 or older and an individual fixed-effects difference-in-difference approach to understand the effect of an income supplement on healthcare use patterns, out-of-pocket expenditures and health insurance uptake patterns. Results The implementation of the old-age pension was associated with increased use of healthcare with nuanced effects on the type of care. Old-age pensions increase the use of formal healthcare by 15 percentage points (95% CI 6.1 to 23.9) for those with healthcare use at baseline and by 7.5 percentage points (95% CI 3.7 to 11.3) for those without healthcare use at baseline. We find no evidence of greater out-of-pocket expenditures, likely because old-age pensions were associated with a 4.2 percentage point (95% CI 1.5 to 6.9) increase in use of public health insurance. Conclusion Old-age pensions can shift healthcare demand towards formal services and eliminate financial barriers to basic care. Pension benefits can also increase the uptake of insurance programmes. These results demonstrate how social programmes can complement each other This highlights the potential role of old-age pensions in achieving universal health coverage for individuals at older ages