The Hazard of Mortality among Aging Retired- and Disabled-Wo

This article reports on the hazard of mortality of aging retired- and disabled-worker men over the decade after they became Social Security beneficiaries. Basic patterns of mortality rates are described using data from the 1982 New Beneficiary Survey linked to administrative records. The article examines the association of increasing age, race socioeconomic status, private health insurance, and other demographic and health characteristics with the duration of life between the two groups of men, using statistical models. Over the decade, the hazard of death for retired workers significantly increased with aging and with lower socioeconomic status. The hazard of death for the disabled was significantly associated with being black. This article reports on the results of a hazard analysis of aging retired- and disabled-worker men interviewed in the 1982 New Beneficiary Survey (NBS), whose survival status was monitored over time through linked Social Security administrative records. The purpose is first to describe the basic patterns of mortality of these two groups, and second to specify and estimate a model of their duration-dependent transition t mortality. The study compares the relationships of selected sociodemographic, health, and functional status characteristics to survival time over a 9-year period. Since it has been demonstrated in previous research that these two populations differ markedly in overall age structure, functional capacity, and health status (Iams and McCoy 1991; McCoy and Iams 1994), the two groups can be expected to demonstrate contrasts in their survival patterns. We first provide a brief discussion of the Social Security Old-Age and Survivors Insurance (OASI) and the Social Security Disability Insurance (DI) program. Next, we present a comparative demographic and health status profile. This is followed first by a life table analysis of survival, and then by a discrete exponential proportional hazard analysis of sociodemographic and health characteristics. Finally, we discuss the results and their implications for social and health care policy. Old-Age and Survivors Insurance The Old-Age and Survivors Insurance program, popularly known as "Social Security," is designed to provide monthly benefits to retired workers, their dependents, and their survivors. A person builds protection under OASI through work in employment covered under Social Security; currently, about 95 percent of all jobs in the United States are covered. Actuarially reduced benefits are payable to retired insured workers at age 62, and full benefits are payable at age 65. In 1982, the year in which the NBS was conducted, there were approximately 20.7 million retired workers receiving Social Security benefits. The median age at first benefit receipt of retired workers interviewed in the NBS was 63 years. Social Security Disability Insurance The Social Security Disability Insurance program assists primarily the working population under the age of 65 when they meet both the Social Security Administration's definition of disability and insured status requirements. To receive benefits, a disabled worker must be unable to engage in any substantial gainful activity by reason of a medically determinable physical or mental impairment expected to result in death or to last for a continuous period of at least 12 months. Applicants must also have a recent and substantial attachment to the labor force; in technical terms, they must be fully and currently insured.(1) In 1982, 2.6 million disabled workers were receiving benefits. The DI program requires that disabled workers must be unable to work in any job in the national economy, a standard that may be more easily met by persons of blue-collar background with physically demanding work histories and limited educational attainment than by their white-collar counterparts whose higher educational attainment levels and clerical/managerial skills may have greater transferability potential. …