Author Interviews, JAMA, Social Issues / 01.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48278" align="alignleft" width="200"]Rajan Sonik, PhD JD MPHResearch ScientistTucker-Seeley Research LabLeonard Davis School of GerontologyPostdoctoral Research FellowLeonard D. Schaeffer Center for Health Policy and EconomicsLeonard Davis School of GerontologyUniversity of Southern CaliforniaLos Angeles, CA 90089-3333 Dr. Sonik[/caption] Rajan Sonik, PhD JD MPH Research Scientist Tucker-Seeley Research Lab Leonard Davis School of Gerontology Postdoctoral Research Fellow Leonard D. Schaeffer Center for Health Policy and Economics Leonard Davis School of Gerontology University of Southern California Los Angeles, CA 90089-3333 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Not everyone who is eligible for public benefits like Supplemental Security Income (SSI) tries to receive them. One distinguishing factor is that those who apply for benefits disproportionately experience shocks (e.g., divorce, job loss, health problems) and sharp increases in material hardships (e.g., food insecurity, housing insecurity) shortly before applying. Typically, these increases in hardships are then partially—but not fully—alleviated by receipt of the public benefits. Given strong associations between these hardships and poor health outcomes, we wanted to examine whether health status might fluctuate before and after the receipt of public benefits as well. We examined SSI in particular given its focus on individuals with disabilities, keeping in mind the particular health vulnerabilities experienced by this population. In line with patterns previously observed for material hardships, we found in a nationally representative sample that the health status of eventual SSI recipients worsened significantly in the period prior to program entry. After enrollment began, the decline in health status stopped but was not fully reversed. In the paper, we discuss why these findings were more likely to be driven by changes in material hardship levels rather than changes in disability status.