What Are the Effects of Expanding Social Pension on Health? Evidence from the Basic Pension in South Korea

Pak, Tae-Young (2020): What Are the Effects of Expanding Social Pension on Health? Evidence from the Basic Pension in South Korea. Forthcoming in: The Journal of the Economics of Ageing

Abstract

Non-contributory social pension has been widely used to provide minimum income support for disadvantaged seniors. Despite its efficacy in reducing old-age poverty, only a few studies systematically assessed whether the benefits of social pension extend to health outcomes. In this paper, we exploit a reform to the South Korean social pension in 2014 to provide evidence on the health effects of expanding social pension. Using data from the Korean Longitudinal Study of Aging, we estimate a series of difference-in-differences models that compare changes in health of individuals age-eligible for the social pension (age ≥ 65) to those younger than the minimum qualification age (age < 65), before and after the reform in 2014. The estimates show an average of 8.1-9.0% reductions in the count of depressive symptoms attributable to the reform. We also find that the mental health benefit comes primarily from beneficiaries being more satisfied with their financial condition and overall quality of life. However, despite the large increase in income there were no significant improvements in grip strength and self-rated health. Overall, this study highlights the importance of social pension as a means of protecting mental health of disadvantaged seniors.

• Item Type: MPRA Paper
• Language: English
• Keywords: old-age poverty; non-contributory pension; depression; financial satisfaction; South Korea
• Subjects: H - Public Economics > H5 - National Government Expenditures and Related Policies; I - Health, Education, and Welfare > I3 - Welfare, Well-Being, and Poverty > I31 - General Welfare, Well-Being; I - Health, Education, and Welfare > I3 - Welfare, Well-Being, and Poverty > I38 - Government Policy ; Provision and Effects of Welfare Programs; J - Labor and Demographic Economics > J1 - Demographic Economics > J14 - Economics of the Elderly ; Economics of the Handicapped ; Non-Labor Market Discrimination

References

Aguila, E., Kapteyn, A., & Smith, J. P. (2015). Effects of income supplementation on health of the poor elderly: The case of Mexico. Proceedings of the National Academy of Sciences, 112(1), 70–75.

Aguila, E., Lopez-Ortega, M., & Robledo, L. M. G. (2018). Non-contributory pension programs and frailty of older adults: Evidence from Mexico. PLoS One, 13(11), e0206792.

Bando, R., Galiani, S., & Gertler, P. (2016). The effects of non-contributory pensions on material and subjective well being (NBER Working Paper No. w22995). Cambridge, MA: National Bureau of Economic Research.

Barrientos, A., & Lloyd-Sherlock, P. (2002). Non-contributory pensions and social protection. Geneva, Switzerland: International Labour Organization.

Case, A. (2004). Does money protect health status? Evidence from South African pensions. In D. A. Wise (Ed.), Perspectives on the Economics of Aging (pp. 287–312). Chicago, IL: University of Chicago Press.

Cheng, L., Liu, H., Zhang, Y., & Zhao, Z. (2018). The health implications of social pensions: Evidence from China’s new rural pension scheme. Journal of Comparative Economics, 46(1), 53–77.

Christensen, H., Mackinnon, A. J., Korten, A., & Jorm, A. F. (2001). The “common cause hypothesis” of cognitive aging: Evidence for not only a common factor but also specific associations of age with vision and grip strength in a cross-sectional analysis. Psychology and Aging, 16(4), 588–599.

Deaton, A., & Case, A. (1998). Large cash transfers to the elderly in South Africa. The Economic Journal, 108, 1330–1361.

Decker, S., & Schmitz, H. (2016). Health shocks and risk aversion. Journal of Health Economics, 50, 156–170.

Dooley, D., & Prause, J. (2002). Mental health and welfare transitions: Depression and alcohol abuse in AFDC women. American Journal of Community Psychology, 30(6), 787–813.

Engelhardt, G. V., & Gruber, J. (2011). Medicare Part D and the financial protection of the elderly. American Economic Journal: Economic Policy, 3(4), 77–102.

Frederick, S., & Loewenstein, G. (1999). Hedonic adaptation. In D. E. Kahneman, E. Diener, & N. Schwarz (Eds.), Well-being: The foundations of hedonic psychology (pp. 302–329). New York, NY: Russell Sage Foundation.

French, D. J., Browning, C., Kendig, H., Luszcz, M. A., Saito, Y., Sargent-Cox, K., & Anstey, K. J. (2012). A simple measure with complex determinants: Investigation of the correlates of self-rated health in older men and women from three continents. BMC Public Health, 12(1), 649.

Galiani, S., Gertler, P., & Bando, R. (2016). Non-contributory pensions. Labour Economics, 38, 47–58.

Gruber, J., & Yelowitz, A. (1999). Public health insurance and private savings. Journal of Political Economy, 107(6), 1249–1274.

Hessel, P., Avendano, M., Rodríguez-Castelán, C., & Pfutze, T. (2018). Social pension income associated with small improvements in self-reported health of poor older men in Colombia. Health Affairs, 37(3), 456–463.

Hubbard, R. G., Skinner, J., & Zeldes, S. P. (1995). Precautionary saving and social insurance. Journal of Political Economy, 103(2), 360–399.

Idler, E. L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38(1), 21–37.

John, J. A., & Draper, N. R. (1980). An alternative family of transformations. Journal of the Royal Statistical Society: Series C (Applied Statistics), 29(2), 190–197.

Jones, R.S., & Urasawa, S. (2014). Reducing the high rate of poverty among the elderly in Korea (Economics Department Working Paper No. 1163). Paris, France: OECD Publishing.

Kang, S. H., & Choi, O. K. (2010). The impact of the Basic Old-Age Pension scheme on poverty reduction and income. Korea Social Policy Review, 17, 43–71.

Kaushal, N. (2014). How public pension affects elderly labor supply and well-being: Evidence from India. World Development, 56, 214–225.

Koh, K., & Yang, H. (2017). Does a government public transfer program crowd out intergenerational transfers? Evidence from South Korea. Paper presented at the Korean Association of Public Finance.

Krause, N. (1996). Welfare participation and self-esteem in later life. The Gerontologist, 36(5), 665–673.

Kuhn, A. (2018). The complex effects of retirement on health. IZA World of Labor, 430.

Kwon, J. W., Chun, H., & Cho, S. I. (2009). A closer look at the increase in suicide rates in South Korea from 1986–2005. BMC Public Health, 9, 72.

Lee, S., & Jang, H. (2015). Impact of basic senior pension on income and consumption: The regression-discontinuity approach. Journal of Governance Studies, 10, 117–142.

Lee, S., Ku, I., & Shon, B. (2019). The effects of old-age public transfer on the well-being of older adults: The case of social pension in South Korea. The Journals of Gerontology: Series B, 74(3), 506–515.

Lee, C. J., & Kwon, H. J. (2016). Analysis of impacts of the basic pension: Focusing on living expenses of the elderly. Korean Public Administration Quarterly, 28, 365–388.

Lee, J., & Lee, Y. (2009). Old-age income security and private transfers in South Korea. Journal of Aging & Social Policy, 21(4), 393–407.

Lee, J. H., & Moon, S. (2014). The effects of basic pension on elderly consumption. Korean Policy Studies Review, 23, 411–440.

Lee, H. S., & Wolf, D. A. (2014). An evaluation of recent old-age policy innovations in South Korea. Research on Aging, 36(6), 707–730.

Lee, W., Hong, K., Lim, S. S., Kim, D. H., & Yoon, J. H. (2017). The association between symptomatic and diagnostic depression and pain among the elderly population in South Korea. The Journal of Nervous and Mental Disease, 205(9), 699–704.

Lloyd-Sherlock, P., & Agrawal, S. (2014). Pensions and the health of older people in South Africa: Is there an effect?. The Journal of Development Studies, 50(11), 1570–1586.

Pak, T. Y. (2020a). Old-age income security and tourism demand: A quasi-experimental study. Journal of Travel Research, 59(7), 1298–1315.

Pak, T. Y. (2020b). Social protection for happiness? The impact of social pension reform on subjective well-being of the Korean elderly. Journal of Policy Modeling, 42(2), 349–366.

Phelan, J. C., Link, B. G., & Tehranifar, P. (2010). Social conditions as fundamental causes of health inequalities: Theory, evidence, and policy implications. Journal of Health and Social Behavior, 51(1 Suppl.), S28–S40.

Powers, E. T. (1998). Does means-testing welfare discourage saving? Evidence from a change in AFDC policy in the United States. Journal of Public Economics, 68(1), 33–53.

Qi, D., & Wu, Y. (2018). Does welfare stigma exist in China? Policy evaluation of the Minimum Living Security System on recipients’ psychological health and wellbeing. Social Science & Medicine, 205, 26–36.

Ruger, J. P., & Kim, H. J. (2007). Out-of-pocket healthcare spending by the poor and chronically ill in the Republic of Korea. American Journal of Public Health, 97(5), 804–811.

Salinas-Rodríguez, A., Torres-Pereda, M. D. P., Manrique-Espinoza, B., Moreno-Tamayo, K., & Solís, M. M. T. R. (2014). Impact of the non-contributory social pension program 70 y mas on older adults’ mental well-being. PLoS One, 9(11), e113085.

Shin, K. M., Cho, S. M., Hong, C. H., Park, K. S., Shin, Y. M., Lim, K. Y., et al. (2013). Suicide among the elderly and associated factors in South Korea. Aging & Mental Health, 17(1), 109–114.

Shin, E. H., & Do, Y. K. (2015). Basic old-age pension and financial wellbeing of older adults in South Korea. Ageing and Society, 35(5), 1055–1074.

Silventoinen, K., Magnusson, P. K., Tynelius, P., Batty, G. D., & Rasmussen, F. (2009). Association of body size and muscle strength with incidence of coronary heart disease and cerebrovascular diseases: A population-based cohort study of one million Swedish men. International Journal of Epidemiology, 38(1), 110–118.

Stuber, J., & Schlesinger, M. (2006). Sources of stigma for means-tested government programs. Social Science & Medicine, 63(4), 933–945.

Syddall, H., Cooper, C., Martin, F., Briggs, R., & Aihie Sayer, A. (2003). Is grip strength a useful single marker of frailty?. Age and Ageing, 32(6), 650–656.

Tseng, F. M., & Petrie, D. J. (2014). The implications for health, depression, and life satisfaction from a permanent increase in income for the disadvantaged elderly: Evidence from Taiwan. Review of Social Economy, 72(3), 311–336.

Turvey, C. L., Wallace, R. B., & Herzog, R. (1999). A revised CES-D measure of depressive symptoms and a DSM-based measure of major depressive episodes in the elderly. International Psychogeriatrics, 11(2), 139–148.

van Ginneken, W. (1999). Social security for the informal sector: A new challenge for the developing countries. International Social Security Review, 52(1), 49–69.