Assets and Income: Disability-based Disparities in the United States

Parish, Susan L.; Grinstein‐Weiss, Michal; Yeo, Yeong Hun; Rose, Roderick A.; Rimmerman, Arie

doi:10.1093/swr/34.2.71

Cited by 35 publications

(34 citation statements)

References 11 publications

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“…A recent Canadian study found that people with disabilities held about $22,000 less in net worth compared to people without disabilities after controlling for factors such as education, employment, and family structure (Maroto 2016). Similarly, Parish (2010) found large net worth gaps across households with and without disabilities in the United States, and McKnight (2014) found that people with disabilities in the United Kingdom experienced net worth and asset gaps that were largest among middle‐aged individuals. Although these disparities were partly associated with differences in household structure, employment, and education, large gaps remained even after accounting for such factors.…”

Section: Income Wealth and Asset Disparitiesmentioning

confidence: 98%

“…Assets include financial products such as retirement plans, savings accounts, stocks, and bonds, along with nonfinancial goods such as vehicles and real estate. While income facilitates immediate consumption, it can also be invested or transformed into assets contributing to aggregated household wealth (Parish 2010; Shapiro and Wolff 2001). Certain assets, such as money in savings accounts, can also be particularly valuable in times of economic distress.…”

Section: Income Wealth and Asset Disparitiesmentioning

confidence: 99%

“…Scholars studying links between health, employment, and wealth (see, e.g., Headey and Wooden 2004; Parish et al. 2010; Shuey and Wilson 2017) have shown that anything undermining the ability to earn and save during individuals’ active years can have long‐lasting repercussions. Clarke and Latham's (2014) analysis of American Panel Study of Income Dynamics (PSID) data showed that having a work‐limiting disability in pre‐midlife compounded economic and health inequalities over the life course.…”

Section: Income Wealth and Asset Disparitiesmentioning

confidence: 99%

“…Importantly, disability not only increases financial insecurity for the individual person with the disability, but it also limits options for other household members who may or may not have disabilities (Batavia and Beaulaurier 2001; Crawford 2013; Erickson, Lee and von Schrader, 2015; McKnight 2014; Parish et al. 2010; Shuey and Willson 2017). As She and Livermore (2007) describe, because insecurity disseminates throughout entire households, measuring disability at only the individual‐level underestimates the ways in which disability affects economic hardship.…”

Section: Income Wealth and Asset Disparitiesmentioning

confidence: 99%

“…Limited studies on disability and wealth find that households with disabilities were less likely to own their homes, held lower net worth, and reported lower incomes in Canada, the United States, and the United Kingdom (Maroto 2016; McKnight 2014; Parish et al. 2010). These findings show that employment earnings are but one, albeit a significant, dimension of persistent economic inequality.…”

mentioning

confidence: 99%

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Barriers to Economic Security: Disability, Employment, and Asset Disparities in Canada

Maroto

Pettinicchio

2020

Canadian Review of Sociology

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Although ample research shows that people with disabilities face significant labor market barriers, questions remain about whether and how disadvantages in employment and earnings contribute to economic insecurity. We use 1999 to 2012 Canadian Survey of Financial Security data to study disparities in nonhousing assets, which include household savings, stocks, and pensions, across households with and without disabilities. We find that households where the respondent or their spouse reported a disability held 25 percent less in nonhousing assets after accounting for key employment, education, and demographic factors. Demonstrating the more complicated relationship between disability, employment, and assets, these direct effects were further strengthened by disability's indirect effects on assets through its relationship with employment income.

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Section: Income Wealth and Asset Disparitiesmentioning

confidence: 98%

Section: Income Wealth and Asset Disparitiesmentioning

confidence: 99%

Section: Income Wealth and Asset Disparitiesmentioning

confidence: 99%

Section: Income Wealth and Asset Disparitiesmentioning

confidence: 99%

mentioning

confidence: 99%

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Barriers to Economic Security: Disability, Employment, and Asset Disparities in Canada

Maroto

Pettinicchio

2020

Canadian Review of Sociology

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Health Care Expenses and Financial Hardship Among Medicare Beneficiaries With Functional Disability

Park,

Stimpson

2024

JAMA Netw Open

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ImportanceMedicare beneficiaries with functional disabilities often require more medical care, leading to substantial financial hardship. However, the precise magnitude and sources of this hardship remain unknown.ObjectivesTo quantify the financial burden from health care expenses by functional disability levels among Medicare beneficiaries.Design, Setting, and ParticipantsThis cross-sectional study used data, including demographic and socioeconomic characteristics, health status, and health care use, from a nationally representative sample of Medicare beneficiaries from the 2013 to 2021 Medical Expenditure Panel Survey. Functional disability was measured using 6 questions and categorized into 3 levels: none (no difficulties), moderate (1-2 difficulties), and severe (≥3 difficulties). Data were analyzed from December 2023 to March 2024.Main Outcomes and MeasuresFinancial hardship from health care expenses was assessed using objective measures (annual out-of-pocket spending, high financial burden [out-of-pocket spending exceeding 20% of income], and catastrophic financial burden [out-of-pocket spending exceeding 40% of income]) and subjective measures (difficulty paying medical bills and paying medical bills over time). We applied weights to produce results representative of national estimates.ResultsThe sample included 31 952 Medicare beneficiaries (mean [SD] age, 71.1 [9.7] years; 54.6% female). In weighted analyses, severe functional disability was associated with a significantly higher financial burden from health care expenses, with out-of-pocket spending reaching $2137 (95% CI, $1943-$2330) annually. This exceeded out-of-pocket spending for those without functional disability by nearly $700 per year ($1468 [95% CI, $1311-$1625]) and for those with moderate functional disability by almost $500 per year ($1673 [95% CI, $1620-$1725]). The primary factors that played a role in this difference were home health care ($399 [95% CI, $145-$651]) and equipment and supplies ($304 [95% CI, $278-$330]). Beneficiaries with severe functional disability experienced significantly higher rates of both high and catastrophic financial burden than those without disability and those with moderate disability (13.2% [12.2%-14.1%] vs 9.1% [95% CI, 8.6%-9.5%] and 9.4% [95% CI, 9.1%-9.7%] for high financial burden, respectively, and 8.9% [95% CI, 7.8%-10.1%] vs 6.4% [95% CI, 6.1%-6.8%] and 6.0% [95% CI, 5.6%-6.4%] for catastrophic financial burden, respectively). Similar associations were observed in subjective financial hardship. For example, 11.8% (95% CI, 10.3%-13.3%) of those with severe functional disability experienced problems paying medical bills, compared with 7.7% (95% CI, 7.6%-7.9%) and 9.3% (95% CI, 9.0%-9.6%) of those without functional disability and those with moderate functional disability, respectively. Notably, there were no significant differences in financial hardship among those with Medicaid based on functional disability levels.Conclusions and RelevanceIn this cross-sectional study of Medicare beneficiaries, those with severe functional disability levels experienced a disproportionate burden from health care costs. However, Medicaid played a pivotal role in reducing the financial strain. Policymakers should explore interventions that effectively relieve the financial burden of health care in this vulnerable population.

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Centering Home Care in Bioethics Scholarship, Education, and Practice

Gary¹,

Berlinger²

2023

Hastings Center Report

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This commentary responds to “Home Care in America: The Urgent Challenge of Putting Ethical Care into Practice,” by Coleman Solis and colleagues, in the May‐June 2023 issue of the Hastings Center Report. More specifically, we respond to the authors’ call for “inquiry into the nature, value, and practice” of home care. We argue that the most urgently needed normative reset for thinking about care work is the replacement of dominant individualistic thinking with systemic thinking. Deepening a focus on the social, economic, and historical forces that shape the state of contemporary care work will help bioethicists to argue more effectively for improvements to working conditions. In turn, better working conditions will ease the oppositional stance between caregivers and receivers that has been set up by the current system, enabling all parties involved to better pursue the feminist ethical ideal of care.

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Assets and Income: Disability-based Disparities in the United States

Cited by 35 publications

References 11 publications

Barriers to Economic Security: Disability, Employment, and Asset Disparities in Canada

Barriers to Economic Security: Disability, Employment, and Asset Disparities in Canada

Health Care Expenses and Financial Hardship Among Medicare Beneficiaries With Functional Disability

Centering Home Care in Bioethics Scholarship, Education, and Practice

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