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无论是生病还是健康?基于登记的证据表明,配偶双方相互领取疾病津贴和残疾养恤金。

In sickness or in health? Register-based evidence on partners' mutual receipt of sickness allowance and disability pension.

机构信息

Åbo Akademi University, Finland.

Lund University, Sweden.

出版信息

Soc Sci Med. 2019 Nov;240:112576. doi: 10.1016/j.socscimed.2019.112576. Epub 2019 Sep 27.

Abstract

Studies on partners' mutual receipt of benefits constitute a growing research field in the way individual health and health-related decisions depend on social relations. This paper provides the first study on the mutual receipt of sickness allowance. We analysed married and cohabiting couples' receipt of sickness allowance and disability pension by estimating discrete-time hazard models for individuals aged 40-65 years, using longitudinal register data from Finland. The data cover the period 1987-2011, and allowed us to explore socioeconomic and demographic variables at both the individual and couple level. We found strong and long-term interrelations in receipt behaviour and dependencies across benefit types. The risk of receiving sickness allowance increases by 50 per cent during the first years after the partner's first receipt of the same benefit, while the risk of receiving disability pension is twice as high even five years after the partner's receipt of the same. Women appear to be more instrumental than men in the production of health within the couple, even in a context of high level of state support, gender equality and female labour force participation. Their receipt of disability pension is more related to the male partner's receipt than vice versa. For sickness allowance receipt, the gender asymmetry is small. Mutual benefit receipt of benefits may relate not only to collateral health effects but also to shared preferences and partner selection. We cannot distinguish between the mechanisms. However, couples with more economic and social resources seem to be more efficient in joint decision making. Correlations are particularly strong in the immediate term, and for couples who are highly educated, for those with high income, and for those with children in the household. More effective policies may be needed to equalise information regarding benefits, and monitor the use, and potential misuse, of these health benefits.

摘要

伴侣之间互惠获得福利的研究构成了一个不断发展的研究领域,因为个体健康和与健康相关的决策取决于社会关系。本文首次研究了互惠获得疾病津贴的情况。我们使用来自芬兰的纵向登记数据,通过为年龄在 40-65 岁的个体估计离散时间风险模型,分析了已婚和同居伴侣获得疾病津贴和残疾养恤金的情况。该数据涵盖了 1987-2011 年期间,使我们能够探索个体和夫妻层面的社会经济和人口统计学变量。我们发现,在收益行为和各种收益类型之间存在着强烈和长期的相互关系和依赖性。在伴侣首次获得相同福利后的头几年,获得疾病津贴的风险增加了 50%,而在伴侣获得相同福利五年后,获得残疾养恤金的风险甚至增加了一倍。即使在国家支持程度高、性别平等和女性劳动力参与度高的情况下,女性似乎也比男性更能在夫妻关系中促进健康,而不仅仅是作为工具人。她们获得残疾养恤金更多地与男性伴侣的获得有关,而不是相反。对于获得疾病津贴而言,性别不对称性很小。互惠获得福利可能不仅与间接的健康影响有关,还与共同的偏好和伴侣选择有关。我们无法区分这些机制。然而,具有更多经济和社会资源的夫妻在联合决策方面似乎更有效率。相关性在短期内尤为强烈,对于那些受教育程度高、收入高、家中有子女的夫妻更是如此。可能需要制定更有效的政策,以实现关于福利的信息平等,并监测这些健康福利的使用情况和潜在滥用情况。

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