Inflows into disability and sickness benefit schemes should be monitored

Economics of mental well-being: a prospective study estimating associated health care costs and sickness benefit transfers in Denmark

The European Journal of Health Economics ◽

10.1007/s10198-021-01305-0 ◽

2021 ◽

Author(s):

Ziggi Ivan Santini ◽

Hannah Becher ◽

Maja Bæksgaard Jørgensen ◽

Michael Davidsen ◽

Line Nielsen ◽

...

Keyword(s):

Health Care ◽

Mental Illness ◽

Healthcare Costs ◽

Psychiatric Morbidity ◽

Government Expenditure ◽

Well Being ◽

Population Based ◽

Sickness Benefit ◽

A Prospective Study ◽

Mental Well Being

Abstract Background Previous literature has examined the societal costs of mental illness, but few studies have estimated the costs associated with mental well-being. In this study, a prospective analysis was conducted on Danish data to determine 1) the association between mental well-being (measured in 2016) and government expenditure in 2017, specifially healthcare costs and sickness benefit transfers. Methods Data stem from a Danish population-based survey of 3,508 adults (aged 16 + years) in 2016, which was linked to Danish registry data. A validated scale (WEMWBS) was used for the assessment of mental well-being. Costs are expressed in USD PPP. A two-part model was applied to predict costs in 2017, adjusting for sociodemographics, health status (including psychiatric morbidity and health behaviour), as well as costs in the previous year (2016). Results Each point increase in mental well-being (measured in 2016) was associated with lower healthcare costs ($− 42.5, 95% CI = $− 78.7, $− 6.3) and lower costs in terms of sickness benefit transfers ($− 23.1, 95% CI = $− 41.9, $− 4.3) per person in 2017. Conclusions Estimated reductions in costs related to mental well-being add to what is already known about potential savings related to the prevention of mental illness. It does so by illustrating the savings that could be made by moving from lower to higher levels of mental well-being both within and beyond the clinical range. Our estimates pertain to costs associated with those health-related outcomes that were included in the study, but excluding other social and economic outcomes and benefits. They cover immediate cost estimates (costs generated the year following mental well-being measurement) and not those that could follow improved mental well-being over the longer term. They may therefore be considered conservative from a societal perspective. Population approaches to mental health promotion are necessary, not only to potentiate disease prevention strategies, but also to reduce costs related to lower levels of mental well-being in the non-mental illness population. Our results suggest that useful reductions in both health care resource use and costs, as well as in costs due to sick leave from the workplace, could be achieved from investment in mental well-being promotion within a year.

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From Substitutive to Supplementary: Institutional Interplay between Public and Occupational Sickness Benefits in Finland, 1947-2016

European Journal of Social Security ◽

10.1177/1388262720988295 ◽

2021 ◽

Vol 23 (1) ◽

pp. 62-80

Author(s):

Laura Järvi

Keyword(s):

Welfare State ◽

Institutional Development ◽

Point Of View ◽

Sickness Benefit ◽

Individual Level ◽

The Public ◽

Blue Collar Workers ◽

Sickness Benefits ◽

Over Time ◽

Benefit System

In the context of the Finnish welfare state, this article examines the role of occupational welfare in the interplay between public and occupational sickness benefits from 1947 to 2016, to analyse how the two sickness benefits have interacted over time and the role occupational welfare has played in sickness provision. Previous research has noted that occupational benefits may support or compensate for the much-debated declining welfare state. Hence, it is important to acquire greater knowledge about the public-occupational interplay. The study uses in-depth individual-level analysis from a retrospective point of view, which has been rare in previous research, and examines the public-occupational interplay in the Finnish sickness benefit system from the first national collective agreements to 2016. Based on the reforms made to the public system, the article identifies and utilises six different phases of the Finnish sickness allowance system in the main analysis. The institutional development of sickness provision is investigated by analysing the compensation rate and benefit period, using metalworkers as a representative example of blue-collar workers. The results indicate that occupational benefits are strongly institutionalised in the Finnish sickness benefit system. The interplay between statutory and occupational sickness benefits has taken different forms over time, and occupational benefits have been re-negotiated as the statutory system has been reformed. The article provides valuable information on the historical development and relevance of occupational welfare, in terms of not only understanding its significance for individuals but also comprehending the logic of the interplay in the public-private mix of welfare provision.

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Gender and Social Security: Some Lessons from Europe

European Journal of Social Security ◽

10.1023/a:1021328903833 ◽

2002 ◽

Vol 4 (3) ◽

pp. 227-239 ◽

Cited By ~ 3

Author(s):

Ann-Charlotte Ståhlberg

Keyword(s):

Social Security ◽

Labour Market ◽

Old Age ◽

Gender Inequality ◽

Sickness Benefit ◽

Men And Women ◽

Dual Earner ◽

The Family ◽

Gender Neutral ◽

The Individual

Different social security schemes affect men and women differently. This article compares the family or single earner model with the individual or dual earner model and examines their impact on gender inequality. However, even where social security schemes are designed to be gender neutral, when applied in a context that is systematically structured by gender, it points out that they will have a different impact on men and women. The article examines the ways in which supposedly gender-neutral rules, in sickness benefit, survivors' pensions and old age pensions have affected men and women in Sweden and concludes that, if countries wish to achieve equal economic outcomes for men and women, they will need to introduce measures to equalise men's and women's commitments to the home and the labour market, and to enable women to attain higher-paid jobs on the same basis as men.

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