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健康不平等对终身收入不平等有多重要?

How Important Is Health Inequality for Lifetime Earnings Inequality?
Review of Economic Studies · 2025 · Roozbeh Hosseini、Karen Kopecky、Kai Zhao

中文摘要

采用动态面板方法,我们提供的经验证据表明,负向健康冲击会显著降低收入。这一效应主要由劳动参与边际驱动,并集中于受教育程度较低者和健康状况较差者。随后,我们构建了一个劳动供给生命周期模型,其中具有风险且存在异质性的虚弱状况特征会影响个体的生产率、获得社会保险的可能性、工作的负效用、死亡率和医疗支出。个体可以选择工作或不工作,并可申请社会保障残疾保险(SSDI/SSI)。在我们的模型中,消除健康不平等会使55岁时终身(累计)收入对数的方差降低28%。这一效应中约有60%源于健康状况不佳对获得SSDI/SSI福利概率的影响。尽管如此,我们表明取消SSDI/SSI计划会降低事前福利。

Abstract

Abstract Using a dynamic panel approach, we provide empirical evidence that negative health shocks significantly reduce earnings. The effect is primarily driven by the participation margin and is concentrated among the less educated and those in poor health. Next, we develop a life-cycle model of labour supply featuring risky and heterogeneous frailty profiles that affect individuals’ productivity, likelihood of access to social insurance, disutility from work, mortality, and medical expenses. Individuals can either work or not work and apply for social security disability insurance (SSDI/SSI). Eliminating health inequality in our model reduces the variance of log lifetime (accumulated) earnings by 28% at age 55. About 60% of this effect is due to the impact of poor health on the probability of obtaining SSDI/SSI benefits. Despite this, we show that eliminating the SSDI/SSI program reduces ex ante welfare.
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