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异质性残障冲击与收入、就业及部分保险的动态

Heterogeneous disability shocks and the dynamics of income, employment, and partial insurance
Journal of Health Economics · 2026 · Robert G. Millard

中文摘要

本研究考察残障的长期经济后果,并依据受损的活动类型对残障状况加以区分。利用关联匹配的加拿大调查数据与税务行政数据,我估计了残障发生对细分收入组成部分在十年期内的效应,并评估了不同残障类型之间部分收入保险的缺口。与身体残障相比,心理—认知残障会导致更大且更持久的市场收入损失。尽管如此,两组人群获得的部分保险水平相近,税后收入的下降幅度也相当。重要的是,这些宽泛类别内部存在相当大的异质性。将身体残障和心理—认知残障进一步分解为互斥的、基于活动的子类型后发现,总体分类所掩盖的收入轨迹与保险可及性方面存在明显差异。虽然税收—转移支付体系总体上提供了部分收入保护,但其有效性在不同子类型之间差异明显,对与心理健康相关的残障所提供的支持尤为有限,在较年轻和受教育程度较低的人群中尤其如此。

Abstract

This study examines the long-run economic consequences of disability, distinguishing conditions by the activities they impair. Using linked Canadian survey and administrative tax data, I estimate the effects of disability onset on detailed income components over a ten-year horizon and assess gaps in partial income insurance across disability types. Mental–cognitive disabilities lead to larger and more persistent losses in market income than physical disabilities. Despite this, both groups experience similar levels of partial insurance and comparable declines in after-tax income. Importantly, substantial heterogeneity exists within these broad categories. Disaggregating physical and mental–cognitive disabilities into mutually exclusive activity-based subtypes reveals pronounced differences in income trajectories and access to insurance that are masked by aggregate classifications. While the tax–transfer system provides partial income protection overall, its effectiveness varies markedly across subtypes, offering especially limited support for mental health-related disabilities, particularly among younger and less-educated individuals.
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