Are we suffering traumatic injuries from falling trees, collapsing scaffolds, dangerous industrial machines?
Is it because so many of us work at jobs requiring intense physical labor, and we are working long hours long past middle age? Conversely, is it the very sedentary nature of many jobs that saps energy and wastes muscle?
Could it be we are just living longer than we ever have, and our bodies, programmed by evolution to live long enough to procreate, just aren’t built to stay strong, flexible, and resilient for decades?
Or are we way too fat, get far too little exercise, eat lousy food, and blame everyone but ourselves for the consequences?
Is it the continuing high unemployment rate and dearth of good-paying jobs?
And/Or – and here’s the scary thought – is it the definition of “disabled” that’s changed – both the public one and the way some view themselves?
This is becoming an increasingly critical question – as the number of Americans on Social Security for “disability” has increased rather dramatically – doubling from 1985 to 2005. In 1984 2.2% of the working-age population was receiving Social Security Disability Insurance (SSDI); 4.1% was in 2005. This increase was, according to a paper published by the National Bureau of Economic Research, driven by a change in the definition of disability:
The most important factor is the liberalization of the DI screening process that occurred due to a 1984 law. This law directed the Social Security Administration to place more weight on ap-plicants’ reported pain and discomfort, relax its screening of mental illness, consider applicants with multiple non-severe ailments, and give more credence to medical evidence provided by the applicant’s doctor.
These changes had the effect of both increasing the number of new DI awards and shifting their composition towards claimants with low-mortality disorders. For example, the share of awards for a primary impairment of mental illness rose from 16 percent in 1983 to 25 percent in 2003, while the share for a primary impairment of musculoskeletal disorders (primarily back pain) rose from 13 per-cent in 1983 to 26 percent in 2003.
The number of working-age folks receiving SSDI reached 8.8 million at the end of last year. That’s about 4.4 percent of the working age (18-64) population, an increase of 0.3 percent over the last seven years.
There’s been an increasing amount of attention paid to this issue; that’s both warranted and appropriate.
Yet I’m reminded of something Jennifer Christian MD told me years ago; “there’s no condition so disabling that there isn’t someone in the US with that condition working full time today.”
So, what is it?
My sense is it is all of the above. Some are really hurting or unable to work at jobs they can perform, others lazy, some dispirited, some enabled by physicians, many just getting older and wearing down, many unable to find good-paying jobs.
What does this mean for you?
Big, knotty problems aren’t fixed by simple answers or assignment of blame. They are fixed by understanding drivers and the various moving parts needed to assemble solutions.