In the United States, employment rates among individuals with disabilities are persistently low but vary substantially. In this study, we examine the relationship between employment outcomes and features of the state and county physical, economic, and policy environment among a national sample of individuals with disabilities. To do so, we merge a set of state- and county-level environmental variables with data from the 2009'2011 American Community Survey accessed in a U.S. Census Research Data Center. We estimate regression models of employment, work hours, and earnings as a function of health conditions, personal characteristics, and these environmental features. We find that certain environmental variables are significantly associated with employment outcomes. Although the estimated importance of environmental variables is small relative to individual health and personal characteristics, our results suggest that these variables may present barriers or facilitators to employment that can explain some geographic variation in employment outcomes across the United States.
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Complex Survey Questions and the Impact of Enumeration Procedures: Census/American Community Survey Disability Questions
April 2009
Working Paper Number:
CES-09-10
This paper explores challenges relating to the identification of the population with disabilities,focusing on Census Bureau efforts using the 2000 Decennial Census Long-Form (Census 2000) and 2000-2005 American Community Survey (ACS). In particular, the analyses explore the impact of survey methods on responses to the work limitation (i.e., employment disability) question in these two Census products. Building on the research of Stern (2003) and Stern and Brault (2005), we look for further evidence of misreporting of an employment disability by specific sub-populations using the participation in the Supplemental Security Income program as an exogenous employment disability status indicator along with a subset of ACS disability questions. We expand upon these earlier studies by examining both false-positive and falsenegative reports of employment disability by implementing logit estimations to examine the role of respondent/enumerator error on the accuracy of the employment disability response. In this manner, we enhance our understanding of Census 2000 and ACS responses to employment disability questions through an exploration of the role of enumeration procedures in two types of misclassifications, as well as by evaluating existing data and estimates to uncover characteristics that might make an individual more likely to misreport an employment disability.
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Reporting of Indian Health Service Coverage in the American Community Survey
May 2018
Working Paper Number:
carra-2018-04
Response error in surveys affects the quality of data which are relied on for numerous research and policy purposes. We use linked survey and administrative records data to examine reporting of a particular item in the American Community Survey (ACS) - health coverage among American Indians and Alaska Natives (AIANs) through the Indian Health Service (IHS). We compare responses to the IHS portion of the 2014 ACS health insurance question to whether or not individuals are in the 2014 IHS Patient Registration data. We evaluate the extent to which individuals misreport their IHS coverage in the ACS as well as the characteristics associated with misreporting. We also assess whether the ACS estimates of AIANs with IHS coverage represent an undercount. Our results will be of interest to researchers who rely on survey responses in general and specifically the ACS health insurance question. Moreover, our analysis contributes to the literature on using administrative records to measure components of survey error.
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Transitions in Welfare Participation and Female Headship
February 2004
Working Paper Number:
CES-04-01
This study uses data from the 1990, 1992, 1993, and 1996 panels of the Survey of Income and Program Participation to examine how welfare policies and local economic conditions contribute to women's transitions into and out of female headship and into and out of welfare participation. It also examines whether welfare participation is directly associated with longer spells of headship. The study employs a simultaneous hazards approach that accounts for unobserved heterogeneity in all of its transition models and for the endogeneity of welfare participation in its headship model. The estimation results indicate that welfare participation significantly reduces the chances of leaving female headship. The estimates also reveal that more generous welfare benefits contribute indirectly to headship by increasing the chances that mothers will enter welfare. More generous Earned Income Tax Credit benefits are associated with longer spells of headship, nonheadship, and welfare participation and nonparticipation. Other measures of welfare policies, including indicators for the adoption of welfare waivers and the implementation of Temporary Assistance for Needy Families programs, are generally not significantly associated with headship or welfare receipt. Better economic opportunities are estimated to increase headship but reduce welfare participation among unmarried mothers.
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Differences in Disability Insurance Allowance Rates
August 2025
Working Paper Number:
CES-25-54
Allowance rates for disability insurance applications vary by race and ethnicity, but it is unclear to what extent these differences are artifacts of other differing socio-economic and health characteristics, or selection issues in SSA's race and ethnicity data. This paper uses the 2015 American Community Survey linked to 2015-2019 SSA administrative data to investigate DI application allowance rates among non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, non-Hispanic American Indian/Alaska Native, and Hispanic applicants aged 25-65. The analysis uses regression, propensity score matching, and inverse probability weighting to estimate differences in allowance rates among applicants who are similar on observable characteristics. Relative to raw comparisons, differences by race and ethnicity in multivariate analyses are substantially smaller in magnitude and are generally not statistically significant.
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Geographic Disparities in Alzheimer's Disease and Related Dementia Mortality in the US: Comparing Impacts of Place of Birth and Place of Residence
January 2025
Working Paper Number:
CES-25-11
Objective: Building on the hypothesis that early-life exposures might influence the onset of Alzheimer's Disease and Related Dementia (ADRD), this study delves into geographic variations in ADRD mortality in the US. By considering both state of residence and state of birth, we aim to discern the comparative significance of these geospatial factors.
Methods: We conducted a secondary data analysis of the National Longitudinal Mortality Study (NLMS), that has 3.5 million records from 1973-2011 and over 0.5 million deaths. We focused on individuals born in or before 1930, tracked in NLMS cohorts from 1979-2000. Employing multi-level logistic regression, with individuals nested within states of residence and/or states of birth, we assessed the role of geographical factors in ADRD mortality variation.
Results: We found that both state of birth and state of residence account for a modest portion of ADRD mortality variation. Specifically, state of residence explains 1.19% of the total variation in ADRD mortality, whereas state of birth explains only 0.6%. When combined, both state of residence and state of birth account for only 1.05% of the variation, suggesting state of residence could matter more in ADRD mortality outcomes.
Conclusion: Findings of this study suggest that state of residence explains more variation in ADRD mortality than state of birth. These results indicate that factors in later life may present more impactful intervention points for curbing ADRD mortality. While early-life environmental exposures remain relevant, their role as primary determinants of ADRD in later life appears to be less pronounced in this study.
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The Impact of Unemployment Insurance Extensions On Disability Insurance Application and Allowance Rates
March 2013
Working Paper Number:
CES-13-10
Both unemployment insurance (UI) extensions and the availability of disability benefits have disincentive effects on job search. But UI extensions can reduce the efficiency cost of disability benefits if UI recipients delay disability application until they exhaust their unemployment benefits. This paper, the first to focus on the effect of UI extensions on disability applications, investigates whether UI eligibility, extension, and exhaustion affect the timing of disability applications and the composition of the applicant pool. Jobless individuals are significantly less likely to apply to Social Security Disability Insurance (SSDI) during UI extensions, and significantly more likely to apply when UI is ultimately exhausted. Healthier potential applicants appear more likely to delay, as state allowance rates increase after a new UI extension. Simulations find that a 13-week UI extension decreases SSDI and Medicare costs, offsetting about half of the increase in UI payments; this suggests that the benefits of UI extensions may be understated ' permanent disability benefits are diverted to shorter-run unemployment benefits and, potentially, new jobs, while easing the burden on the nearly insolvent SSDI Trust Fund.
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Long-Run Adult Socio-economic Outcomes
from In Utero Airborne Lead Exposure
November 2022
Working Paper Number:
CES-22-53
As a neurotoxin, early exposure to lead has long been assumed to affect socioeconomic out-comes well into adulthood. However, the empirical literature documenting such effects has been limited. This study documents the long-term effects of in utero exposure to air lead on adult socio-economic outcomes, including earnings, disabilities, employment, public assistance, and education, using US survey and administrative data. Specifically, we match individuals in the 2000 US Decennial Census and 2001-2014 American Community Surveys to average lead concentrations in the individual's birth county during his/her 9 months in utero. We find a 0.5 'g/m3 decrease in air lead, representing the average 1975-85 change resulting from the passage of the U.S. Clean Air Act, is associated with an increase in earnings of 3.5%, or a present value, at birth, of $21,400 in lifetime earnings. Decomposing this effect, we find greater exposure to lead in utero is associated with an increase in disabilities in adulthood, an increase in receiving public assistance, and a decrease in employment. Looking at effects by sex, long-term effects for girls seem to fall on participation in the formal labor market, whereas for boys it appears to fall more on hours worked. This is the first study to document such long-term effects from lead using US data. We estimate the present value in 2020, from all earnings impacts from 1975 forward, to be $4,230 Billion using a discount rate of 3%. In 2020 alone, the benefits are $252 B, or about 1.2% of GDP. Thus, our estimates imply the Clean Air Act's lead phase out is still returning a national dividend of over 1% every year.
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The Underserved Have Less Access to Employer-Sponsored Telemedicine Coverage
September 2022
Working Paper Number:
CES-22-40
Telemedicine has been proposed as one means of improving health care access for underserved communities, and information about insurance coverage for telemedicine (TMC) is important in understanding its utilization and provision. We use 2018-2019 Medical Expenditure Panel Survey-Insurance Component data on employer-sponsored coverage to examine pre-pandemic TMC relative to employer, worker, and health plan characteristics. We find that the share of employees in private sector establishments offering TMC was lower in the most rural counties, in smaller firms, in establishments without unionized employees, and in establishments where most workers were low wage, part-time and older when compared to other establishments. These findings reflect differences across establishments in insurance offers, as well as differences in TMC conditional on an insurance offer, which suggests that TMC may function as a premium plan feature with limited availability and potential support for improving healthcare access for the underserved.
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The Rural/Urban Volunteering Divide
June 2025
Working Paper Number:
CES-25-42
Are rural residents more likely to volunteer than those living in urban places? Although early sociological theory posited that rural residents were more likely to experience social bonds connecting them to their community, increasing their odds of volunteer engagement, empirical support is limited. Drawing upon the full population of rural and urban respondents to the United States Census Bureau's Current Population Survey (CPS) Volunteering Supplement (2002-2015), we found that rural respondents are more likely to report volunteering compared to urban respondents, although these differences are decreasing over time. Moreover, we found that propensities for rural and urban volunteerism vary based on differences in both individual and place-based characteristics; further, the size of these effects differ across rural and urban places. These findings have important implications for theory and empirical analysis.
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Income Packaging and Economic Disconnection: Do Sources of Support Differ from Other Low-Income Women?
December 2013
Working Paper Number:
CES-13-61
Income packaging, or piecing together cash and non-cash resources from a variety of sources, is a common financial survival strategy among low-income women. This strategy is particularly important for economically disconnected women, who lack both employment income and public cash assistance receipt. Using data from the confidential Census Bureau versions of the Survey of Income and Program Participation, this study compares the use of public and private supports between disconnected and connected low-income women, controlling for differences in state welfare rules and county unemployment rates. Findings from bivariate comparisons and multilevel logistic regressions indicate that disconnected women utilize public non-cash supports at similar rates to connected women, but rely more heavily on private sources. Conclusions focus on the policy implications for outreach and program development.
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