Burden Reduction in a Social Safety Net Program Reduces Mortality

Many eligible individuals do not enroll in social safety net programs because ofburdensome administrative procedures, ranging from confusion about eligibilityguidelines to complicated paperwork. But what happens when eligible individuals don'ttake up benefits for which they’re eligible? While we know the short-term impacts, suchas forgone income and benefits, the long-term consequences of these losses remainpoorly understood. We examine the mortality impacts of burden reduction – particularlylearning costs associated with understanding eligibility and benefits – for theSupplemental Security Income (SSI) program. Using data from a large-scale randomizedcontrolled trial (N=4,016,461) in which informational letters were sent to older adults likelyeligible but not enrolled in SSI, we estimate the mortality effects of older adults’subsequent enrollment in SSI. The intervention increased SSI awards by an estimated 1.8percentage points (or a 340 percent increase from a baseline enrollment rate of 0.5percent). Among those who enrolled in SSI, we estimate a meaningful reduction inmortality (Hazard Ratio=0.6101, 95% CI=0.5127 - 0.7075). These results demonstrate thatburden reduction increased access to social welfare programs like SSI in the short termand may have significant downstream impacts by reducing beneficiaries’ mortality risk.