The Impact of Growing Health and Mortality Inequalities on Lifetime Social Security Payouts

The prevalence of obesity, diabetes, and other health problems has increased in recent
decades in the United States, and there is a growing gap between the health and longevity of
individuals with high socioeconomic status (SES) and low SES. These trends likely have
implications for Social Security’s financial position in the coming decades. Because high-SES
individuals tend to receive higher annual benefits and live longer, increases in health and
mortality inequalities may result in increases in aggregate Social Security payouts. This paper
uses data from the Health and Retirement Study, and a microsimulation model of health,
mortality, and Social Security benefits, to forecast lifetime Social Security benefits of the 1934 to
1959 birth cohorts in the U.S. We compare alternative assumptions about the future course of
mortality. We find that accounting for health and mortality inequalities is important. In a baseline
model that ignores trends in mortality inequalities, we estimate that lifetime Social Security
benefits would grow by 26% in real terms between the 1934 and 1959 birth cohorts due to
increasing benefit levels and improvements in average mortality. When we account for mortality
inequalities, we find an increase of 28% to 38% in average lifetime benefits, depending on the
assumptions of the model. We also forecast lifetime benefits using the alternative assumption
that improvements in population mortality will slow for younger birth cohorts.