The number of Americans applying for Social Security Disability Insurance rose sharply during the 2000s, a phenomenon that appears to have been driven more by the job market — which was pretty weak for most of the decade, especially for those without college degrees — than by people’s health.
Social Security field offices were closed to visitors from March 2020 until this April, which the Social Security Administration said led to a decline in disability claims. So some of what we’re seeing is just catchup. But there is something else that might also be playing a role: the lingering effects of Covid-19 infections, aka Long Covid.
Given that you have to be unable to work for at least 12 months to qualify for Social Security disability and going on the program is a momentous step that effectively requires leaving the labor market, the still-new phenomenon that is Long Covid is probably not playing a big role (the Social Security Administration has said that only about 1% of recent claims mention Covid). Still, the turnaround in disability applications is at least not incompatible with a rise in long-term health problems related to the disease — and it turns out there are stronger signs of Long Covid in other employment-related data.
I started looking for them in part because I was dubious of some of the direct estimates of the scope of the phenomenon. With blood tests showing 58% of Americans infected with Covid-19 through February, studies finding that 10% or 25% or 30% or 37% or 55% of those with the disease develop long-term symptoms imply that 20 million to 100 million of us have Long Covid. An April attempt by the advocacy group Solve Long Covid Initiative to whittle that down to “disabling” cases still put the range at 7 million to 14 million, or 2.3% to 4.4% of US adults.
Given that labor-force-participation and employment rates in May were only about half a percentage point below where they were before the pandemic for prime-working-age adults (those aged 25 through 54), and above pre-pandemic levels for those aged 55 to 64, such estimates seem high. Still, dig a little deeper into the monthly Current Population Survey from which these statistics are derived and it is apparent that something new is ailing millions of Americans, even though many are staying on the job despite it.
The Census Bureau, which conducts the 60,000-household CPS on behalf of the Bureau of Labor Statistics, asks about disabilities as well as employment. The resulting estimate of the number of 16-and-older Americans with a disability is up by about two million since early 2020. It had been rising over the decade before then as the population aged, but not at nearly that fast a pace.
These two million additional disabled Americans are divided almost equally between people who are in the labor force (that is, they’re employed or actively looking for a job) and people who aren’t. Since the latter group make up the great majority of the disabled, the increase in disability among those in the labor force has been much sharper in percentage terms.
That dip in disability in spring 2020 was likely not for real: Survey response rates plummeted in the early months of the pandemic, with lower-income households seeing the biggest drop, skewing the results. What’s happened since spring 2021, though, has the look of being driven by actual changes in health status. More than a million additional Americans, representing a 19% increase from before the pandemic, are complaining of a disability while continuing to work.
What’s ailing them? The six questions that Census Bureau survey takers ask to determine disability are:
• Is anyone [in your household] deaf or does anyone have serious difficulty hearing?
• Is anyone blind or does anyone have serious difficulty seeing even when wearing glasses?
• Because of a physical, mental, or emotional condition, does anyone have serious difficulty concentrating, remembering, or making decisions?
• Does anyone have serious difficulty walking or climbing stairs?
• Does anyone have difficulty dressing or bathing?
• Because of a physical, mental, or emotional condition, does anyone have difficulty doing errands alone such as visiting a doctor’s office or shopping?
If the answer to one or more of those is yes, the person is counted as disabled. Here’s how the responses have changed over the course of the pandemic:
Having trouble concentrating, remembering or making decisions (I lopped off that last bit in the table to make it more readable) tracks well with the common Long Covid symptom known as “brain fog.” Fatigue and difficulty breathing, two other top Long Covid symptoms, are less directly addressed by the disability questions, although they might be reflected in difficulty doing errands alone and walking or climbing stairs. Hearing problems such as tinnitus have also been associated with Covid, although they aren’t near the top of the list of lingering symptoms.
The craziness of the past couple of years is another possible cause of all that brain fog, as well as of the kind of anxiety that might keep one from venturing out on errands. But another survey that the Census Bureau started conducting early in the pandemic points to a Covid connection.
Since January 2021, the online Household Pulse Survey has included a question about past Covid-19 diagnoses, and since April 2021 it has included questions similar to the first four disability queries in the CPS, albeit with multiple choice answers rather than yes-no. The percentage of respondents reporting severe problems remembering or concentrating has gone up both among those who’ve definitely had Covid and those who probably haven’t, but it’s higher and the rise has been steeper among the first group.
On the basis of the Household Pulse responses, the Census Bureau estimated that during the survey period of April 27 through May 9 of this year, 5.1 million Americans aged 18 and older had (1) a previous Covid-19 diagnosis and (2) severe difficulty with remembering or concentrating. A lot of those memory and concentration problems likely predated Covid, and big changes in response rates over time make it hard to compare estimates from the most recent Household Pulse surveys with those from spring 2021. But my back-of-the-envelope estimate(1) from the Household Pulse results is that overall about 2.2 million more US adults are complaining of severe brain-fog-like problems now than in spring 2021. The CPS-based estimate, recorded in the table above, is that there are 1.2 million more than before the pandemic.
Neither of those is 20 million, or even seven million, but it’s a lot of people and the number could keep growing. This accounting may also miss many who are suffering from fatigue, breathing or other Long Covid complaints not captured so well by the surveys. Neither the Household Pulse survey nor the CPS — including the set of pandemic-related questions added to it in May 2020 — addresses Long Covid much more directly than this. Even the Survey of Working Arrangements and Attitudes organized by economists Jose Maria Barrero, Nicholas Bloom and Steven J. Davis, which has focused on some important Covid-related topics that government surveys have not, has so far avoided health questions out of concern that, as Bloom put it in an email, they were “maybe too sensitive to include in the survey.”
Barrero, Bloom and Davis did conclude recently that what they called “Long Social Distancing,” prompted in part by concerns about catching Covid-19, is depressing the 16-and-older US labor-force participation rate by about 2.5 percentage points, which adds up to more than six million people. The Long Covid effect is probably smaller than that: In a January Brookings Institution report, jobs expert (and pizza-company executive) Katie Bach estimated on the basis of several studies that it was costing the US labor market about 1.6 million full-time equivalent workers, which seems to be in the same ballpark as what I found. That’s still enough to have an impact, especially at a time when available jobs are more plentiful than people looking for them — as Bach put, it’s equivalent to about 15% of all unfilled US jobs.
And discussing this purely in terms of how it has affected employment and labor-force participation is probably a mistake. My reading of the disability data is that the majority of people with Long Covid-like symptoms are still working, and I imagine that even most of those with debilitating cases would prefer not to check out of the labor force for good.
There do, however, seem to be a lot of Long Covid sufferers who could use some help. Which brings me back to Social Security Disability Insurance, a program that has long been criticized for disconnecting recipients from the labor market. In 2010, economists David Autor and Mark Duggan proposed a new approach that would offer:
• workplace accommodations, rehabilitation services, partial income support, and other services to workers who suffer work limitations, with the goal of enabling them to remain in employment;
• financial incentives to employers to accommodate workers who become disabled and minimize movements of workers from their payrolls onto the SSDI system
With encouragement from Congress, the Social Security Administration has been undertaking some experiments along these lines. Long Covid seems like good reason to speed up the process.
More From Other Writers at Bloomberg Opinion:
The Covid Era Has More Diabetes, Brain Fog: Raphael and Fazeli
Good Jobs Don’t Need Costly College Degrees Anymore: Conor Sen
Covid-19 Public Health Guidance Is Anyone’s Guess: Faye Flam
(1) The average share of those responding who reported severe difficulties remembering or concentrating was 5.86% in the first two Household Pulse surveys that asked the question in April and May 2021 and 6.74% in the most recent two, so I multiplied the 0.88-percentage-point increase by the Household Pulse 18-and-older population estimate of 252 million to get 2.2 million.
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
Justin Fox is a Bloomberg Opinion columnist covering business. A former editorial director of Harvard Business Review, he has written for Time, Fortune and American Banker. He is author of “The Myth of the Rational Market.”
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