Path Dependence in Disability

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Population Center Working Papers (PSC/PARC)
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activity limitations
panel data
Demography, Population, and Ecology
Disability Studies
Family, Life Course, and Society
Gender and Sexuality
Inequality and Stratification
Social and Behavioral Sciences
We gratefully acknowledge the support for the Mature Adults Cohort of the Malawi Longitudinal Study of Families and Health (MLSFH-MAC) by the Swiss Programme for Research on Global Issues for Development (SNF r4d Grant 400640_160374) and the pilot funding received through the Penn Center for AIDS Research (CFAR), supported by NIAID AI 045008 and the Penn Institute on Aging. We are also grateful for support for the Malawi Longitudinal Study of Families and Health (MLSFH) by the National Institute of Child Health and Human Development (NICHD, Grant Nos. R01 HD044228, R01 HD053781, R01 HD087391); the National Institute on Aging (NIA, Grant Nos. P30 AG12836 and R21 AG053763); the Boettner Center for Pensions and Retirement Security at the University of Pennsylvania; and the NICHD Population Research Infrastructure Program (Grant Nos. R24 HD-044964), all at the University of Pennsylvania.
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The average prevalence of disability in most African countries is 10% but for many it exceeds the global disability prevalence rate of 15%. The extent to which this disability capturing functional and activity limitations results in permanent job loss, lowered lifetime income, and assets, in part, depends upon the extent to which the onset of limitations becomes permanent. In this paper we use five rounds of longitudinal data from rural Malawi, a low income African country with high prevalence of disability, to examine path dependence in activity limitations. We estimate a dynamic linear panel data model where the coefficient on the one-period lagged health outcome captures path dependence in limitations. Our preferred Arellano-Bover estimates show that males experience persistence in both the incidence and intensity of severe limitations but are able to recover from all other limitations, whereas, females exhibit no significant persistence on any type of limitations. Our findings have important policy implications for computing the long-term costs associated with onsets of activity limitations as these costs can be moderated by the recovery exhibited in these limitations.

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