First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
Policy‐makers in advanced welfare states have increasingly expressed concerns over large numbers of working‐age people claiming social security support. Accordingly, policies aimed at reducing the level of “benefit dependency” have gained prominence. However, such policies rest on shaky empirical evidence. Systematic collections of national “caseload” data are rare, social security programmes overlap and administrative categories vary over time. The internationally inconsistent treatment of national transfer programmes provides a further challenge for cross‐national comparisons. This article first identifies and discusses several of these problems, and ways in which they may be addressed. It then employs administrative claimant data from six European countries as a way of illustrating trends over time and across countries. The underlying aim is to explore the scientific potential of benefit recipient numbers as an indicator for welfare state change over time and across countries.
This article assesses the effectiveness of pension provision and health insurance in preventing ill health among older people in developing countries. It argues that, until recently, social protection agendas devoted insufficient attention to health risk prevention, instead focusing on the reduction of income poverty through cash transfers. The article shows that there is little reliable evidence to indicate that providing older people with pension benefits enhances their health status and that these effects should not be taken for granted by policy‐makers. The article then focuses on the effect of inclusion in health insurance schemes on health outcomes for older people, with specific reference to outcomes related to hypertension. Drawing on newly‐available data from the World Health Organization for Ghana, Mexico and South Africa, it shows that older people with health insurance are marginally more likely to be aware of health conditions such as hypertension and more likely to have them under control. Nevertheless, the great majority of hypertensive older people, insured or uninsured, are not effectively treated. The chief barriers to treatment are shown to be mainly related to awareness and service provision, rather than financial ones. Consequently, the capacity of pensions or health insurance to enhance health outcomes for older people in such countries, including in rural areas, is heavily contingent upon health education, health screening and adequate health service provision. These interventions should be viewed as an integral element of mainstream social protection strategies, rather than adjuncts to them. Yet, in practice, social protection and health promotion continue to be treated as almost entirely separate spheres, thus presenting substantial institutional barriers to developing combined interventions.