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      Social Security: Offering Welfare Opportunities for the Vulnerable People

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          Abstract

          Dear Editor-In-Chief The International Labor Organization has defined social security as the shield that a society provides to their members to ensure health care accessibility and to warrant income security, especially for the elderly/unemployed/sick/injury during job, pregnancy or death of the earning member of the family (1). Social security benefits directly influence the economic well-being of a household at difficult times and even bring about a significant improvement in the quality of life of the patient and their family members / survivors (2). It has been suggested that social security programs should be developed as a part of community action to ensure that disabled persons lead a complete life and eventually become productive members of the society (3). In fact, social security measures are essential instruments of social and economic justice and one of the key pillars to determine the ability of a society to meet basic needs of the people who constitute it (4). In addition, social security acts as a modulator between work and health in an individual’s vocational environment (4). Globally, only twenty percent of the world’s populations have adequate social security coverage, while the remaining either have insufficient or no coverage at all (1). Furthermore, to a great extent the benefits of social security are limited to the organized sector only and many important sectors like agricultural workers are not covered at all (1, 3). In order to expand the benefit of social security to the citizens of the country, apart from providing services for industrial workers / civil servants / general public, the Government has formulated multiple laws for bringing about a universal transparency (3, 4). Generally, social security facilities have shown a powerful impact on all levels of society including the employees and their families (viz. for access to health care and protection against loss of income attributed to any cause); the elderly people for financial security in post-retirement period; children by assisting their families to cope with the cost of education; and for the employers by assisting them in maintaining stable labor relations and a productive workforce. In addition, social security can contribute to social cohesion and to a country’s overall growth and development by improving the socioeconomic standards (1, 3, 5). In fact, it has been reported that in the United States, social security is the single most important and effective income support program introduced to alleviate the burden of poverty (5). As already discussed, absence of organized social security measures or poor implementation of such public policies will not only harm the individuals concerned, but also will lead to exploitation of the dependants. A range of factors such as age at which people become eligible for the benefits (6); types of illnesses covered (3, 4, 6); poor awareness among the community (3); trends of macroeconomics on reimbursements (7); neoliberal economic policies and guidelines developed to combat the global crisis in capitalism (8); alterations in the legislative provisions developed for the social security (3, 4); and trust of the institutions on the national social security system (9); have been suggested that have ultimately influenced the benefits of the social security. Worldwide, with an aim to cover more and more people, different strategies have been drawn up and implemented to extend the beneficial services to those who need them the most in a tailor-made manner (1). In addition, specific interventions such as sustained political commitment (8); formulating a multistage process to improve the completeness and time/cost-effectiveness of ascertaining disabilities or deaths in large employee cohorts (10); medico-economic evaluation of health products (11); developing standardized protocol for performing medical examination (3, 4); devising strategies for strengthening and developing universal social security systems (5, 6); and implementing measures to sustain institutional trust and thus remove the anxiety among different sections of society (3, 6); have been suggested to maximize the output of the social security schemes. To conclude, social security encompasses multiple interventions planned by the government to guarantee the welfare of the vulnerable population. However, the need of the hour is to enhance the existing provisions and extend the benefits of the social security measures to all the sections of the society.

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          Most cited references9

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          Strategies for using the National Death Index and the Social Security Administration for death ascertainment in large occupational cohort mortality studies.

          This paper describes a multistage process to improve the completeness and time-/cost-effectiveness of ascertaining deaths in large employee cohorts. The process uses the vital status data service of the Social Security Administration (SSA) to identify people who can be confirmed as living, in order to reduce the number of records submitted for a National Death Index (NDI) search. The accuracy of SSA results is verified by submitting a sample of known-living and known-deceased people. For the NDI search results, an algorithm based on a discrete combination of matching variables is applied to distinguish NDI records as true, false, or questionable matches to reduce the number of death certificate requests to state offices. Subsequent decision making is based on manual reviews at various stages. In a cohort of over 200,000 employees, an SSA vital status search reduced the size of the NDI death record search by 85%. The algorithm sorted thousands of NDI records into 15 distinct strata and reduced the number of death certificate requests by 76%. The authors believe that the matching process is enhanced by obtaining paper copies of death certificates from the states, because death certificates often provide additional information and aid in determining true matches to company employees.
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            Social security and mortality: the role of income support policies and population health in the United States.

            Social Security is the most important and effective income support program ever introduced in the United States, alleviating the burden of poverty for millions of elderly Americans. We explored the possible role of Social Security in reducing mortality among the elderly. In support of this hypothesis, we found that declines in mortality among the elderly exceeded those among younger age groups following the initial implementation of Social Security in 1940, and also in the periods following marked improvements in Social Security benefits via legislation and indexing of benefits that occurred between the mid-1960s and the early 1970s. A better understanding of the link between Social Security and health status among the elderly would add a significant and missing dimension to the public discourse over the future of Social Security, and the potential role of income support programs in reducing health-related socioeconomic disparities and improving population health.
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              Institutional trust in the national social security and municipal healthcare systems for the elderly in Japan.

              Japanese social security systems and institutions for the elderly, as well as the general attitude toward elderly care services among the Japanese population, have been undergoing a dramatic change. By examining the association between institutional trust, which is a representative element of social capital, and anxiety regarding receiving elderly care, we can uncover clues toward building a more robust social security system for the elderly. This study examines the relationship between institutional trust, in the national social security and municipal healthcare systems for the elderly, and anxiety with respect to receiving elderly care among the general Japanese population. A cross-sectional survey was conducted using a self-administered questionnaire that was returned by mail in January and February 2005. The target population was 4735 community residents aged 20-75 years, who lived in the city of Koka, Shiga, Japan. A total of 2264 questionnaires were included in the analysis. A binominal logistic regression analysis showed that responses of 'trust' [odds ratio (OR): 2.09, 95% confidence interval (95% CI): 1.01-4.30] and 'strongly trust' (OR: 3.80, 95% CI: 1.55-9.31) for the national system were associated with not having anxiety regarding elderly care, compared with the reference category of feeling strongly distrust. However, trust in the municipal system showed no association with this anxiety. These results indicate the importance of developing strategies to increase a common trust in the national care services for the elderly to reduce the anxiety people feel regarding whether they will be able to receive elderly care when required.
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                Author and article information

                Journal
                Iran J Public Health
                Iran. J. Public Health
                IJPH
                Iranian Journal of Public Health
                Tehran University of Medical Sciences
                2251-6085
                2251-6093
                August 2014
                : 43
                : 8
                : 1150-1151
                Affiliations
                [1]Dept. of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Kancheepuram District , Tamil Nadu, India
                Author notes
                * Corresponding Author: Email: drshrishri2008@ 123456gmail.com
                Article
                IJPH-43-1150
                4411914
                cffbc8d2-0a1c-4d7f-95de-4d0dae7b1571
                Copyright © Iranian Public Health Association & Tehran University of Medical Sciences

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                : 22 May 2014
                : 29 May 2014
                Categories
                Letter to the Editor

                Public health
                Public health

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