Social Security Advisory Board Panels

The Future of Mortality, Disability, and Work: 

Helping to Inform the Social Security Trust 

Fund Projections

Office of the Chief Actuary

Social Security Administration

August 25, 2023
The Future of Mortality

2
Remarkable Reduction in Mortality in Latter Half of the 20th

Century: Antibiotics After WWII and Later Cardiovascular

3
But Declines Have Been Slowing, With Remaining Causes 

Harder to Address: Cancer, Violence, Dementia

4
We Have Been “Rectangularizing” the Survival Curve, With 

Little Evidence of Advancing Maximum Lifespan

5
Obesity, Drug Abuse, and Even Climate Effects Seem Likely 

to Diminish Prospects for Mortality Improvement

6

Trends in Obesity: US 1971-2006

Must consider cumulative effects; increasing duration of obesity for aged in future (courtesy Sam Preston, 2010)
Obesity, Drug Abuse, and Even Climate Effects Seem Likely 

to Diminish Prospects for Mortality Improvement

7
COVID-19 a Major Distortion—Frequency of Future 

Pandemics in the “Shrinking World”?

8
Many Questions About the Future of Mortality...

• Can we expect major breakthroughs in cancer and dementia, and a 

reduction in violence?

• What will the effects be of COVID, post-COVID conditions, and other 

future pandemics?

• What do we expect for obesity and “deaths of despair” in the future?

• Health spending cannot continue to rise at historical rates (and has 

slowed down recently); what are long-term effects of deceleration?

• Effects of an aging population and climate change, straining 

resources?

9
The Future of Disability

10
Applications for 

Disability 

Benefits Remain 

Historically Low

At the peak of the last 

economic cycle in 2007, 

applications were low, but 

they increased rapidly in 

the 2007-09 recession 

from 1.5 million in 2007 to 

1.9 million in 2010.

In 2017 through 2022, 

applications have dropped 

below the 2007 level.

11

1.2

1.3

1.4

1.5

1.6

1.7

1.8

1.9

2003 2005 2007 2009 2011 2013 2015 2017 2019 2021 2023 2025 2027 2029 2031

(millions)

Social Security Disabled Worker Receipts at Disability Determination 

Services by Calendar Year: Historical and Intermediate Assumptions for 

2012 through 2023 Trustees Reports

2012TR

2017TR

2016TR

2015TR

2014TR

2013TR

2018TR 2019TR

2020TR

2021TR

2022TR 2023TR

2012TR

2017TR

2016TR

2015TR

2014TR

2013TR

2018TR 2019TR

2020TR

2021TR

2022TR 2023TR
Disability 

Incidence Rate 

Also Remains 

Historically Low

DI disabled worker 

incidence rate rose sharply 

in the 2007-09 recession 

and has declined since the 

peak in 2010 to 

extraordinarily low levels in 

2016 through 2022.

What will be the net effect 

of COVID and post-COVID 

conditions? 

12

2.5

3.0

3.5

4.0

4.5

5.0

5.5

6.0

6.5

1990 1995 2000 2005 2010 2015 2020 2025 2030

DI Age-Sex-Adjusted Incidence Rates:

Historical and Intermediate Assumptions for 2012 through 2023 Trustees Reports

2012TR

2013TR

2014TR

2015TR

2016TR

2017TR

Average 1990-2022 5.0

Ultimate Assumption 4.8

2018TR

2019TR

2020TR

2021TR

2022TR

2023 TR
Disabled Worker 

Prevalence Rates

Will prevalence recover 

to a level above that 

seen before the 2007-

09 recession? 

The Trustees Report 

projections assume the 

incidence rate will 

ultimately rise to 4.8 

per thousand, from the 

levels seen since 2016 

of between 3 and 4.3.

13

0

10

20

30

40

50

60

70

80

90

100

1970 1980 1990 2000 2010 2020 2030 2040 2050 2060 2070 2080 2090 2100

Calendar year

DI Disability Prevalence Rates, 1970-2100

Gross prevalence rates

Age-sex-adjusted prevalence rates

III

II

I

Historical Projected

II

I

III
Fewer Disabled 

Worker 

Beneficiaries

Fewer now and in near 

term based on recent 

applications and 

incidence rates, with 

assumed increases 

deferred another year.

14

6,000

7,000

8,000

9,000

10,000

11,000

2006 2008 2010 2012 2014 2016 2018 2020 2022 2024 2026 2028 2030 2032

Calendar Year

Disabled Worker Beneficiaries

In Current Payment Status at End of Year (in thousands)

2008 TR (no recession)

2022 TR

2023 TR
Primary Impairment for New Disabled Worker Entitlements at 

Ages 30-39 Has Been Consistent & Dominated by Mental Disorders

Women Men

Note: Data for 2019 and later are incomplete. 15
Primary Impairment for New Disabled Worker Entitlements at 

Ages 50-59 Has Been Increasingly Musculoskeletal

Women Men

Note: Data for 2019 and later are incomplete. 16
Reductions in Disability Applications and Number Receiving 

Benefits Have Been Similar by Age, Sex, Geography, Impairment, 

and Education; COVID Has Not Contributed Significantly

• Reasons for these reductions and future expectations?

oHealthier population?

oGreater demand for workers given the changing age distribution of the 

population?

oGreater accommodation by employers?

o More highly educated population; more automation of physical jobs?

o Changing distribution of jobs/occupations in the economy? 

o Changing nature of work and jobs? (see next panel)

17
The Future of Work

18
Distribution of Workers by Occupation Has Been Changing

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

Management, business,

and financial operations

occupations

Professional and related

occupations

Service occupations Sales and office

occupations

Natural resources,

construction, and

maintenance occupations

Production,

transportation, and

material moving

occupations

Number of Employed Workers by Major Occupation: Men + Women (in thousands)

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

19
Since 1970, Employment Rates by Age Have Changed 

Substantially, and Very Differently for Men and Women 

20

• Women have 

responded, 

increasing 

employment at 

all ages. 

• But men have 

fallen from their 

employment 

rates in 1970. 
Employment Over Age 60 Has Been Rising as the Age 

Distribution of the Population Moves to Older Ages

21

How much of this shift is from changing demands on workers and accommodation by employers? 

Will this trend continue with further changes in the age distribution of the population?

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 2018 2020 2022

Ratio of Employment to Non-Institutionalized Population, Men, by Age

25-54

55-59

60-64

65-69

70 and older

Start of 2008 

recession

Start of 2020 

recession

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 2018 2020 2022

Ratio of Employment to Non-Institutionalized Population, Women, by Age

25-54

55-59

60-64

65-69

70 and older

Start of 2008 

recession

Start of 2020 

recession
Quits Rate vs. 

Ratio of 

Employment to 

Population

The elevated quits rate 

after 2020 indicated 

increased demand for 

workers. 

Will this continue as the 

changing age distribution 

decreases the share of 

adults at traditional 

working ages?

22
0

5

10

15

20

25

30

35

40

45

45

50

55

60

65

70

75

80

85

Jan-08 Dec-09 Dec-11 Dec-13 Dec-15 Dec-17 Dec-19 Dec-21 Dec-23

Unemployment rate

LFPR, employment-to-population, and "prevalence

Non-Disabled Employment Data: Men+Women 18-64 

Non-disabled LFPR Non-disabled employ-pop ratio Non-disabled U/E rate

Employment of 

the Disabled

Employment of individuals 

self-identifying as disabled 

appears to be gradually rising 

from low rates experienced in 

2013-15.

Current rates of employment 

are at the highest levels since 

the beginning of 2008. Will 

this continue to increase or 

level out?

Note that this is selfidentification of disability by 

CPS survey respondents, so 

the definition of disability may 

greatly differ from what is 

used for the OASDI program.

23

0

5

10

15

20

25

30

35

40

45

0

5

10

15

20

25

30

35

40

45

Jan-08 Dec-09 Dec-11 Dec-13 Dec-15 Dec-17 Dec-19 Dec-21 Dec-23

Unemployment rate

LFPR, employment-to-population, and "prevalence"

Disabled Employment Data: Men+Women 18-64 

Disability prevalence Disabled LFPR Disabled employ-pop ratio Disabled U/E rate
What Does the Future Hold for the Nature of Work?

• Will further automation and AI diminish the need and demand for people 

to be working?

◦ Mechanization of farming and industrialization did not

• Will work continue to become less physically demanding and less 

dangerous, thus allowing workers to work longer and to older ages?

◦ Effects of infrastructure, immigration, climate change?

• Even automation and AI will require human production, maintenance, and 

design for the foreseeable future

◦ No matter how automated work becomes, will we continue to find ways people can contribute 

through services?

◦ In the near term, there will certainly be a need for medical practitioners, given the aging population

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