Comprehensive Social Security Assistance Research Articles

To Claim or Not to Claim: Investigating Non-Take-Up of Welfare Schemes Targeting Hong Kong Older Adults and the Stigma Attached to Them

AbstractThis article investigates the unique contribution of specific programme characteristics together with personal stigma, stigmatisation by the public, and claims stigma, to the non-take-up of targeted income support among Hong Kong older adults. Drawing on data from a sample of 3,299 Hong Kong older adults aged 65 or above, we find that between 11-14 per cent of eligible participants did not receive cash transfers from Normal and Higher Old Age Living Allowance (OALA) and old-age Comprehensive Social Security Assistance (old-age CSSA). By combining mainstream economic analysis with attempts to quantify welfare stigma (Baumberg, 2016) we find that transaction costs were most consistently and strongly related to non-take-up of targeted income support; non-take-up of old-age CSSA and Higher OALA but not Normal OALA varied with welfare stigma after controlling for personal and household characteristics of study participants. This article further adds to the literature by examining the effect of recent reforms to asset- and means-tested benefits for the same target population of older adults on take-up in the East Asian context. The article suggests that automatic switching of beneficiaries from Normal OALA to Higher OALA effectively facilitated higher take-up of the latter. The policy implications of these various findings are discussed.

Comparing the mental health effects of different social assistance programmes in Hong Kong

ABSTRACT This study compares the mental health effects of different social assistance programmes. We proposed a theoretical framework to explain how social assistance programmes may affect recipients’ mental health through positive resource effect and negative stigma effect. We examined the mental health of people participating in one of three social assistance programmes in Hong Kong: Comprehensive Social Security Assistance (CSSA), Social Security Allowance (SSA) and education subsidies. We analysed two waves of data from the Hong Kong Panel Survey for Poverty Alleviation (2015, 2017). SSA and education subsidies had no impact on recipients’ mental health. SSA targets vulnerable groups such as people with disabilities and imposes minimal (or no) means tests. Education subsidies target families with school-age children and impose moderate means tests. The programme that exerted positive mental health effects on recipients was CSSA, the public assistance scheme that serves as the last resort for those who cannot financially support themselves. The positive relationship was largely driven by old-age recipients who were viewed as ‘deserving poor,’ and thus experienced less stigma. Our findings demonstrated that social assistance programmes can enhance the mental health of their beneficiaries, particularly when positive mental health effects associated with economic security override negative stigma effects.

Oral Health Care of Older Adults in Hong Kong.

The older adult population is increasing both in number and in proportion worldwide. In Hong Kong, the number of people aged 65 or above is expected to reach 2.5 million in 2039, thus becoming one-third of the population. With this growing population, the need for dental care among older adults is expected to surge. Oral health care is one of the government’s core policy agendas and the Department of Health has emphasised its importance. It has implemented a number of policies, such as increasing the number of dental training places, setting up an expert group for oral health care policy planning, and conducting regular oral health surveys of the population. It is subsidizing several programmes, including the Elderly Health Care Voucher Scheme, Community Care Fund Elderly Dental Assistance Programme, Outreach Dental Care Programme, and Comprehensive Social Security Assistance Programme, in order to promote oral health care in older adults. These programmes have received support and positive feedback from both the public and dental service providers. The purpose of this review is to provide an overview of the oral health care of older adults in Hong Kong and recommendations to enhance their effectiveness.

Healthcare inequalities in emergency visits and hospitalisation at the end of life: a study of 395 019 public hospital records

ObjectivesTo investigate whether there were any socioeconomic disparities in utilisation of hospital care services during end of life in Hong Kong.MethodsSecondary data analyses were conducted using frequency of the accident...

A decomposition analysis to examine the change in the number of recipients in the comprehensive social security assistance (CSSA) system.

Social security is an important social and public policy measure to help address poverty in any contemporary society. The Comprehensive Social Security Assistance (CSSA) system in Hong Kong provides a safety net for those aged children and adults below 65 years old who cannot support themselves financially. It is designed to bring their income up to a prescribed level to meet their basic needs. The rapid increase in social welfare expenditure in the last decade has become a concern to the Hong Kong SAR Government. The overall social welfare expenditure has accounted for nearly 15.6% of government expenditure in 2018, with the total amount increasing from $58 billion to $90 billion (an increase of 72.4%) for the period 2014-2018. However, the amount spent on CSSA only increased from $20.7 billion to $22.3 billion with an increase of 7.7% only for the same period. The much slower magnitude of increase is related to the reduction in the number of CSSA recipients, which decreased from 237,501 to 185,528 over the period. A decomposition method was used to assess the changes in the number of people in the CSSA system. It showed that the rate of arriving into the system has been decreasing due to a robust economy with a very low unemployment rate; whereas moving out of the system has also been decreasing in the past 5 years. This phenomenon can be partly attributed to the widening of the income gap in the community in the period. Despite the increase in population size, as long as employment conditions remain strong and the momentum of leaving the system can be maintained, the number of CSSA recipients will continue to decrease. However, the results also suggested that a certain proportion of CSSA recipients will not be able to move out of the system and have been trapped. Some innovative methods to help them out of CSSA are discussed. In view of the poor economic outlook arising from the COVID-19 pandemic, it is important for the Government to have effective measures to keep people in their jobs. If the unemployment rate will does not substantially increase and then increase of in CSSA recipients can be contained.

Problems encountered by elders in residential care services in Hong Kong

PurposeHong Kong implements a policy for the aging population involving the core themes of “aging in place as the core,” “institutional care as backup” and “continuum of care.” Encouraging elders to live independently at home is a top priority, and elders who are not able to live at home independently are provided with various residential care services, namely Hostels for the Elderly, Homes for the Aged, Care and Attention (C&A) Homes for the Elderly and Nursing Homes (NHs). The purpose of this paper is to analyze the adoption of the publicly funded model of providing residential care services of elderly in Hong Kong.Design/methodology/approachThe paper analyzes the current conundrum encountered by elders in residential care services and makes recommendations. A comprehensive literature review was conducted covering relevant government reports, academics' journal papers and nongovernmental organizations’ reports concerning residential care service of elderly from 1965 to present.FindingsSubsidized residential care homes for the elderly (RCHEs) clearly outperform private RCHEs in terms of space and staff provisions, but the supply of subsidized RCHEs cannot meet the demand. Hence, between 2007 and 2018, the average waiting time was 33 months for NHs and that for C&A homes was 23 months. Several viable measures to meet the demand are purchasing Enhanced Bought Place Schemes (EBPSs) from private RCHEs, subsidizing elders who opt for living in private RCHEs by providing them with Comprehensive Social Security Assistance (CSSA) and residential care service voucher (RCSV) and subsidizing elderly applicants who opt for living in RCHEs in Guangdong. However, these viable measures are problematic because of the inadequate quality of EBPSs and private RCHEs, which is attributed to the costing arrangement of public and private RCHEs that were established in the colonial period. The brief history of RCHEs also indicates a deviation from the original policy aim, namely aging in place, which was introduced in the Green Paper on Services for the Elderly in 1977.Practical implicationsThe supply and quality of community and home care services should be thoroughly examined; effective community and home care services can prevent and even delay unnecessary institutionalization. Another complementary solution is to devise a long-term plan for residential care services. To address disparities in quality standards in different RCHEs, adopting the combination of punitive and compliance models such as conducting frequent inspections and implementing an accreditation system for private RCHEs is imperative.Originality/valueAlthough the principle of “aging in place” originated in 1977, the institutionalization rate 6.8% of elders was unexpectedly high in Hong Kong and even surpassed the Asian counterparts. It necessities to rethink how to implement policy concerning long-term care services of elders.

Optimal Strategies for Reducing Number of People in the Social Security System.

Providing social security to the population in need has become a major expenditure for many governments. Reducing the number of dependents in the social security system and maintaining a dynamic economically active population is a high priority concern for policymakers. A good understanding of the dynamics of the social security system—specifically, who enters and who exits the system—would be helpful for formulating effective interventions. Here, we made use of the data of Hong Kong’s Comprehensive Social Security Assistance (CSSA), which is currently a basic welfare scheme in Hong Kong that provides supplementary payments to households that cannot support themselves financially. We proposed a stochastic model to examine the in- and out- movement in the CSSA scheme and conducted elasticity analyses. The elasticity analyses allowed us to identify the potential target groups of people that would lead to the largest reduction in the number of the CSSA recipients in the system. This analytical method can also reveal whether policies would be more effective in preventing people from entering the CSSA system or helping them leave the CSSA scheme. Our analyses suggest that targeting those aged 30–49 with children would have the largest impact. Additionally, we found that policies that aim to prevent this group from entering the CSSA system would be more effective in reducing the number of CSSA recipients compared with policies that aim to help them exit. In contrast, for the younger age group of 10–29, policies that help them leave CSSA would be more effective than policies that prevent them from entering CSSA. Providing employment for those unemployed in this younger group would be more effective. The results indicate that by tailoring measures to specific subgroups, the overall number of CSSA recipients would be reduced, thereby improving the efficiency of Hong Kong’s social security system, which has accounted for more than 16.5% of Hong Kong government expenditure in 2018, amounting to more than HKD 92 billion.

중국 본토에서 홍콩으로 이주한 신이민자의 사회경제적 상태와 함의

This study set out to examine the social and economic causes of 2019 Hong Kong Protests instead of political ones as media and researchers reported that the Umbrella Revolution of Hong Kong in 2014 began with a political cause but had Hong Kong citizens’ social and economic complaints at its root. 2019 Hong Kong Protests also began with political causes including the Fugitive Offenders amendment bill and the guarantee of the Hong Kong system, but there are more and more data reporting that the deterioration of Hong Kong citizens’ social and economic life worked at the bottom of the protests. The present study focused on new immigrants under the ultimate goal of investigating the effects of increasing new immigrants on the lives of Hong Kong citizens. The results were as follows: first, the number of new immigrants was reduced recently. Recent data shows that the accumulated number of new immigrants amounts to 1.50 million, but the number of new immigrants with the settlement pass and that of inadmissible immigrants are dropping gradually in recent years; secondly, the study examined the economic state of new immigrants and found that their participation rate in labor continued to rise. The proportions of immigrants are increasing in service and sales and non-skilled labor, which will affect Hong Kong citizens that have worked in low-wage jobs. The income of new immigrants is rising, which means that their settlement in the Hong Kong society is accelerating; and finally, a look at the social state of new immigrants reveals that supports for the Comprehensive Social Security Assistance are decreasing over time with no big increase in expenditures. The percentage of public housing is dropping among new immigrants, whereas that of individual homes is rising among them, which indicates that their penetration into public housing, which Hong Kong citizens had concerns with, is not happening. Like income, the settlement of new immigrants in Hong Kong housing is intensified. In addition, the population using Putonghua is growing in Hong Kong. These results suggest that new immigrants are competing against Hong Kong citizens in economic aspects including employment and participation rates in labor in the Hong Kong society. There are, on the other hand, no negative influences including growing expenditures for new immigrants in Comprehensive Social Security Assistance. New immigrants do not violate the right of Hong Kong citizens in housing welfare including public apartments. Rising income, growing percentage of individual homes, and increasing use of Putonghua indicate that new immigrants have become stable in their settlement in the Hong Kong society. It means that the growing number of new immigrants has not exerted as negative effects on the lives of Hong Kong citizens as the citizens’ concerns.

Presenting a new defamilization and familization framework for investigating the residualization of old‐age income security measures—The case study of Hong Kong

AbstractFamilization and defamilization studies are increasingly seen as an important component of welfare research. They are concerned with the threats to the welfare of individuals caused by involuntary participation in the unwanted family relationship. Moreover, they address the idea that governments have the potential to reduce these threats through the provision of welfare measures. This article contributes to the familization and defamilizaion studies with the focus on the link between these studies and the studies of residualization strategies. It carries out three analytical tasks. The first is to present a new defamilization and familization framework. The second is to demonstrate the usefulness of this framework in analyzing the problem of employing the residualization strategies to reform the old‐age income security system. Our focus is particularly on the insufficient sensitivity of these strategies to women's (and men's) diverse preferences relating to ways of organizing their family life. The third is to demonstrate the empirical significance of this framework. To meet this objective, we apply the framework to the investigation of two old‐age income security measures in Hong Kong—the Mandatory Provident Fund and the Comprehensive Social Security Assistance scheme.

Targeting, Universalism and Child Poverty in Hong Kong

Concerns about the long-term effects of child poverty on individuals and society have been increasing. Urgent action needs to be taken to combat child poverty, but what is the best strategy likely to be? The relative effectiveness of means-tested versus universal schemes for poverty alleviation strategies has long been debated. Key differences include screening costs, targeting errors, incentive gaps and issues of financial sustainability. This article explores and compares the extent to which the Hong Kong SAR Government’s current means-tested Comprehensive Social Security Assistance (CSSA) scheme and alternative simulated means-tested and universal schemes could alleviate child poverty and income inequality. Core data for the study was taken from cross-sectional household survey data in Hong Kong. The study found that means-tested schemes with flat rates had higher adequacy in terms of the amount of benefits reaching poor households, than those with sliding scales. Targeting schemes had relatively higher exclusion errors compared to schemes with universal benefits. Evidence was found that that universal benefit schemes with flat rates had substantially greater impacts on all child poverty and income inequality indicators compared to the current CSSA and simulated means-tested schemes with flat rate benefits. The study is timely and presents a new and important opportunity to assess the extent to which a simulated policy change from means-tested to universal benefit could more effectively combat child poverty and reduce income inequality as well as achieve financial sustainability. The article concludes that more effective policy initiatives and approaches to child poverty and income inequality could be gained by varying dimensions, including: type of programmes (means-tested versus universal basis); benefit levels; and delivery methods (flat rate versus sliding scales). The projected expenditures of 42 cash transfer benefit schemes and four selected means-tested and universal programmes with the lowest and highest average costs can form the basis for future discussion on policy options to promote social and economic improvement for all groups.

Individual-, household- and neighbourhood-level characteristics associated with life satisfaction: A multilevel analysis of a population-based sample from Hong Kong

We examined the relationships between individuals’ life satisfaction and individual-, household- and neighbourhood-level characteristics and evidence for cross-level interactions. We used data on individuals’ life satisfaction and a range of individual- and household-level characteristics from the Hong Kong Panel Study of Social Dynamics (2011) with linkage to neighbourhood-level aggregated data extracted from the 2011 census. The neighbourhood-level variables included the poverty rate and four factors derived from factor analysis based on 21 variables. Multilevel models were used to allow for the hierarchical nature of the data. Most of the variance in life satisfaction could be explained by individual- and household-level characteristics. Neighbourhood-level characteristics accounted for a small proportion (around 5% or less) of the variance. Most of the individual- and household-level characteristics studied were associated with life satisfaction. Life satisfaction was negatively associated with local poverty rate and three neighbourhood factors (deprivation, social fragmentation and ageing). There was evidence of cross-level interactions. For example, the level of life satisfaction decreased with an increasing neighbourhood poverty rate among individuals who did not receive Comprehensive Social Security Assistance (CSSA), but CSSA recipients had a higher level of life satisfaction in areas with higher poverty rates. The negative effect of neighbourhood poverty on life satisfaction was more marked in individuals who rented or owned their homes than in those who lived in public housing. Our results have implications for urban policies that may improve life satisfaction such as financial and housing support for high risk individuals.

Hong Kong Chinese community leaders' perspectives on family health, happiness and harmony: a qualitative study

This paper examines the views of Hong Kong community leaders on the underlying issues that affect family health, happiness and harmony (3Hs) in Hong Kong. Using a community reconnaissance method, a series of individual in-depth interviews with 26 leaders that represent neighbourhoods of diverse socio-economic status (SES) from June to August 2008 were conducted. Participants considered that changing family structure, economic situation and strong work ethic are the most salient factors that affect family 3Hs. The deprived comprehensive social security assistance recipients, single-parent families and migrant women were considered to be the most vulnerable groups to breakdown in family 3Hs and particularly, they lack family resources. Families from different SES have to overcome different challenges in order to achieve and sustain family 3Hs. Leaders from low SES neighbourhood were concerned more about providing tangible help such as child care facilities to improve family resources, whereas leaders from high SES neighbourhood focused more on preventive interventions such as education on relationship skills to achieve better family well-being. The findings offer insights in designing effective social marketing education campaigns and family-friendly workplace policy to promote social harmony through the maintenance of 3Hs families.

The Minimum Wage Policy in Hong Kong

An across-the-board statutory minimum wage (SMW) will come into effect in Hong Kong on 1 May 2011. We draw on theoretical arguments for and against a SMW policy, examining empirical evidence outside Hong Kong to suggest an agenda for research. The anti-poverty argument for a SMW implies that the SMW rate should significantly exceed the comprehensive social security assistance (CSSA) monthly payment rate of HK$4095. However, the anti-poverty argument is problematic because of the complexity of the poverty problem. The unemployment argument against a SMW has a lower level of consensus today than it did three decades ago because of conflicting empirical results. The theory of a monopsonistic labour market is the leading theoretical explanation for this situation. It is an empirical question if the labour market that hires low-wage workers in Hong Kong is monopsonistic or competitive. The source of monopsony power and the effects of an across-the-board SMW can differ among industries depending on the difference between the industry average wage rates and the SMW. Firms that hire low-wage workers can also adjust differently, depending on their competitiveness in their product markets. Empirical investigations can help improve policy making with informed decision making.

Weather inference and daily demand for emergency ambulance services

AimTo examine weather effects on the daily demand for ambulance services in Hong Kong.MethodsOver 6 million cases of emergency attendance from May 2006 through April 2009 (3 years) were obtained...

Negative public perception on welfare recipients and its implications for social security in Hong Kong

The Comprehensive Social Security Assistance (CSSA) scheme is the core part of Hong Kong's social security system. This simple system retains most of its early characteristics as a temporal, transitional and minimal assistance scheme aiming at helping those ‘least able to help themselves’. Over the years, the basic philosophy of the system has remained largely unchanged, while Hong Kong has rapidly transformed socially and economically. Increasingly, CSSA has shown itself incapable of meeting social needs, especially with the increasing number of ‘working poor’. Based on a study examining people's perception of CSSA, this article argues that negative views about CSSA and its recipients make the working poor more vulnerable to social and economic transformations. It concludes that value rebuilding in the society is a vital component of the future development of social security in Hong Kong.

Pension Reforms in Hong Kong: Using Residual and Collaborative Strategies to Deal With the Government's Financial Responsibility in Providing Retirement Protection

ABSTRACT In 2000, the Hong Kong government introduced the first compulsory retirement saving scheme intended to protect the entire workforce, the Mandatory Provident Fund (MPF). Prior to the introduction of this scheme, the government's main measure for giving financial protection to retirees was the Comprehensive Social Security Assistance (CSSA) scheme, which is a noncontributory, means-tested financial assistance scheme. This paper studies the government's attempt to introduce the MPF on top of the CSSA scheme as a means to illustrate how governments might address their financial responsibilities in providing pension schemes by adopting both the residual strategy-centered reform approach and the collaborative strategy-centered reform approach. The former approach is concerned with developing noncontributory schemes using residual strategies, and the latter is concerned with developing contributory schemes using collaborative strategies. The paper shows the difficulties involved in carrying out these two reform approaches simultaneously.

THE IDEOLOGICAL ORIENTATION OF THE NEW DAWN PROJECT

This paper is concerned with the ideological dimension of the New Dawn project. It focuses on two analytical tasks. The first is to show that this project is not an independent reform measure. Instead it is a part of a series of pro-market welfare-to-work programmes launched by the Government to tackle social exclusion. The second is concerned with the debate on the desirability of this project in reducing social exclusion. As the design of this project is heavily indebted to market values, it is highly supported by those analysts and policy-makers who stress the importance of the labour market in helping socially excluded groups achieve social inclusion but it receives criticisms from those analysts who question the ability of the private market in tackling social exclusion. By carrying out these two tasks, the paper raises our awareness of the fact that whether people support the New Dawn project or not reflects not only their judgment on the effectiveness of this project in meeting the needs of single parents and carers on the Comprehensive Social Security Assistance scheme but also their views on market ideologies.

The Failure of Social Security in Alleviating Poverty in Hong Kong

This paper reviews results of different researches on Hong Kong's poverty problem in the 1990s and suggests the level of benefit of the Comprehensive Social Security Assistance Scheme (CSSA) is not adequate to raise the poor out of poverty but creates and maintains a poverty trap for the recipients. The paper argues that the residual approach of the government's welfare philosophy is a failure rather than a success in fighting against poverty.