Socioeconomic differences in disability retirement in Finland: The contribution of ill-health,health behaviours and working conditions

Abstract

Aims: Socioeconomic differences in disability retirement are large. In this study, the main interest was to find out the contribution of diseases, self-rated health, health behaviours and working conditions to socioeconomic differences in disability retirement. Methods: The data are from the nationally-representative Health 2000 Survey to which register-based retirement data have been linked. These data include 3674 persons aged 30–62 years who were employed at baseline. Of the participants, 363 ended up in disability retirement during the follow-up period 2000–2009. Cox regression analysis was used to calculate hazard ratios and their 95% confidence intervals. Results: The risk of all-cause disability retirement was higher among manual workers (HR for men 2.44, 95% CI 1.64–3.63, women 2.33, 1.57–3.44) than upper-grade non-manual employees. Ill-health and physical working conditions contributed to the socioeconomic differences in disability retirement. The importance of physical working conditions was seen in particular among those aged 50 years or over and those in disability retirement due to musculoskeletal diseases. The contribution of self-rated health was stronger in older than younger disability retirees. Conclusions : Our findings suggest that preventing ill-health and improving working conditions, especially among the lower socioeconomic classes, would help reduce socioeconomic differences in disability retirement.

Keywords

Disability retirement health behaviours mental disorders socioeconomic differences somatic diseases working conditions

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References

OECD. The OECD “Sickness, Disability and Work” project [Internet]. Paris: OECD, www.oecd.org/els/disability (accessed 11 March 2013)

Finnish Centre for Pensions (ETK). The Social Insurance Institution of Finland (KELA). Statistical yearbook of pensioners in Finland 2010. Helsinki: ETK and KELA, 2010.

Bruusgaard

Smeby

Claussen

. Education and disability pension: a stronger association than previously found. Scand J Public Health 2010;38:686–90.

Borg

Hensing

Alexanderson

. Predictive factors for disability pension – An 11-year follow up of young persons on sick leave due to neck, shoulder or back diagnoses. Scand J Public Health 2001;29:104–12.

Krokstad

Johansen

Westin

. Social determinants of disability pension: a 10-year follow-up of 62 people in a Norwegian county population. International J Epidemiology 2002;31:1183–91.

Albertsen

Lund

Christensen

. Predictors of disability pension over a 10-year period for men and women. Scand J Public Health 2007;35: 78–85.

Månsson

N-O

Råstam

. Self-rated health as a predictor of disability pension and death – A prospective study of middle-aged men. Scand J Public Health 2001;29:151–8.

Rahkonen

Laaksonen

Martikainen

. Job control, job demand, or social class? The impact of working conditions on the relation between social class and health. J Epidemiol Community Health 2006;60:50–4.

Laaksonen

Roos

Rahkonen

. Influence of material and behavioural factors on occupational class differences in health. J Epidemiol Community Health 2005;59:163–9.

10.

Schrijvers

Van de Mheen

Stronks

. Socioeconomic inequalities in health in the working population: the contribution of working conditions. Int J Epidemiol 1998;27:1011–8.

11.

Kivimäki

Ferrie

Hagberg

. Diagnosis-specific sick leave as a risk marker for disability pension in a Swedish population. J Epidemiol Community Health 2007;61:915–20.

12.

Wallman

Wedel

Palmer

. Sick-leave track record and other potential predictors of a disability pension. A population based study of 8,218 men and women followed for 16 years. BMC Publ Health 2009;9:104–116.

13.

Alexanderson

Kivimäki

Ferrie

. Diagnosis-specific sick leave as a long-term predictor of disability pension: a 13-year follow-up of the GAZEL cohort study. J Epidemiol Community Health 2012;66:155–9.

14.

Gjesdal

Bratberg

. Diagnosis and duration of sickness absence as predictors for disability pension: result from a three-year, multi-register based and prospective study. Scand J Public Health 2003;31; 246–254.

15.

Ahola

Gould

Virtanen

. Occupational burnout as a predictor of disability pension: a population-based cohort study. Occup Environ Med 2009;66:284–90.

16.

Mykletun

Heradstveit

Eriksen

. Health anxiety and disability pension award: the HUSK study. Psychosom Med 2009;71:353–60.

17.

Upmark

Hemmingsson

Romelsjo

. Longitudinal, population-based study of self reported alcohol habits, high levels of sickness absence and disability pensions. J Epidemiol Community Health 1999;53;223–9.

18.

Karnehed

Rasmussen

Kark

. Obesity in young adulthood and later disability pension: a population-based cohort study of 366,929 Swedish men. Scand J Public Health 2007; 35:48–54.

19.

Holte

Tambs

Bjerkedal

. Manual work as predictor of disability pensioning with osteoarthritis among the employed in Norway 1971–1990. Int J Epidemiol 2000;29:487–94.

20.

Tüchsen

Christensen

Lund

. A 15-year prospective study of shift work and disability pension. Occup Environ Med 2008;65:283–5.

21.

Labriola

Feveile

Christensen

. The impact of job satisfaction on the risk of disability pension. A 15-year prospective study. Scand J Public Health 2009;37:778–80.

22.

Leinonen

Pietiläinen

Laaksonen

. Occupational social class and disability retirement among municipal employees – the contribution of health behaviors and working conditions. Scand J Work Environ Health 2011;37:464–72.

23.

Haukenes

Mykletun

Knudsen

. Disability pension by occupational class – the impact of work related factors: the Hordaland Health Study Cohort. BMC Publ Health 2011;11: 406–416.

24.

Østby

Ørstavik

Knudsen

. Health problems account for a small part of the association between socioeconomic status and disability pension award. Results from the Hordaland Health Study. BMC Publ Health 2011;11: 12–19.

25.

Aromaa

Koskinen

(eds). Health and functional capacity in Finland. Baseline results of the Health 2000. Health examination Survey. Helsinki, Finland: Publications of the National Public Health Institute B3/2003.

26.

Statistics Finland. Classification of socioeconomic groups 1989. Statistics Finland, http://www.tilastokeskus.fi/meta/luokitukset/sosioekon_asema/001–1989/index_en.html (accessed 17 January 2013).

27.

Pirkola

Isometsä

Suvisaari

. DSM-IV mood-, anxiety- and alcohol use disorders and their comorbidity in the Finnish general population. Results from the Health 2000 study. Soc Psychiatry Psychiatr Epidemiol 2005;40:1–10.

28.

Karasek

Brisson

Kawakami

. The job content Questionnaire (JCQ): an instrument for internationally comparative asessments of psychosocial job characteristics. J Occup Health Psychol 1998;3:322–55.

29.

Pulkki-Råback

Ahola

Elovainio

. Socio-economic position and mental disorders in a working-age Finnish population: the Health 2000 Study. Eur J Publ Health 2012;22:327–332.

30.

Pietiläinen

Laaksonen

Rahkonen

. Self-Rated health as a predictor of disability retirement – the contribution of ill-health and working conditions. PlosOne 2011;6: e25994.