Scand J Work Environ Health 2014;40(4):353-360 pdf full text
https://doi.org/10.5271/sjweh.3411 | Published online: 18 Dec 2013, Issue date: 01 Jul 2014
The contribution of major diagnostic causes to socioeconomic differences in disability retirement
Objectives The aim of this study was twofold: to investigate socioeconomic differences in disability retirement (DR) due to major diseases and find out which diseases contribute most to the overall socioeconomic differences in DR.
Methods The data were longitudinal register-based (10% sample of Finns) from Statistics Finland. These data included 258 428 participants aged 35–64 years during the follow-up. The participants were employed or unemployed before the follow-up period 1997–2010. Of all participants, 14 303 men and 13 188 women ended up in DR during the follow-up. Socioeconomic status was categorized into upper- and lower-class non-manual employees, manual workers, and self-employed persons. Cox models were used to estimate hazard ratios for DR due to different diseases.
Results Compared to upper-class non-manual employees, DR was especially high for manual workers whose retirement diagnoses included psychoactive substance use, musculoskeletal diseases (MSD), or cardiovascular diseases. Socioeconomic differences in DR were stronger for younger age groups and men versus women. For females and males, the largest part of the excess DR among manual workers compared to upper-class non-manual employees was due to MSD. In the age group 54–64 years, the contribution of MSD to the total excess was >50% among male manual workers and 75% among female manual workers. Excess DR due to mental disorders concerned only 35–54-year-old manual workers (among 23% men and 26% women).
Conclusion The contribution of MSD to the total excess DR among lower socioeconomic groups was large. Prevention of MSD among manual workers would likely reduce socioeconomic differences in DR.
Key terms depression; diagnosis; disability pension; disability retirement; excess disability retirement; mental disorder; mental illness; musculoskeletal disease; musculoskeletal disorder; socioeconomic difference; socioeconomic status