Contribution of age, gender and occupational group to the higher risk of disability retirement among Finnish public sector employees.

BACKGROUND: The aim of this study was to examine the differences in disability retirement between public and private sector employees and to examine the contribution of age, gender and occupational group to the differences between the sectors. METHODS: Our Finnish register data consisted of about two million non-retired men and women aged 30-62 years. Cox proportional hazard models were used to calculate hazard ratios for any, full and partial disability retirement in the public sector compared with the private sector. RESULTS: The risk of any disability retirement was higher in the public sector than in the private sector in all occupational groups. The unadjusted hazard ratio ranged from 1.29 (95% CI 1.16-1.44) among teaching professionals to 2.25 (95% CI 1.95-2.58) among skilled agricultural, forestry and fishery workers. Adjustment for age and gender attenuated the differences between the sectors. After adjusting for age, gender and occupational group, the hazard ratio was 1.29 (95% CI 1.27-1.32) for any disability retirement and 2.02 (95% CI 1.96-2.08) for partial disability retirement, but there was no difference between the public sector and private sector employees for full disability retirement. CONCLUSIONS: Adjustment of age and gender attenuated the higher risk of disability retirement in the public sector, while adjustment for occupational group widened the sector differences in any and full disability retirement. The risk of partial disability retirement was higher in all occupational groups in the public sector than in the private sector. For full disability retirement, the differences between the sectors were small or non-existent.

Educational inequalities in employment of Finns aged 60-68 in 2006-2018.

The aim of this study was to explore the employment of 60-68-year-old men and women by educational level over the period 2006-2018 and the magnitude of educational inequalities in employment. We used individual-level register data from Statistics Finland including all Finns aged 60-68 over a period of 13 years. In addition to calculating employment rates for men and women by educational levels, we estimated the relative index of inequality (RII) and slope index of inequality (SII) to measure the magnitude of relative and absolute educational inequalities in employment. The results show that the employment rates increased in all educational levels over the period 2006-2018. Relative educational inequalities in employment remained stable mainly among the 63-65-year-olds but decreased among the 60-62-year-olds and the 66-68-year-olds. However, absolute educational inequalities in employment increased in all age groups for both men and women.

Determinants of transition from partial to full disability pension: A register study from Finland.

Aims: This study explored the rate of transition from partial to full disability pension (DP) and aimed to determine whether age, sex, education, employment status, employment sector, pension type and medical cause of disability were associated with transition to full DP during a four-year follow-up. Methods: We used register data, including a 70% random sample of partial disability pensioners aged 20-58 at the time that their partial DP started in 2010 or 2011 (N=5277). Competing risk analysis was used to estimate sub-hazard ratios (SHR) and their 95% confidence intervals (CI) for full DP. Results: One third of partial disability pensioners transitioned to full DP during the four-year follow-up. More than half (52%) continued on partial DP, and 15% were in some other state. Men, older people, those with low education levels, those whose pension was granted until further notice and those whose pension was due to mental disorders (MD) proceeded to full DP more often than others. The SHR for full DP was 1.62 (95% CI 1.43-1.83) among partial disability pensioners with MD and 1.15 (95% CI 1.02-1.28) among partial disability pensioners with other diseases compared to those whose pension was granted due to musculoskeletal diseases. Conclusions: Partial DP is a relatively stable state, and moving to full DP is relatively rare. However, male sex, older age, low education level, a pension granted until further notice and partial DP due to MD are important risk factors for full DP. The risk factors for ending up on full DP varies by diagnosis and pension type.

Explanations for economic difficulties among old-age pensioners previously on disability pension.

BACKGROUND: This study looks at how previous disability retirement is associated with economic difficulties in covering the costs of everyday basic necessities in old age, and the extent to which the differences in economic difficulties between old-age pensioners with previous disability pension and other old-age pensioners are mediated by health, income and life satisfaction. METHODS: The survey data includes 2227 retirees aged 63-85 who were receiving old-age pension in 2017. A quarter of them had received a disability pension before their old-age pension. Economic difficulties were measured through a subjective assessment of how difficult it was to cover the following necessities: food, housing, medication, health services, transport, phone and internet use. The odds ratios and their 95%-confidence intervals were analyzed with ordered logistic regression models. RESULTS: Old-age pensioners with previous disability retirement experienced more economic difficulties in covering cost of necessities than other old-age pensioners. The differences were especially large among those with a mental diagnosis. Health, pension income and life satisfaction attenuated the differences slightly. The fully adjusted odds ratio for having economic difficulties in covering the cost of medicine and health care among old-age pensioners with previous disability retirement due to mental disorders was 2.15 (95% CI 1.44-3.22) compared to other old-age pensioners without previous disability retirement. CONCLUSIONS: Preventing disability retirement among working-age people diminishes the risk of economic difficulties in old age. More attention should be focussed especially on those with a high risk of disability retirement due to mental disorders.

Individual- and Company-Level Predictors of Receiving Vocational Rehabilitation: A Multilevel Study of Finnish Private Sector Workplaces.

Purpose The aim of this study was to examine the magnitude of company-level variation in vocational rehabilitation (VR) and to determine which individual- and company-level characteristics are associated with receiving VR due to mental disorders, musculoskeletal diseases, and other somatic diseases. Methods A 30% random sample of all Finnish private sector companies with more than 10 employees aged 25-62 years at the end of 2010 (5567 companies with 300,601 employees) was followed up for the receipt of VR over the next 6 years. Company size and industry, as well as gender, age, education, social class and sickness absence measured both at the individual- and company-level were used as explanatory variables in multilevel logit models. Results After controlling for the individual-level characteristics, 12% of the variance in VR was attributed to the company level. The proportion was largest in VR due to musculoskeletal diseases. Receiving VR was more common among women, older employees (except the oldest age group), those with low education (particularly due to musculoskeletal diseases), low social class, and previous sickness absence. Receiving VR was more common in larger companies, and in construction and in health and social work, and less common in professional, scientific and technical activities. Furthermore, receiving VR was more common in companies with low proportion of highly educated employees and with higher sickness absence rates. Conclusions Company-level variation in receiving VR was substantial. Adopting the practices of the companies with highest participation in VR could help to avoid work disability problems.

Company-level determinants of disability retirement: a multilevel study of Finnish private sector workplaces.

BACKGROUND: We examined whether the risk for disability retirement varies between companies over and above the individual-level characteristics of their employees and which company-level characteristics are associated with the risk for any, full or partial disability retirement. METHODS: A 30% random sample of Finnish private sector companies with at least 10 employees was used (5567 companies and 301 313 employees). The risk for disability retirement over 6 years was analyzed using multilevel logistic regression. Company size and industry, as well as gender, age, education and social class measured both at the individual- and the company-level were used as explanatory variables. RESULTS: 3.8% of the variance in the risk for disability retirement was attributed to the company level after controlling for individual-level characteristics of the employees. Company-level variance was much larger in partial (11.7%) than in full (4.2%) disability retirement. After controlling for all individual- and company-level characteristics, those working in health and social work activities had increased risk for both full and partial disability retirement. The risk for full disability retirement increased by decreasing educational level of the company. The risk for partial disability retirement increased by increasing company size and was elevated in companies with the highest proportion of women. CONCLUSIONS: After controlling for the individual-level characteristics, variation in the risk for disability retirement between companies was modest. The more substantial variation in partial disability pension suggests that companies have a marked role in advancing working with partial disabilities.

Working while on a disability pension in Finland: Association of diagnosis and financial factors to employment.

AIMS: The aim of this study was to find out whether health and financial factors are associated with engagement in paid work during a disability pension. METHODS: The data included a 10 per cent sample of Finns aged 20-62 years who were drawing earnings-related full or partial disability pension in 2012 ( n = 14,418). Logistic regression analysis was used to estimate odds ratios for working while on a full or partial disability pension. RESULTS: Fourteen per cent of full disability pensioners and 76 per cent of partial disability pensioners were engaged in paid work. Full disability pensioners due to mental disorders were working less often than full disability pensioners due to other diseases. Partial disability pensioners due to cardiovascular diseases were working more than partial disability pensioners due to other diseases. More recent timing of disability pension was associated with working for both partial and full disability pensioners. Working while on disability pension was more common among those with higher education. Partial disability pensioners with average pension worked more often than those with high pension. CONCLUSIONS: By knowing the factors associated with working while on a disability pension, policies could be more efficiently allocated to encourage disability pensioners to take up work. One way would be to support disability pensioners with low education to work more. Another way to increase work among disability pensioners is to support the recently retired in working longer.

Socioeconomic Differences in Cause-Specific Disability Retirement in Finland, 1988 to 2009.

OBJECTIVE: The major aim was to study socioeconomic inequalities in disability retirement due to different diagnostic causes over the period 1988 to 2009. METHODS: The register data are 11% sample of people aged 30 to 64 years and living in Finland in 1987 to 2007. Incidence rates were calculated for disability retirement due to different diseases during the follow-up period 1988 to 2009. RESULTS: The incidence of disability retirement decreased in each socioeconomic class from the early 1990s onward. Decreasing absolute socioeconomic inequalities in disability retirement due to any diagnostic cause and musculoskeletal diseases were seen in the period 1988 to 2009. Musculoskeletal diseases were the largest contributor to the overall socioeconomic inequalities in disability retirement throughout the whole study period. CONCLUSIONS: The contribution of musculoskeletal diseases to the overall socioeconomic inequalities has been large during the whole study period.

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.

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

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.