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1.
Front Public Health ; 12: 1394688, 2024.
Article in English | MEDLINE | ID: mdl-38832229

ABSTRACT

Introduction: As an important component of the social security system, basic pension insurance for urban and rural residents is expected to improve the quality of life of rural older adult people and make their lives better and happier. This article mainly studies the relationship between the basic pension for urban and rural residents and the subjective well-being of older adult people in rural China. Methods: This paper uses data from the China Health and Retirement Longitudinal Study (CHARLS) for the years 2018 and 2020. It selected samples of rural older adult people aged 60 and above, ultimately obtaining 9,310 samples. The impact of the basic pension for urban and rural residents on the subjective well-being of rural older adult people was estimated by constructing Ordinary Least Squares (OLS) estimation methods and ordered logistic regression models. The robustness of the results was verified by changing the regression methods, and the samples were divided into different groups for heterogeneity analysis according to three different standards. Results: The results show that the basic pension for urban and rural residents significantly improves the life satisfaction of rural older adult, reduces their degrees of depression, and thereby enhances their subjective well-being. The impact of the basic pension for urban and rural residents is more significant for older adult individuals in areas with a higher gender ratio, those suffering from chronic diseases, and those in the eastern regions of the country. Further verification indicates that the basic pension for urban and rural residents enhances the subjective well-being of the rural older adult by improving their health status and reducing their labor supply. Discussion: Most of the existing research on basic pension insurance for urban and rural residents and subjective well-being has been conducted from the perspective of whether individuals are enrolled in the pension scheme or whether they received a pension. However, there are few studies analyzing from the perspective of the amount of pension benefits received by residents. The results of this study help to enrich the research perspective on the basic pension insurance system for urban and rural residents in China and expand the understanding of the impact and value of the basic pension for urban and rural residents.


Subject(s)
Pensions , Quality of Life , Rural Population , Urban Population , Humans , China , Pensions/statistics & numerical data , Rural Population/statistics & numerical data , Female , Male , Aged , Urban Population/statistics & numerical data , Middle Aged , Longitudinal Studies , Aged, 80 and over , Personal Satisfaction , Retirement/statistics & numerical data , East Asian People
2.
PLoS One ; 19(5): e0296334, 2024.
Article in English | MEDLINE | ID: mdl-38728309

ABSTRACT

This paper studies the redistributive effects of two major pay-as-you-go pension systems by constructing an intergenerational iterative model which does not only considers standard utility but also relative utility. The study find that the two main pay-as-you-go pension systems are both sustainable. If we consider different preferences, then the choice of pension system should depend on the question of whether individuals are more interested in the absolute level of consumption or in the consumption related to a reference group. If the latter is more important, the Beveridgean system is superior, it provides greater protection for vulnerable groups than the Bismarck pension system, and the pension income after retirement is relatively more balanced, but the price is a lower level of consumption in the long run compared to an economy with Bismarckian system. If individuals prefer instead the absolute level of consumption, the Bismarckian system is better, because it guarantees a comparable higher level of consumption, but the disadvantaged groups face a higher risk of poverty and the degree of social inequality will be relatively higher. However, it is important to note that in the long run, only the level of consumption differs, not the speed of growth or number of children.


Subject(s)
Pensions , Social Welfare , Pensions/statistics & numerical data , Humans , Social Welfare/economics , Income , Socioeconomic Factors , Retirement/economics , Salaries and Fringe Benefits/statistics & numerical data
3.
JMIR Public Health Surveill ; 10: e49129, 2024 May 02.
Article in English | MEDLINE | ID: mdl-38696246

ABSTRACT

BACKGROUND: As income and health are closely related, retirement is considered undesirable for health. Many studies have shown the association between pension and health, but no research has considered the association between contribution-based public pensions or their types and health. OBJECTIVE: This study investigates the association between the type of contributory public pension and depressive symptoms among older adults. METHODS: We analyzed the data of 4541 older adults who participated in the South Korea Welfare Panel Study (2014-2020). Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression scale. Public pensions in South Korea are classified into specific corporate pensions and national pensions. For subgroup analyses, pensioners were categorized according to the amount of pension received and the proportion of public pension over gross income. Analyses using generalized estimating equations were conducted for longitudinal data. RESULTS: Individuals receiving public pension, regardless of the pension type, demonstrated significantly decreased depressive symptoms (national pension: ß=-.734; P<.001; specific corporate pension: ß=-.775; P=.02). For both pension types, the higher the amount of benefits, the lower were the depression scores. However, this association was absent for those who received the smaller amount among the specific corporate pensioners. In low-income households, the decrease in the depressive symptoms based on the amount of public pension benefits was greater (fourth quartile of national pension: ß=-1.472; P<.001; second and third quartiles of specific corporate pension: ß=-3.646; P<.001). CONCLUSIONS: Our study shows that contributory public pension is significantly associated with lower depressive symptoms, and this association is prominent in low-income households. Thus, contributory public pensions may be good income sources for improving the mental health of older adults after retirement.


Subject(s)
Depression , Pensions , Humans , Pensions/statistics & numerical data , Republic of Korea/epidemiology , Longitudinal Studies , Male , Female , Aged , Middle Aged , Depression/epidemiology , Mental Health/statistics & numerical data , Retirement/statistics & numerical data , Retirement/psychology , Aged, 80 and over
4.
Occup Environ Med ; 81(5): 262-265, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38719454

ABSTRACT

INTRODUCTION: Working in emotionally demanding jobs is associated with an increased risk of temporarily leaving the labour market due to long-term sickness absence. We tested whether employees working in emotionally demanding jobs are also at higher risk of permanently leaving the labour market due to disability pension compared with employees working in jobs that are not emotionally demanding. METHODS: We conducted a 10-year cohort study in the workforce in Denmark (n=1 670 825), aged 30-59 years at baseline, by linking job exposure matrices with nationwide registries on social transfer payments and covariates. Using Cox regression, we analysed the risk of disability pension in relation to emotional demands in the full population and sex stratified. Multivariable adjusted models included sex, age, cohabitation, migration background, household disposable income and other work environmental factors (physical workload, influence, possibilities for development and role conflicts). RESULTS: We identified 67 923 new cases of disability pension during 15 649 743 person-years of follow-up (mean follow-up: 9.4 years). We found an increasing risk of disability pension with higher levels of emotional demands, with HRs of 1.20, 1.23 and 1.73 for medium-low, medium-high and high emotional demands, respectively, compared with low emotional demands in the most adjusted model. There was an exposure-response association in women and a tendency towards an exposure-response association in men. DISCUSSION: In this nationwide cohort study, we found an increased risk of permanent exit from the labour market due to disability pension in women and men working in emotionally demanding jobs.


Subject(s)
Disabled Persons , Pensions , Workload , Humans , Denmark/epidemiology , Male , Female , Middle Aged , Adult , Pensions/statistics & numerical data , Cohort Studies , Disabled Persons/statistics & numerical data , Disabled Persons/psychology , Workload/psychology , Emotions , Risk Factors , Proportional Hazards Models , Sick Leave/statistics & numerical data
6.
Scand J Rheumatol ; 53(3): 199-206, 2024 May.
Article in English | MEDLINE | ID: mdl-38607692

ABSTRACT

OBJECTIVE: To investigate sickness benefits following delivery in mothers with systemic lupus erythematosus (SLE) and mothers without SLE. METHOD: SLE and non-SLE mothers, matched by age and month of delivery, with a singleton liveborn (2004-2008), were identified from the Swedish Lupus Linkage cohort. Work loss (sum of sick leave and disability pension) was studied from 1 year prenatally to 3 years postpartum. Adjusted logistic regression models of covariates associated with > 30 days of work loss in the first and second years postpartum were estimated in SLE mothers. RESULTS: Among 130 SLE mothers and 440 non-SLE mothers, SLE mothers were more likely to have work loss from the prenatal year (42% vs 16%) to 3 years postpartum (49% vs 15%). In SLE mothers, work loss was on average 61 ± 112 days (mean ± sd) in the prenatal year and 38 ± 83 days in the first year postpartum, which increased to 71 ± 114 days in the third year postpartum. Having > 30 days of sick leave in the year of delivery [odds ratio (OR) 4.4, 95% confidence interval (CI) 1.5-12.9] and ≤ 12 years of education (OR 2.6, 95% CI 1.1-6.0) were associated with work loss in the first year postpartum. No covariates were associated with work loss in the second year postpartum. CONCLUSION: SLE mothers more often had work loss in the prenatal year to 3 years postpartum compared to non-SLE mothers. Lower education and sick leave in the year of delivery were associated with a higher odds of work loss in the first year postpartum in SLE.


Subject(s)
Lupus Erythematosus, Systemic , Sick Leave , Pregnancy , Humans , Female , Educational Status , Logistic Models , Lupus Erythematosus, Systemic/epidemiology , Pensions
7.
Fam Med Community Health ; 12(2)2024 Apr 04.
Article in English | MEDLINE | ID: mdl-38575348

ABSTRACT

OBJECTIVE: Currently, little is known regarding changes in family situation with concurrent changes in working life. This study aimed to examine whether changes in family situation (based on living with children and/or marrying/divorcing) were associated with changes in working life and whether the associations were influenced by sex, genetics and early life environment. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: Data from Swedish national registers of 16 410 twins were used. Fixed-effects logistic regression models assessing ORs with 95% CIs were applied to examine associations between changes in family situation and working life controlling for time-invariant effects and adjusted for covariates, and conditional models to account for confounding of genetics and early life environment. RESULTS: Changes in individuals life situation from being single and living without children to married and living with children were associated with transitioning from unsustainable (ie, having unemployment or sickness absence/disability pension) to sustainable working life (men: OR 2.40, 95% CI 2.26 to 2.56; women: OR 1.68, 95% CI 1.59 to 1.78). Changes from being married to single, in contrast, attenuated the likelihood of transitioning to a sustainable working life. Moreover, changes in men's working life seem to be more dependent on changes in family situation compared with women. Genetic factors and early life environment play a role in the associations. CONCLUSIONS: Family formation increases the likelihood of a more stable working life whereas divorce is a risk factor for work interruptions. Our study emphasises that family formation improves the work life situation and to a higher degree for men.


Subject(s)
Disabled Persons , Unemployment , Male , Child , Humans , Female , Prospective Studies , Risk Factors , Pensions
8.
BMC Musculoskelet Disord ; 25(1): 273, 2024 Apr 08.
Article in English | MEDLINE | ID: mdl-38589843

ABSTRACT

BACKGROUND: Musculoskeletal pain is one of the leading causes of work productivity loss. Long-term conditions (LTCs) commonly occur alongside musculoskeletal pain. However, the incidence of sick leave and disability pension according to LTC status in people with musculoskeletal pain has not been previously described. METHODS: Working-age participants (20-65 years) with persistent musculoskeletal pain who participated in the HUNT3 Study (1995-97) were included. Twenty-five LTCs were classified into 8 LTC groups according to the International Classification of Diseases version 11. Data on sickness and disability benefits were obtained from the National Insurance Database and linked to the HUNT3 data using participants' personal identification number. Age-adjusted incidence rates (IRs) (per 10,000 person-years) and hazard ratios (HRs) of sick leave during 5-year follow-up and disability pension during ~ 25-year follow-up were estimated with 95% confidence intervals (CIs) and presented according to LTC status. RESULTS: Overall, 11,080 participants with musculoskeletal pain were included. Of those, 32% reported one LTC and 45% reported ≥ 2 LTCs. During the follow up period, 1,312 participants (12%) received disability pension due to musculoskeletal conditions. The IR of sick leave and disability pension due to musculoskeletal conditions increased with number of LTCs. Specifically, the IR of sick leave was 720 (95% CI 672 to 768) in participants without any LTCs and 968 (95% CI 927 to 1,009) if they had ≥ 2 LTCs. The IRs of disability pension were 87 (95% CI 75 to 98) and 167 (95% CI 154 to 179) among those with no LTCs and ≥ 2 LTCs, respectively. The incidence of sick leave and disability pension due to musculoskeletal conditions was largely similar across LTCs, although the incidence of disability pension was somewhat higher among people with sleep disorders (IR: 223, 95% CI 194 to 252). CONCLUSIONS: Among people with persistent musculoskeletal pain, the incidence of prematurely leaving the work force due to musculoskeletal conditions was twice as high for those with multiple LTCs compared to those without any LTCs. This was largely irrespective of the type of LTC, indicating that the number of LTCs are an important feature when evaluating work participation among people with musculoskeletal pain.


Subject(s)
Musculoskeletal Pain , Adult , Humans , Young Adult , Middle Aged , Aged , Incidence , Musculoskeletal Pain/diagnosis , Musculoskeletal Pain/epidemiology , Sick Leave , Pensions , Registries , Sweden/epidemiology
9.
Int J Geriatr Psychiatry ; 39(5): e6088, 2024 May.
Article in English | MEDLINE | ID: mdl-38666751

ABSTRACT

OBJECTIVES: This study investigates the impact of pension on depressive symptoms among Chinese older adults. Additional effort is made to test the mediating effect of multidimensional downward intergenerational support and the moderating effect of age on this relationship. METHODS: A total of 1828 Chinese older community-dwellers who met our inclusion criteria are drawn from the 2018 China Health and Retirement Longitudinal Study. Multivariate regression modeling is applied to analyze the effect of pensions on depressive symptoms of older adults. Additionally, bootstrap method with resampling strategies is used to estimate the mediating effect of three dimensions of downward intergenerational support (instrumental, emotional, and financial support). Further, Johnson-Neyman technique is employed to analysis and visualize the moderating effect of age. RESULTS: The findings reveal a significant inverse relationship between pension levels and depressive symptoms (B = -6.664, SE = 2.826, p < 0.05). The analysis shows that downward intergenerational emotional support (B = -0.195, Boot SE = 0.103, 95% Boot CI [-0.404, -0.003]) serves as a partial mediator in this relationship. Furthermore, the results highlight the moderating role of age in the linkage between pension and depressive symptoms (B = 0.065, SE = 0.039, p < 0.1). DISCUSSION: This investigation is pioneering in simultaneously assessing the mediating role of multidimensional downward intergenerational support and the moderating effect of age in the context of pension and depressive symptoms. The study underscores the necessity of an interdisciplinary approach in devising comprehensive intervention strategies. These should encompass pension policy consultation, respite services, and other crucial elements aimed at mitigating the severity or reducing the risk of depressive symptoms among the older adults.


Subject(s)
Depression , Pensions , Humans , Female , Male , Aged , Pensions/statistics & numerical data , China/epidemiology , Depression/psychology , Longitudinal Studies , Middle Aged , Intergenerational Relations , Aged, 80 and over , Social Support , East Asian People
10.
JAMA Netw Open ; 7(4): e247519, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38648059

ABSTRACT

Importance: The health outcomes of increased poverty and inequalities in low- and middle-income countries (LMICs) have been substantially amplified as a consequence of converging multiple crises. Brazil has some of the world's largest conditional cash transfer (Programa Bolsa Família [PBF]), social pension (Beneficio de Prestacão Continuada [BPC]), and primary health care (Estratégia de Saúde da Família [ESF]) programs that could act as mitigating interventions during the current polycrisis era of increasing poverty, slow or contracting economic growth, and conflicts. Objective: To evaluate the combined association of the Brazilian conditional cash transfer, social pension, and primary health care programs with the reduction of morbidity and mortality over the last 2 decades and forecast their potential mitigation of the current global polycrisis and beyond. Design, Setting, and Participants: This cohort study used a longitudinal ecological design with multivariable negative binomial regression models (adjusted for relevant socioeconomic, demographic, and health care variables) integrating the retrospective analysis from 2000 to 2019, with dynamic microsimulation models to forecast potential child mortality scenarios up to 2030. Participants included a cohort of 2548 Brazilian municipalities from 2004 to 2019, projected from 2020 to 2030. Data analysis was performed from September 2022 to February 2023. Exposure: PBF coverage of the target population (those who were poorest) was categorized into 4 levels: low (0%-29.9%), intermediate (30.0%-69.9%), high (70.0%-99.9%), and consolidated (≥100%). ESF coverage was categorized as null (0), low (0.1%-29.9%), intermediate (30.0%-69.9%), and consolidated (70.0%-100%). BPC coverage was categorized by terciles. Main outcomes and measures: Age-standardized, all-cause mortality and hospitalization rates calculated for the entire population and by age group (<5 years, 5-29 years, 30-69 years, and ≥70 years). Results: Among the 2548 Brazilian municipalities studied from 2004 to 2019, the mean (SD) age-standardized mortality rate decreased by 16.64% (from 6.73 [1.14] to 5.61 [0.94] deaths per 1000 population). Consolidated coverages of social welfare programs studied were all associated with reductions in overall mortality rates (PBF: rate ratio [RR], 0.95 [95% CI, 0.94-0.96]; ESF: RR, 0.93 [95% CI, 0.93-0.94]; BPC: RR, 0.91 [95% CI, 0.91-0.92]), having all together prevented an estimated 1 462 626 (95% CI, 1 332 128-1 596 924) deaths over the period 2004 to 2019. The results were higher on mortality for the group younger than age 5 years (PBF: RR, 0.87 [95% CI, 0.85-0.90]; ESF: RR, 0.89 [95% CI, 0.87-0.93]; BPC: RR, 0.84 [95% CI, 0.82-0.86]), on mortality for the group aged 70 years and older, and on hospitalizations. Considering a shorter scenario of economic crisis, a mitigation strategy that will increase the coverage of PBF, BPC, and ESF to proportionally cover the newly poor and at-risk individuals was projected to avert 1 305 359 (95% CI, 1 163 659-1 449 256) deaths and 6 593 224 (95% CI, 5 534 591-7 651 327) hospitalizations up to 2030, compared with fiscal austerity scenarios that would reduce the coverage of these interventions. Conclusions and relevance: This cohort study's results suggest that combined expansion of conditional cash transfers, social pensions, and primary health care should be considered a viable strategy to mitigate the adverse health outcomes of the current global polycrisis in LMICs, whereas the implementation of fiscal austerity measures could result in large numbers of preventable deaths.


Subject(s)
Hospitalization , Pensions , Primary Health Care , Humans , Brazil/epidemiology , Primary Health Care/statistics & numerical data , Primary Health Care/economics , Hospitalization/statistics & numerical data , Hospitalization/economics , Hospitalization/trends , Female , Male , Pensions/statistics & numerical data , Adult , Child, Preschool , Middle Aged , Adolescent , Child , Mortality/trends , Young Adult , Infant , Retrospective Studies , Aged , Longitudinal Studies , Poverty/statistics & numerical data
12.
Rehabilitation (Stuttg) ; 63(2): 81-88, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38626789

ABSTRACT

BACKGROUND AND PURPOSE: In the last decades, Germany has experienced a vast increase in the number of individuals applying for or receiving disability benefit. Only a small proportion of them intends to return to work. The present study aims to identify and describe the percentage of temporary disability pensioners, who have the intention to return to working life. METHODS: The final sample consisted of 496 insured individuals who were receiving temporary disability pension from the Regional German Pension Insurance (DRV) at that time. Participation was voluntary and anonymous. The following self-report instruments were administered: a. Evaluation of Contextual Factors; b. German Symptom Validation Test (BEVA); c. German Patient Health Questionnaire (PHQ-9); d. Readiness for Return-to-Work German Scale (RRTW). RESULTS: The results revealed that approximately 6% of participants were at the stage of "preparation", 31.9% at the stage of "contemplation", and more than half of the participants were at the stage of "pre-contemplation" according to the RRTW. Comparing the groups of "pre-contemplation" (Group 1) and "contemplation+preparation" (Group 2+3), no statistically significant differences were found, except for age. CONCLUSIONS: In conclusion, further research is required to identify possible factors which could predict the stage of RRTW. New interventions are needed that can raise the motivation for and success in the return to work of disability pensioners.


Subject(s)
Disabled Persons , Return to Work , Humans , Intention , Germany/epidemiology , Pensions
13.
BMC Geriatr ; 24(1): 291, 2024 Mar 27.
Article in English | MEDLINE | ID: mdl-38539121

ABSTRACT

BACKGROUND: Social pensions, social assistance systems for older people in rural areas, have been put into place in many nations and have positively impacted health. The long-term health consequences of social pension programs in China are uncertain. The aim of this study is to evaluate the long-term health consequences of the new rural social pension (NRSP) for the rural older people in China. METHODS: Based on the 2011 and 2018 China Health and Retirement Longitudinal Study, we compared the scores on eight Health-Related Quality of Life (HRQoL) subscales of the rural older people before and after participation in the NRSP. The propensity score matching and difference-in-difference methods were used in data analysis. We also conducted a heterogeneity analysis for subgroups with different characteristics and pension enrolment times. RESULTS: The NRSP significantly enhanced scores on physical functioning, role-physical, and self-rated mental health of old rural participants by 1.90 (p < 0.01), 2.05 (p < 0.01), and 2.93 (p < 0.05), respectively. After excluding newly enrolled individuals, the beneficial health effects of the NRSP remained significant. There were no significant changes due to NRSP in the other five scores on the HRQoL subscale of the rural older people. The NRSP had more health benefits for older people in underdeveloped areas without formal schooling. CONCLUSIONS: The NRSP reduced health disparities and had long-term benefits on the physical and mental health of the rural older people. We suggest continuously expanding the NRSP throughout rural China and further improving the social support system to enhance the overall quality of life of the rural older people. Comparable social pension programs aimed at underprivileged groups could also be conducted in other low- or middle-income nations.


Subject(s)
Pensions , Quality of Life , Humans , Aged , Longitudinal Studies , Income , China/epidemiology , Rural Population
14.
Injury ; 55(4): 111480, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38452702

ABSTRACT

INTRODUCTION: Previous research has identified low socioeconomic status (SES) as a risk factor for long-term sickness absence (LTSA) and disability pension (DP) following trauma. However, most studies lack information on medical diagnoses, limiting our understanding of the underlying factors. To address this gap, we retrieved information about diagnostic causes for receipt of welfare benefits to explore the role of SES in the transition from post-injury LTSA to permanent DP among the working population in Norway. MATERIALS AND METHODS: We conducted a population-based cohort study of all Norwegian residents aged 25-59 years registered with a spell of LTSA due to injury commencing in the period 2000-2003. This cohort was followed through 2014 by linking information on receipt of welfare benefits with sociodemographic data from administrative registers. SES was defined as a composite measure of educational attainment and income level. We used flexible parametric survival models to estimate hazard ratios (HR) with 95 % confidence intervals (CI) for all-cause and diagnosis-specific DP according to SES, adjusting for sex, age, marital status, immigrant status and healthcare region of residence. RESULTS: Of 53,937 adults with post-injury LTSA, 9,665 (18 %) transferred to DP during follow-up. The crude risk of DP was highest for LTSA spells due to poisoning and head injuries. Overall, individuals in the lowest SES category had twice the risk of DP compared to those in the highest SES category (HR = 2.25, 95 % CI 2.13-2.38). The difference by SES was greatest for LTSA due to poisoning and smallest for LTSA due to head injuries. A majority (75 %) of DP recipients had a non-injury diagnosis as the primary cause of DP. The socioeconomic gradient was more pronounced for non-injury causes of DP (HR = 2.47, 95 % CI 2.31-2.63) than for injury causes (HR = 1.73, 95 % CI 1.56-1.92) and was especially steep for DP due to musculoskeletal diseases and mental and behavioural disorders. CONCLUSIONS: The relationship between SES and DP varied by both the type of injury that caused LTSA and the diagnosis used to grant DP, highlighting the importance of taking diagnostic information into account when investigating long-term consequences of injuries.


Subject(s)
Craniocerebral Trauma , Disabled Persons , Adult , Humans , Cohort Studies , Prospective Studies , Sick Leave , Pensions , Social Class , Risk Factors
15.
BMC Geriatr ; 24(1): 265, 2024 Mar 18.
Article in English | MEDLINE | ID: mdl-38500023

ABSTRACT

BACKGROUND: Unhealthy behavior is an important factor threatening the health of older rural residents in China. We examine the effects of receiving pension on elderly rural residents' health behavior (namely conscious control of sugar, salt, and edible oil intake, as well as learning health or wellness knowledge), also including effect heterogeneity by income level and gender. METHODS: Using China Rural Revitalization Survey (CRRS) in 2020, we used the policy rule of the China's New Rural Pension Scheme that only those people who are over 60 years old can have access to pension as the natural experiment, and explore the causal effect of receiving pensions on the health behaviors by using regression discontinuity design method. RESULTS: Having access to pension can improve the health behavior of rural elderly residents, including increasing the probability of rural residents' conscious control of sugar (p < 0.1) and conscious control of salt intake (p < 0.1), which is still valid after a series of robustness tests. Heterogeneity analysis finds that access to pensions is more likely to improve the health behavior of low-income families and male rural elderly residents. CONCLUSIONS: The research has expanded the discussion on the correlation between the pension and the health of rural elderly residents, and the conclusion provides important policy implications for optimizing the rural elderly insurance system and leveraging pension to improve the health behavior of rural elderly residents.


Subject(s)
Pensions , Poverty , Humans , Male , Aged , China/epidemiology , Rural Population , Health Behavior , Sugars
16.
Eur J Gastroenterol Hepatol ; 36(6): 695-703, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38526938

ABSTRACT

OBJECTIVES: Inflammatory bowel diseases (IBD) are an increasing burden for societies. We examined Polish Social Insurance Institution (ZUS) work incapacity expenditures for people with IBD compared with the general population. METHODS: Aggregate data were obtained on ZUS expenditures between 2012 and 2021 in Polish zlotys (PLN). Annual work incapacity benefit expenditures were analyzed and IBD benefit expenditures were examined relative to innovative IBD drug utilization in individual provinces. RESULTS: Between 2012 and 2021, annual ZUS expenditures per person increased, while expenditures per IBD patient decreased. Proportionally, absenteeism was the largest ZUS expenditure in the general population, while disability pensions were the largest in the IBD population. ZUS expenditures due to absenteeism in the general population increased by PLN 282 per person; those due to disability pensions decreased by PLN 85. Disability pension spending due to Crohn's disease (CD) and ulcerative colitis (UC) decreased by PLN 371 and PLN 284, respectively, while absenteeism spending per person with CD and UC decreased (PLN 58 and PLN 35, respectively). Nationwide in 2021, 8.5% of people with CD and 1.9% of those with UC received innovative drugs. The percentage of people receiving innovative drugs and ZUS expenditure per person were inversely related in 9/16 provinces for CD and 5/16 for UC. CONCLUSION: Polish state spending on work incapacity benefits increased in the general population but decreased in people with IBD between 2012 and 2021. Use of innovative drugs was associated with reduced spending per person with IBD in some provinces.


Subject(s)
Absenteeism , Colitis, Ulcerative , Crohn Disease , Health Expenditures , Humans , Poland , Colitis, Ulcerative/economics , Colitis, Ulcerative/therapy , Health Expenditures/statistics & numerical data , Crohn Disease/economics , Crohn Disease/therapy , Cost Savings , Health Services Accessibility/economics , Pensions/statistics & numerical data , Work Capacity Evaluation , Drug Costs , Sick Leave/economics , Sick Leave/statistics & numerical data , Gastrointestinal Agents/therapeutic use , Gastrointestinal Agents/economics , Inflammatory Bowel Diseases/economics , Inflammatory Bowel Diseases/therapy , Male , Female
17.
Scand J Work Environ Health ; 50(4): 279-289, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38527330

ABSTRACT

OBJECTIVES: This study aimed to compare the risk of labor market marginalization among refugees across different host countries of resettlement and examine the moderating role of birth country and length of stay on these associations. METHODS: Cohorts of refugees and native-born individuals aged 19-60 in Sweden (N=3 605 949, 3.5% refugees) and Norway (N=1 784 861, 1.7% refugees) were followed during 2010-2016. Rates (per 1000 person-years) of long-term unemployment, long-term sickness absence, and disability pension were estimated for refugees and the host populations. Cox regression models estimated crude and adjusted (for sex, age, educational level, and civil status) hazard ratio (HRadj) for refugees compared to their respective host population, with 95% confidence intervals (CI). Analyses were also stratified by birth country and length of stay. RESULTS: Refugees in Norway and Sweden had a higher incidence of labor market marginalization compared to their host population. Refugees in Sweden had a comparatively lower relative risk of long-term unemployment but higher risk of disability pension (HRadj 3.44, 95% CI, 3.38-3.50 and HRadj 2.45, 2.35-2.56, respectively) than refugees in Norway (HRadj 3.70, 3.58-3.82 and HRadj 1.57, 1.49-1.66, respectively). These relative risks varied when stratifying by birth country. A shorter length of stay was associated with a higher risk of long-term unemployment and a lower risk of disability pension, with a stronger gradient in Sweden than in Norway. CONCLUSIONS: The relative risk of labor market marginalization varied by the refugees' birth country but followed similar trends in Sweden and Norway. Although speculative, these findings may hint at non-structural factors related to the refugee experience playing a more important role than host country structural factors for the risk of labor market marginalization among refugees. Future research, including host countries with more variability in structural factors, is required to further investigate these associations. The higher risk of long-term unemployment among refugees with shorter length of stay indicates a need for more efficient labor market integration policies for newly-arrived refugees.


Subject(s)
Refugees , Unemployment , Humans , Sweden , Norway , Refugees/statistics & numerical data , Adult , Female , Male , Middle Aged , Unemployment/statistics & numerical data , Cohort Studies , Sick Leave/statistics & numerical data , Young Adult , Pensions/statistics & numerical data
18.
Adv Life Course Res ; 60: 100595, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38428379

ABSTRACT

The aim of this paper is to explore how divorce is linked to pathways to retirement in West Germany and to understand whether and how patterns are gendered. Using German pension insurance data, I employ sequence and cluster analysis to map and group pathways to retirement of women and men who retired in 2018. Pathways to retirement are defined based on monthly pension insurance histories from age 50 to 65. I find nine distinct pathways to retirement, ranging from unemployment to stable low to high income pathways and to an early retirement pathway through the reduced-earnings-capacity pension, the latter representing 9.3% of the sample. Based on multinomial logistic regression models, I analyse how marital status, distinguishing between divorced and (re)married, was related to different pathways to retirement. The results show that divorced people were more likely than married people to retire through indirect and unstable pathways to retirement characterised by early exit from the labour market and receipt of reduced-earnings-capacity pensions and/or unemployment benefits. Whereas the relationship between divorce and pathways to retirement seemed to be overall unfavourable for men, the results for women are more ambiguous. Divorced women were also more likely to retire through a stable high-income pathway than married women. Nevertheless, the results suggest that divorce is associated with an early retirement pathway through the reduced-earnings-capacity pension for both women and men.


Subject(s)
Divorce , Retirement , Humans , Retirement/statistics & numerical data , Retirement/psychology , Retirement/economics , Divorce/psychology , Divorce/statistics & numerical data , Female , Male , Middle Aged , Aged , Pensions/statistics & numerical data , Germany, West , Income/statistics & numerical data , Marital Status/statistics & numerical data , Germany , Sex Factors
19.
Health Policy ; 143: 105054, 2024 May.
Article in English | MEDLINE | ID: mdl-38522246

ABSTRACT

BACKGROUND: Old Age Security (OAS) represents an public policy through which income-related inequalities in health may be improved. The goal of this cross-sectional study was to investigate the health benefits of receiving OAS in financially insecure older Canadians. METHODS: Using data from the Canadian Longitudinal Study on Aging (CLSA) (n=15,691), ordered logistic regression was used to measure associations between financial insecurity and allostatic load. RESULTS: Receiving OAS as highest personal income source appeared to remove the health penalty of being financially insecure. While financial insecurity was associated with worse allostatic load in both males and females not receiving OAS, those receiving OAS as highest personal income source had better allostatic load compared to other financially insecure older adults (ORM: 0.398, 95 % CI: 0.227, 0.696; ORF: 0.677, 95 % CI: 0.483, 0.949). DISCUSSION: While longitudinal data would be needed to draw causal inferences, these results suggest OAS may play a role improving health outcomes and narrowing income-related health inequalities. Such findings may have important implications on older adults, other vulnerable populations, and future directions of Canadian health and public policy.


Subject(s)
Allostasis , North American People , Male , Female , Humans , Aged , Cross-Sectional Studies , Longitudinal Studies , Canada , Aging , Pensions
20.
BMC Public Health ; 24(1): 735, 2024 Mar 07.
Article in English | MEDLINE | ID: mdl-38454363

ABSTRACT

BACKGROUND: In the last decade, interest in working life expectancy (WLE) and socioeconomic differences in WLE has grown considerably. However, a comprehensive overview of the socioeconomic differences in WLE is lacking. The aim of this review is to systematically map the research literature to improve the insight on differences in WLE and healthy WLE (HWLE) by education, occupational class and income while using different ways of measuring and estimating WLE and to define future research needs. METHODS: A systematic search was carried out in Web of Science, PubMed and EMBASE and complemented by relevant publications derived through screening of reference lists of the identified publications and expert knowledge. Reports on differences in WLE or HWLE by education, occupational class or income, published until November 2022, were included. Information on socioeconomic differences in WLE and HWLE was synthesized in absolute and relative terms. RESULTS: A total of 26 reports from 21 studies on educational and occupational class differences in WLE or HWLE were included. No reports on income differences were found. On average, WLE in persons with low education is 30% (men) and 27% (women) shorter than in those with high education. The corresponding numbers for occupational class difference were 21% (men) and 27% (women). Low-educated persons were expected to lose more working years due to unemployment and disability retirement than high-educated persons. CONCLUSIONS: The identified socioeconomic inequalities are highly relevant for policy makers and pose serious challenges for equitable pension policies. Many policy interventions aimed at increasing the length of working life follow a one-size-fits-all approach which does not take these inequalities into account. More research is needed on socioeconomic differences in HWLE and potential influences of income on working life duration.


Subject(s)
Disabled Persons , Life Expectancy , Male , Humans , Female , Retirement , Unemployment , Pensions , Socioeconomic Factors
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