Educational differences in disability retirement among young employees in Helsinki, Finland

Factors associated with work activity of technical-administrative staff from state universities retired due to disability

OBJECTIVE

To verify the factors associated with the type of work activity performed by university technical-administrative staff retired due to disability.

METHOD

Cross-sectional research with 68 workers, conducted using an electronic questionnaire between November 2019 and September 2020. Data were collected on sociodemographic, occupational characterization and causes of disability. Data were analyzed descriptively and by multiple logistic regressions.

RESULTS

Health professionals were more likely to have mental and behavioral disorders, associated with females and regardless of age. The chances of the nervous system diseases were higher in workers who performed administrative work, being associated with higher education. Operational employees were more likely to have musculoskeletal diseases associated with primary and secondary education and were male, regardless of age.

CONCLUSION

There was an association between work activity performed before retirement and the diseases responsible for disability, with differences between gender, age, and educational levels.

Psychotherapy and change in mental health-related work disability: a prospective Finnish population-level register-based study with a quasi-experimental design

BACKGROUND

Mental disorders are a major cause of work disability among the working-age population. Psychotherapy has shown to be an effective treatment for mental disorders, but the evidence is mainly based on small-scale randomised trials with relatively short follow-ups. We used population-based register data to examine the association between statutory rehabilitative psychotherapy and change in depression or anxiety-related work disability.

METHODS

We drew a nationally representative sample of the working-age population (aged 18-55 in 2010). The study group comprised all those who started rehabilitative psychotherapy in 2011-2014. A total of 10 436 participants who were followed from 3 years prior to 4 years after the onset of rehabilitative psychotherapy. This resulted in 83 488 observations. The annual total number of mental health-related work disability months (0 to 12) was calculated from the total number of annual compensated sickness absence and disability pension days. A quasi-experimental interrupted time series analysis was applied.

RESULTS

The onset of rehabilitative psychotherapy marked a decline in work disability in comparison to the counterfactual trend. Specifically, a 20% decrease in the level (incidence rate ratio, IRR 0.80; 95% CI 0.76 to 0.85) and a 48% decrease in the slope (IRR 0.52; 95% CI 0.50 to 0.54) of work disability were detected in comparison to the counterfactual scenario. No significant gender differences were observed. The decline in work disability was the steepest in the oldest age group.

CONCLUSIONS

This study suggests that statutory psychotherapy may decrease work disability at the population level. However, further evidence of causal inference and the potential heterogeneity of the association is required.

Is Educational Level Linked to Unable to Work Due to Ill-health?

Background

This study aimed to examine the association between educational level and unable to work due to ill-health (UWdIH) among 30- to 79-year-old South Koreans.

Methods

A cross-sectional nationwide survey of the 2010–2016 Korea National Health and Nutritional Evaluation Survey was used for analyses. A total of 29,930 participants aged ≥30 and < 80 years, who do not have any disability in their daily life because of health problems, were included. Educational level and reason for nonworking are self-reported with multiple choices. Multivariate logistic regression was used to examine an association between education level and UWdIH by setting those who graduated college as their final education (n = 6,997) as a baseline while controlling for potential confounding factors.

Results

In the age-stratified result, the ratio of UWdIH was increased as age increases in 3 educational groups (p < .0001). There was a tendency that low-level educated [International Standard Classification of Education (0-2)] participants showed higher ratio of UWdIH than high-level educated [International Standard Classification of Education (5≤)] participants in both sexes (odds ratio: 2.54, 95% confidence interval: 2.12-3.05).

Conclusion

There is a clear link between educational level and UWdIH; the less the educated, the more likely to be UWdIH. Policy priority should be given to plans that can help this vulnerable social group to work and enjoy healthy lives.

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The main finding of this study was a clear educational gradient in unable to work due to ill-health throughout all age groups.

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A gender difference was also observed, as female participants showed a smaller gap between the educational level groups.

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A policy priority should be given to plans that can reduce educational inequalities in unable to work due to ill-health.

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Therefore, it is important to consider national policies and programmes that can help vulnerable social groups to work and enjoy healthy lives.

Unravelling the relationship between parental resources and disability pension in young adulthood

A vast literature exists on the relationship between family background and health outcomes. However, there is a shortage of evidence on the relationship between parental resources and offsprings' disability pension, a severe form of general poor health and functionability. This article analyses how parental income and education are associated with offsprings' disability pension in young adulthood (19-27 years) among 1980-1985 birth cohorts using Finnish register data. The results of discrete-time event history analysis demonstrate that parental income and education have contrasting impacts. High parental income is found to decrease, and parental education to increase, the probability of offspring having disability pension, although mainly among offspring with compulsory education. Further, young adults with high parental resources are better off two years after their first disability pension. We conclude that the influence of parental resources operates via offsprings' educational attainment but also has divergent direct impacts on offsprings' disability pension.

Exploring socioeconomic and mental health trajectories during times of economic recession: a qualitative study with primary health care users and professionals

Background: The 2008 economic recession has been shown to affect populations' mental health due to deterioration of socioeconomic and living conditions. Concurrently, mental health problems may have constituted a vulnerability to wider social inequalities during this period.Aims: To explore perceptions and experiences of primary health care users and professionals regarding the relationship between mental health and socioeconomic position during the economic recession in Portugal.Method: Data were collected in three primary health care centres in Lisbon Metropolitan Area. Focus groups and semi-structured interviews were conducted with users and professionals, respectively. Interviews were audio-recorded, transcribed verbatim and underwent thematic analysis.Results: Two themes were obtained. The first comprised the relationship between changes in socioeconomic conditions (unemployment, precarious work conditions and financial hardship) and poor mental health. The second involved the consequences of experiencing mental health problems during the recession, namely disability, need of sick leave and early retirement.Conclusions: This study provided a comprehensive overview of the bidirectional relationship between socioeconomic conditions and mental health, emphasizing the need to develop policies to address the drivers of poor mental health during times of economic downturn and tackle the barriers faced by people with mental disorders to promote their full social inclusion.

The effect of socioeconomic position in the experience of disability among people with mental disorders: findings from the World Mental Health Survey Initiative Portugal

BACKGROUND

Mental disorders are a major cause of disability with impacts on daily functioning and quality of life, which has been associated with socioeconomic disadvantage. The present study aims to assess how socioeconomic position is related to the disability reported by people with mental disorders, using data from the World Mental Health Survey (WMHS) Initiative Portugal.

METHODS

Using data from the Portuguese Mental Health Survey, a nationally representative cross-sectional study (n = 3849), several logistic regression models with interaction terms were performed to evaluate the effect of different indicators of socioeconomic position on the disability reported by people with any mental disorder (any 12-month mood or anxiety disorder). Odds ratios were estimated at the specific values of the main effects and interaction terms between the presence of any mental disorder and education, employment status, self-perceived financial deprivation and subjective social status.

RESULTS

The prevalence rate of any mood or anxiety disorder was 21.0% (n = 788), among which 14.7% (n = 115) reported disability. The results show that among people with any 12-month mental disorder, those in the employment category of "retired or others" had two times higher odds of reporting disability (OR = 2.19; 95%CI: 1.06-4.48) when compared to participants categorized as "working". Likewise, individuals with financial deprivation had two times higher odds of reporting disability when compared to those non-financially deprived (OR = 2.36; 95%CI: 1.31-4.24). The odds ratios obtained for the specific years of education evaluated were not statistically significant but seem to suggest an educational gradient.

CONCLUSIONS

The findings of this study indicate that the disability reported by people with mental disorders varies according to socioeconomic position and draw attention to the need to develop policies to address these inequalities.

Sickness absence as a predictor of disability retirement in different occupational classes: a register-based study of a working-age cohort in Finland in 2007-2014

OBJECTIVES

The objective of the study was to examine diagnosis-specific sickness absences of different lengths as predictors of disability retirement in different occupational classes.

DESIGN

Register-based prospective cohort study up to 8 years of follow-up.

PARTICIPANTS

A 70% random sample of the non-retired Finnish population aged 25-62 at the end of 2006 was included (n=1 727 644) and linked to data on sickness absences in 2005 and data on disability retirement in 2007-2014.

MAIN OUTCOME MEASURES

Cox proportional hazards regression was utilised to analyse the association of sickness absence with the risk of all-cause disability retirement during an 8-year follow-up.

RESULTS

The risk of disability retirement increased with increasing lengths of sickness absence in all occupational classes. A long sickness absence was a particularly strong predictor of disability retirement in upper non-manual employees as among those with over 180 sickness absence days the HR was 9.19 (95% CI 7.40 to 11.40), but in manual employees the HR was 3.51 (95% CI 3.23 to 3.81) in men. Among women, the corresponding HRs were 7.26 (95% CI 6.16 to 8.57) and 3.94 (95% CI 3.60 to 4.30), respectively. Adjusting for the diagnosis of sickness absence partly attenuated the association between the length of sickness absence and the risk of disability retirement in all employed groups.

CONCLUSIONS

A long sickness absence is a strong predictor of disability retirement in all occupational classes. Preventing the accumulation of sickness absence days and designing more efficient policies for different occupational classes may be crucial to reduce the number of transitions to early retirement due to disability.

Predictors of Depression and Musculoskeletal Disorder Related Work Disability Among Young, Middle-Aged, and Aging Employees

OBJECTIVE

The aim of this study was to investigate the level and predictors of work disability in different age groups.

METHODS

We followed young (18 to 34 years), middle-aged (35 to 50 years), and aging (>50 years) employees (n = 70,417) for 7 years (2005 to 2011) for all-cause and cause-specific work disability (sickness absence and disability pension). Using negative binomial regression, we obtained both relative risk estimates and absolute rates, that is, days of work disability per person-year.

RESULTS

The greatest relative difference in all-cause, and specifically depression-related work disability, was between young women and young men, and between employees with low versus high levels of education. Aging employees with a low education and chronic somatic disease had the highest levels of musculoskeletal disorder related work disability.

CONCLUSIONS

The predictors of work disability vary by age and diagnosis. These results help target age-specific measures for the prevention of permanent work disability.

Short sickness absence and subsequent sickness absence due to mental disorders - a follow-up study among municipal employees

Background

Mental disorders are common diagnostic causes for longer sickness absence and disability retirement in OECD-countries. Short sickness absence spells are also common, and neither trivial for health and work ability. We studied how prior short sickness absence spells and days are associated with subsequent longer sickness absence due to mental disorders in two age-groups of municipal employees during a 2-, 5- and 9-year follow-up.

Methods

The analyses covered 20–34 and 35–49-year-old employees of the City of Helsinki in 2004. Those with prior ≥14 day sickness absence in 2002, 2003 or 2004 were excluded. Women and men were pooled together. Short, 1–13-day sickness absence spells and days were calculated per the actual time of employment during 2004. Logistic regression analysis was used to calculate odds ratios (OR) and their 95% confidence intervals (CI) for the subsequent long (≥14 days) sickness absence due to mental disorders during three follow-ups.

Results

The risk for long sickness absence due to mental disorders increased with increasing amount of short sickness absence spells and days. 3 or more short sickness absence spells and 8–14 sickness absence days from short spells in 2004 were strongly associated with subsequent long sickness absence in all three follow-ups. The associations were strongest for the 2-year follow-up; the younger employees tended to have higher risks than the older ones.

Conclusions

Three spells or 8 days of short sickness absence per year constitutes a high risk for subsequent long sickness absence due to mental disorders and preventive measures should be considered.