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1.
BMC Public Health ; 24(1): 735, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38454363

RESUMO

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.


Assuntos
Pessoas com Deficiência , Expectativa de Vida , Masculino , Humanos , Feminino , Aposentadoria , Desemprego , Pensões , Fatores Socioeconômicos
2.
Injury ; 55(4): 111480, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38452702

RESUMO

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.


Assuntos
Traumatismos Craniocerebrais , Pessoas com Deficiência , Adulto , Humanos , Estudos de Coortes , Estudos Prospectivos , Licença Médica , Pensões , Classe Social , Fatores de Risco
3.
BMC Geriatr ; 24(1): 265, 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38500023

RESUMO

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.


Assuntos
Pensões , Pobreza , Humanos , Masculino , Idoso , China/epidemiologia , População Rural , Comportamentos Relacionados com a Saúde , Açúcares
4.
Sante Publique ; 35(6): 65-85, 2024 02 23.
Artigo em Francês | MEDLINE | ID: mdl-38388403

RESUMO

Introduction: Benefiting from the disability pension implies morbid (physical and psychological) and social (fall in income) implications for the person. It also has economic consequences for society, with increasing expenses since 2011 (+4.9% on average per year). Investing in preventive actions against the loss of the ability to work should limit these consequences, but it requires targeting people at risk. The development of artificial intelligence opens up prospects in this regard. Purpose of the Research: To target, using supervised machine learning methods, those people with a high probability of becoming eligible for the disability pension over the course of the year based on their socio-demographic and medical characteristics (pathologies, work stoppages, drugs taken, and medical procedures). Method: Among the beneficiaries of the French public welfare system aged 20­64 in 2017, we compared the socio-demographic and medical characteristics between 2014 and 2016 of those who received a disability pension in 2017 and not before, and those who did not receive a disability pension from 2014 to 2017. The determination of the boundary between these two groups was tested using logistic regression, decision trees, random forests, naive Bayes classifiers, and support vector machines. The models' performance was compared with respect to accuracy, precision, sensitivity, specificity, and AUC (area under the curve). Finally, the predictive power of each factor was measured by AUC too. Results: The boosted logistic regression had the best performance for three of the five criteria, but low sensitivity. The best sensitivity was obtained with the support vector machines, with an accuracy close to that of the boosted logistic regression, but a lower precision and specificity. Random forests offered the best discriminatory ability. The naive Bayes classifier had the worst performance. The most predictive factors in becoming eligible for the disability pension were having 30 days or more off sick in 2014, 2015, and 2016 and being aged 55 to 64. Conclusion: Supervised learning methods have appeared relevant for identifying people with the highest probability of becoming eligible for the disability pension and, more broadly, for steering public and social policies.


Introduction: Le recours à la pension d'invalidité a des implications morbides (physiques ou psychiques) et sociales (baisse du revenu). Il a aussi des conséquences économiques pour la société, avec des dépenses croissantes depuis 2011 (+4,9 % en moyenne par année). Prévenir la perte de la capacité à travailler devrait permettre de limiter ces conséquences, mais nécessite de cibler les personnes à risque. Le développement des méthodes d'intelligence artificielle ouvre des perspectives en ce sens. But de l'étude: Cibler les personnes ayant une « forte ¼ probabilité de devenir bénéficiaires d'une pension d'invalidité dans l'année au regard de leurs caractéristiques sociodémographiques et médicales (pathologies, arrêts de travail, médicaments et actes médicaux) à partir de méthodes d'apprentissage automatique supervisé. Méthodes: Parmi les bénéficiaires du régime général âgés de 21 à 64 ans en 2017, comparaison des caractéristiques de 2014 à 2016 entre les nouveaux bénéficiaires d'une pension d'invalidité en 2017 et ceux n'en bénéficiant pas. La détermination de la frontière entre ces deux groupes a été testée à l'aide de la régression logistique, des arbres de décision, des forêts aléatoires, de la classification naïve bayésienne et des séparateurs à vaste marge. Les performances des modèles ont été comparées au regard de la justesse, la précision, la sensibilité, la spécificité et l'AUC (Area Under the Curve). Le pouvoir prédictif de chaque facteur est estimé à partir de l'AUC. Résultats: La régression logistique boostée avait les meilleures performances sur trois des cinq critères retenus, mais une faible sensibilité. La meilleure sensibilité était obtenue avec les séparateurs à vaste marge, avec une justesse proche de la régression logistique boostée mais une précision et une spécificité inférieures. Les forêts aléatoires offraient la meilleure capacité discriminatoire. Les facteurs les plus prédictifs du risque de passer en invalidité étaient le bénéfice d'au moins 30 jours d'indemnités journalières pour maladie en 2014, 2015 et 2016 et le fait d'être âgé de 55 à 64 ans. Conclusion: Les méthodes d'apprentissage supervisé sont apparues pertinentes pour le ciblage des personnes les plus à risque de recourir à la pension d'invalidité et, plus largement, pour le pilotage d'autres prestations sociales.


Assuntos
Inteligência Artificial , Pensões , Humanos , Teorema de Bayes , Aprendizado de Máquina , Fatores de Risco
5.
Prev Med ; 181: 107916, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38403033

RESUMO

OBJECTIVE: Specific information for whom and when cardiorespiratory fitness (CRF) is associated with depression risk is lacking. We aimed to study the association between adulthood CRF and incident depression, long-term sickness absence, and disability pension due to depression, as well as examine moderation of sex, age, education, and occupation on associations. METHODS: A large prospective cohort study follows participants over time with Swedish occupational health screenings data. The study includes 330,247 individuals (aged 16-79 years, 46% women) without a depression diagnosis at baseline. CRF was estimated from a submaximal cycle test. RESULTS: CRF was associated beneficially from low to higher levels with incident depression and long-term sickness absence due to depression. Further, CRF at high levels (≥46 ml/min/kg) was associated with a decreased risk of receiving disability pension due to depression. The associations remained after adjustment for age and sex, but not lifestyle-related factors and co-morbidity. Participants with moderate and high CRF had 16% and 21%, respectively, lower risk for incident depression, and participants with high CRF had 11% lower risk for long-term sickness absence due to depression. Associations between higher CRF and the outcomes were mainly evident in men, younger participants, and individuals with low education. CONCLUSION: In a large sample of adults without a depression diagnosis at baseline, higher CRF was shown to be beneficially related to the risk of incident depression and, to some extent, long-term sickness absence due to depression. If causal, targeted interventions focusing on increasing CRF in these sub-groups should be prioritized.


Assuntos
Aptidão Cardiorrespiratória , Adulto , Masculino , Humanos , Feminino , Estudos Prospectivos , Fatores de Risco , Depressão/epidemiologia , Pensões , Licença Médica
6.
Pain Res Manag ; 2024: 4953758, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38327724

RESUMO

Background: Treatment of persistent spinal pain syndrome (PSPS) is challenging. Chronic pain associated with PSPS can lead to an impaired ability to work. Objective: To obtain information on whether receiving a disability pension (DP) affects pain and pain treatments in retiring working-age PSPS patients. Neuropathic pain medication and antidepressant use were considered as an indicator of neuropathic pain. Methods: The study group comprised 129 consecutive PSPS patients with spinal cord stimulation (SCS) devices implanted at Kuopio University Hospital Neurosurgery between January 1, 1996, and December 31, 2014. Purchase data of gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors from January 1995 to March 2016, as well as the data on working ability, were retrieved from national registries. Results: The data showed that 28 of 129 (21.7%) SCS permanent patients had a DP, and 27 had a sufficient follow-up time (two years before and one year after DP). Most patients (61%) used neuropathic pain medications during the follow-up, while 44% used antidepressants. Most patients (70%, n = 19) retired because of dorsopathies. The dose of gabapentinoids started to increase before the DP; after the DP, the doses started to increase again after the decrease but remained at a lower level. Conclusions: Neuropathic pain medication and antidepressant use suggest that pain continues after the DP-that is, pensioners continue to experience inconvenient chronic pain. Resources for patient care are therefore needed after the DP. However, the DP reduces the dose increase of gabapentinoids; the dose is higher immediately before retirement than at the end of the follow-up.


Assuntos
Dor Crônica , Neuralgia , Estimulação da Medula Espinal , Humanos , Dor Crônica/terapia , Neuralgia/tratamento farmacológico , Neuralgia/etiologia , Antidepressivos/uso terapêutico , Pensões , Medula Espinal , Resultado do Tratamento
7.
Prev Med ; 180: 107858, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38228251

RESUMO

The purpose of the study was to investigate to which extent a healthy lifestyle in female healthcare workers with chronic pain contributes to reducing the risk of disability pension. We conducted a prospective cohort study with an 11-year registry follow-up. Overall, 2386 Danish female healthcare workers with chronic pain completed a questionnaire about work and lifestyle (leisure-time physical activity, smoking, and body mass index (BMI)). Data on disability benefit payments were obtained from the Danish Register for Evaluation of Marginalization. Two models (minimally and fully adjusted for different potential confounders) were tested using the Cox proportional hazards model. During the follow-up period, 17.9% of the healthcare workers obtained disability pension. Low levels of leisure time physical activity (reference: moderate level) increased the risk of disability pension in the minimally (Hazard Ratio: 1.38 (95% CI: 1.14-1.69)) and fully adjusted models (Hazard Ratio: 1.27 (95% CI: 1.04-1.56)). Being highly physically active, as opposed to being moderately active, did not confer additional protection. Additionally, a positive association was observed between smoking and disability pension in the minimally adjusted model (Hazard Ratio: 1.27 (95% CI: 1.05-1.54)). BMI was not an influential factor. In female healthcare workers with chronic pain, at least moderate levels of physical activity is a protective factor for disability pension. Effective promotion strategies should be designed for both workplace and non-workplace settings.


Assuntos
Dor Crônica , Pessoas com Deficiência , Humanos , Feminino , Estudos Prospectivos , Seguimentos , Dor Crônica/epidemiologia , Pensões , Inquéritos e Questionários , Estilo de Vida Saudável , Fatores de Risco , Modelos de Riscos Proporcionais
8.
BMC Health Serv Res ; 24(1): 74, 2024 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-38225557

RESUMO

BACKGROUND: This study aimed to describe sequences of vocational rehabilitation services among individuals with approved vocational rehabilitation in Germany and to identify typical service sequences. METHODS: We used administrative data on vocational rehabilitation services and questionnaire data on health and work ability to describe frequencies and sequences of vocational rehabilitation services financed by the Federal German Pension Insurance. Through sequence analysis, we were able to map the service sequences. We did cluster analyses to identify typical different service sequences. RESULTS: Our sample included 1,652 individuals with 2,584 services. Integration services and two-year vocational retraining were the most common services. We could identify three different service clusters around integration services: shorter ones, followed by employer benefits and without employer benefits. We found two different clusters around two-year vocational retraining: shorter and longer clusters. Two-year vocational retraining was more often initiated by preparatory services and followed by employer benefits than integration services. Longer services in both clusters were associated with better baseline data for physical health, work ability, risk of future work disability, and younger age than shorter services. People in two-year-vocational retraining reported at baseline better general health, better work ability, low risk of future work disability, and less mental illness compared to people in integration services. CONCLUSIONS: Multiple services, that is, sequences of services, were more likely to occur among individuals with more complex services like two-year vocational retraining. Utilization of complex services and longer services was influenced by health, age, risk of future work disability, and education. TRIAL REGISTRATION: German Clinical Trials Register DRKS00009910, registration 25/01/2016.


Assuntos
Pessoas com Deficiência , Seguro , Humanos , Reabilitação Vocacional , Estudos de Coortes , Pensões , Alemanha
9.
Gesundheitswesen ; 86(3): 182-191, 2024 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-38242157

RESUMO

BACKGROUND: The age-standardized application rate for medical rehabilitation services of the German Pension Insurance Association has been declining since 2009. Two of the most frequent reasons for applying for rehabilitation services represent musculoskeletal disorders and mental disorders. The aim of this analysis was to identify factors influencing the utilization of rehabilitation services in the federal states of Berlin and Brandenburg. METHODS: The explorative time series analysis is based on a research dataset of the German Pension Insurance Federation. Insured persons of the German Pension Insurance Federation from the federal states of Berlin and Brandenburg with a diagnosis of musculoskeletal disorders or mental disorders were included. Descriptive differences in targeted and prognostic parameters were calculated using chi-square and t-test statistics. Predictive parameters for the utilization of medical rehabilitation services were calculated using binary, logistic regression analyses. RESULTS: A total of 11,257 insured cases were examined. For the population of insured persons from Berlin, the use of medical rehabilitation services showed significant prognostic variables for gender, age at retirement, marital status, level of education, occupational requirement level, total accumulated earning points, gross pension level, status of a temporary pension, health insurance status, and diagnosis group. For Brandenburg, significant prognostic variables were found for age at retirement, marital status, nationality, education level, occupational requirement level, total accumulated earning points, status of a temporary pension, occupational sector, and diagnosis group. CONCLUSION: In Berlin and Brandenburg mental disorders and sociodemographic parameters are associated with an increased probability of not claiming medical rehabilitation services before the onset of reduced earning capacity. It remains to be investigated which mechanisms cause people with mental disorders to make no use of medical rehabilitation services. Future analyses should examine isolated interaction mechanisms for the utilization of medical rehabilitation services, especially in the case of existing F-diagnoses. In addition, explanations for different influencing variables between states remain to be explored.


Assuntos
Pessoas com Deficiência , Seguro , Doenças Musculoesqueléticas , Humanos , Berlim , Fatores de Tempo , Alemanha/epidemiologia , Pessoas com Deficiência/reabilitação , Pensões
10.
Mult Scler ; 30(3): 419-431, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38243631

RESUMO

BACKGROUND: Disease-modifying therapies (DMTs) have led to improved health and work productivity among people with multiple sclerosis (PwMS). OBJECTIVES: To describe trajectories of recent DMT use and their association with sickness absence and/or disability pension (SADP) among PwMS in Sweden. METHODS: A longitudinal register-based study was conducted among 1395 PwMS with treatment start in 2014/2015. While DMT use over 5 years was assessed using sequence analysis resulting in four clusters, a 7-year (Y-2 toY4) trend of SADP was analyzed using zero-inflated negative binomial regression. RESULTS: Four clusters of DMT use trajectories were identified: long-term non-high-efficacy (483, 34.6%), long-term high-efficacy (572, 41%), escalation (221, 15.8%), and discontinuation (119, 8.5%). Progressive MS and higher expanded disability status scale scores were associated with the escalation, long-term high-efficacy, or discontinuation clusters. PwMS in the long-term high-efficacy and escalation clusters had higher likelihood of being on SADP. However, PwMS initiating high-efficacy DMTs demonstrated steeper decline in SADP than others. CONCLUSION: Using sequence analysis, this study showed recent DMT use trajectories among PwMS where initiation of high-efficacy DMTs has become more common. The trend of SADP was stable and lower in those using non-high-efficacy DMTs and larger improvements were shown in those initiating high-efficacy DMTs.


Assuntos
Azidas , Esclerose Múltipla , Humanos , Esclerose Múltipla/terapia , Suécia , Pensões , Estudos Longitudinais
11.
Eur Child Adolesc Psychiatry ; 33(3): 897-907, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37115278

RESUMO

Little is known about the association between common mental disorders (CMD) and labor market integration among refugee and Swedish-born young adults. Socially disadvantaged patients such as refugees are more likely to discontinue their medication use prematurely. This study aimed to identify clusters of individuals with similar psychotropic medication patterns; and examine the relationship between cluster membership with labor market marginalization (LMM) in refugee and Swedish-born young adults with CMD. The study uses a longitudinal matched cohort aged 18-24 years with CMD diagnoses from Swedish registers covering 2006-2016. Dispensed psychotropic medications (antidepressants, antipsychotics, anxiolytics, sedative-hypnotics, mood stabilizers) were collected one year before and after CMD diagnosis. Clusters of patients with similar time courses of prescribed dosages were algorithmically identified. The association of cluster membership with subsequent LMM, (long-term sickness absence, SA, disability pension, DP, or long-term unemployment, UE) was assessed using Cox regression. Among 12,472 young adults with CMD, there were 13.9% with SA, 11.9% with DP, and 13.0% with UE during a mean follow-up of 4.1 years (SD 2.3 years). Six clusters of individuals were identified. A cluster with a sustained increase in all medication types yielded the highest hazard ratio (HR [95% CI]) 1.69 [1.34, 2.13] for SA and 2.63 [2.05, 3.38] for DP. The highest HRs of UE give a cluster with a concentrated peak in antidepressants at CMD diagnosis (HR 1.61[1.18, 2.18]). Refugees and Swedish-born showed similar associations between clusters and LMM. To prevent LMM, targeted support and early assessment of CMD treatment are needed for individuals with a sustained increase in psychotropic medication after CMD diagnosis and for refugees in high-risk clusters for UE characterized by a rapid lowering of treatment dosages, which could be an indicator for premature medication discontinuation.


Assuntos
Transtornos Mentais , Refugiados , Humanos , Adulto Jovem , Suécia/epidemiologia , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Transtornos Mentais/complicações , Pensões , Psicotrópicos/uso terapêutico , Antidepressivos/uso terapêutico
12.
Int J Health Plann Manage ; 39(2): 571-582, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37957707

RESUMO

Delayed retirement initiative proposed in China attaches greater importance to the sustainability of pension systems and the labour shortage, but less to the health status of older people. The existing social health insurance and pension system are not well established to match this initiative. This study investigates the policy mix of delayed retirement, employment-based social health insurance, social pension participation for health status of older people. Results of the data from the China Health and Retirement Longitudinal Study (CHARLS-2018) show that late retirement could benefit health status among older adults. Moreover, such effect of late retirement appears more salient for those uninsured by employment-based social health insurance and those still in the pension contribution phase upon reaching the statutory retirement age. Hence, in countries with inadequate health insurance and pension systems, such as China, delayed retirement may serve as an important alternative to social security for the health of older people.


Assuntos
Aposentadoria , Previdência Social , Humanos , Idoso , Estudos Longitudinais , Seguro Saúde , Pensões , Nível de Saúde , Políticas
13.
Int Arch Occup Environ Health ; 97(1): 45-55, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37971680

RESUMO

OBJECTIVE: Understanding the impact of physical capacity in combination with high physical workload could be beneficial for the prevention of health-related exits from work. Therefore, the aim of this study was to investigate the separate and combined effects of low cardiorespiratory fitness and high physical workload on disability pension (DP) due to any cause, musculoskeletal disorders (MSD), and cardiovascular diseases (CVD). METHODS: A total of 279 353 men born between 1951 and 1961 were followed regarding DP between 2006 and 2020, ages 45-64. Cardiorespiratory fitness was assessed during military conscription, using an ergometer bicycle test. Physical workload was based on a job-exposure matrix (JEM) linked to occupational title in 2005. Cox regression models estimated separate and combined associations with DP. RESULTS: Low cardiorespiratory fitness and high physical workload were associated with increased risk of DP. For all cause DP, the fully adjusted hazard ratio and 95% confidence interval for those with low cardiorespiratory fitness was 1.38 (1.32-1.46) and for those with high physical workload 1.48 (1.39-1.57). For all cause and MSD DP, but not for CVD DP, the combination of low cardiorespiratory fitness and high physical workload resulted in higher risks than when adding the effect of the single exposures. CONCLUSION: Both low cardiorespiratory fitness in youth and later exposure to high physical workload were associated with an increased risk of DP, where workers with the combination of both low cardiorespiratory fitness and a high physical workload had the highest risks (all-cause and MSD DP).


Assuntos
Aptidão Cardiorrespiratória , Doenças Cardiovasculares , Doenças Musculoesqueléticas , Masculino , Adolescente , Humanos , Estudos de Coortes , Suécia/epidemiologia , Carga de Trabalho , Seguimentos , Fatores de Risco , Pensões , Doenças Cardiovasculares/epidemiologia , Doenças Musculoesqueléticas/epidemiologia , Aptidão Física
14.
J Gerontol Soc Work ; 67(2): 157-177, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37483074

RESUMO

The Aid and Attendance (A&A) benefit is a cash entitlement for Veterans who served in the U.S. military to obtain personal care services. Our objective was to identify factors contributing to variation in A&A enrollment across VA Medical Centers (VAMCs). We used VA data to calculate the enrollment rate among older Veterans receiving a VA pension or compensation in 2015, then purposefully sampled social work leaders at 15 VAMCs with the highest (n = 7) and lowest (n = 8) enrollment rates for interviews. All respondents viewed A&A as an important benefit. Participants at high-enrollment sites indicated strong working relationships with Veterans Benefits Administration (VBA) and Veterans Service Organizations (VSOs) with onsite presence and education about A&A facilitate access. Participants at low-enrollment sites indicated they desired education around A&A eligibility criteria and collaboration with VBA/VSOs. VA and non-VA social workers would benefit from education about VBA's benefits, and this requires collaboration with VBA representatives.


Assuntos
Veteranos , Estados Unidos , Humanos , Assistentes Sociais , United States Department of Veterans Affairs , Serviço Social , Pensões
15.
Econ Hum Biol ; 52: 101330, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38043187

RESUMO

Prolonged and active old age provides individuals with more chances to work again after full retirement. Returning to work is an increasingly common form of the retirement process and influences the sustainability of social security systems. Previous studies show a beneficial relationship between returning to work and health; however, little is known about the causal effect of returning to work on health. This study used data from men and women aged 50 and older (11,991 individuals) in the Longitudinal Survey of Middle-aged and Older Adults, conducted annually from 2005 to 2019 in Japan. The effects of three types of labor force transitions (continued work, full retirement, and return to work) on physical and mental health were examined. To obtain the causal effects, an instrumental variable approach was used by exploiting the Japanese pension reform and labor market settings as instruments. Compared with full retirement, returning to work showed significantly worse mental health but no significant difference in physical health. The negative effect of returning to work was pronounced among men, former nonmanual workers, and low-wealth individuals. Contrary to the findings in previous studies, insignificant or detrimental effects of returning to work were found in this study. The rigorous causal analysis adds new evidence to the literature. The findings provide important implications for labor and health policy in aging societies.


Assuntos
Pensões , Aposentadoria , Masculino , Pessoa de Meia-Idade , Humanos , Feminino , Idoso , Japão/epidemiologia , Estudos Longitudinais , Emprego
16.
Salud Publica Mex ; 65(5, sept-oct): 434-445, 2023 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-38060910

RESUMO

OBJECTIVE: We examine the socioeconomic and health drivers of retirement decisions and compare these determinants between formal and informal sector workers in Mexico. MATERIALS AND METHODS: Using data from the Mexican Health and Aging Study 2012 and 2015, we estimate conditional probit models of retirement using sociodemographic, health, health care utilization, health insurance, private pensions, and social security systems covariates. The Institutional Review Board at the University of Southern California reviewed and approved the research (IRB # UP-15-00023). RESULTS: We find that the social security systems are an important determinant for retirement age for formal sector workers. The informal sector workers, who lack access to retirement benefits of the social security system, make retirement decisions mainly based on health and access to health insurance through social security. CONCLUSION: Despite the lack of access to social security benefits, informal sector workers do not respond strongly to socioeconomic factors in determining the timing of retirement. Strengthening access to better health care services could improve health, extend working lives, and promote healthy aging for workers in the informal sector.


Assuntos
Setor Informal , Aposentadoria , Humanos , México , Pensões , Fatores Socioeconômicos , Previdência Social
17.
Epidemiol Serv Saude ; 32(3): e2023294, 2023.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38055525

RESUMO

OBJECTIVE: To investigate association between depressive symptoms and receipt of retirement pensions or other pensions in the Brazilian population aged 50 years or older. METHOD: This was a cross-sectional study with participants from the baseline (2015-2016) of the Longitudinal Study of the Health of Elderly Brazilians. Depressive symptoms were measured by the eight-item Center for Epidemiologic Studies Depression Scale. Prevalence ratios (PR) were obtained by Poisson regression. RESULTS: Among the total 8,469 participants, 33.9% (95%CI 32.8;34.9) reported depressive symptoms and 52.8% (95%CI 51.8;53.9) of the participants received a retirement or other pension. Prevalence of depressive symptoms was lower among participants receiving a retirement or other pension (PR = 0.79; 95%CI 0.73;0.86). Association remained significant after adjustments for sociodemographic and health indicators (PR = 0.84; 95%CI 0.76;0.92). CONCLUSION: Participants who receive retirement or other pensions are less likely to report depressive symptoms. MAIN RESULTS: Prevalence of depressive symptoms was 33.9% in the population studied and, after adjusted analysis, it remained statistically lower among participants who received retirement or other pensions. IMPLICATIONS FOR SERVICES: Prevalence of depressive symptoms was higher in individuals who do not receive retirement or other pensions, which demands attention from health services in caring for this public in vulnerable situations regarding social security. PERSPECTIVES: Carrying out longitudinal studies capable of assessing the temporality of association between receiving retirement or other pensions and the mental health of the elderly, thus contributing to better knowledge about the social determinants of mental health.


Assuntos
Depressão , Pensões , Idoso , Humanos , Estudos Transversais , Depressão/epidemiologia , Brasil/epidemiologia , Estudos Longitudinais
18.
BMJ ; 383: 2869, 2023 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-38049173
19.
Rehabilitation (Stuttg) ; 62(6): 339-348, 2023 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-38056495

RESUMO

AIM OF THE STUDY: The present work is intended to give an overview of rehabilitation of patients with post COVID-19 condition covered by the German Pension Insurance in 2021. METHODS: Cross-sectional analysis of medical rehabilitation completed in 2021, in which COVID-19 sequelae were coded in first or second place in the uniform discharge report according to the International Statistical Classification of Diseases and Related Health Problems was carried out. The codes U08(.9), U09(.9) and U10(.9) as well as the corresponding codes from 2020 were taken into the evaluation as COVID-19-related diseases. Children's rehabilitation and oncological rehabilitation for pensioners and their relatives were excluded. Statistically, relative and absolute frequencies are given for nominal and ordinal variables, and median and quartiles for continuous, skewed distributed variables. RESULTS: 9,666 rehabilitations with one of the codes mentioned in first or second place remained. 54.8% of the patients were women and 43.2% men. The median age was 54 and 55 years (women/men). In all, 64.4% of the rehabilitations were carried out in the pulmonary medicine department. Owing to somatic indications, almost 50% of these patients in rehabilitation remained in the clinic beyond the regular approval period. The most common other diagnoses were diseases of the respiratory system. In 80.7% of those affected, the treating physicians considered the post-COVID-19 condition-associated symptoms as improved through rehabilitation. Furthermore, employment was subject to social security contributions for 88.0% of these patients, and 30.5% were employed in the fields of health, social affairs, teaching, and education. Of those affected, 63.8% were on sick leave when they were admitted, 63.0% when they were discharged. With regard to performance in the last job or on the general job market, over 90.0% received a prognosis for 6 hours and more. CONCLUSION: The importance of post-COVID-19 condition in the context of medical rehabilitation increased significantly over the course of 2021. The disease causes long periods of disability. With regard to performance, the available analyses give a positive picture; only 6.5% of those individuals undergoing rehabilitation were assessed as having a reduced capacity to earn of less than 3 hours on the general labor market.


Assuntos
Seguro , Pensões , Síndrome Pós-COVID-19 Aguda , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , COVID-19/complicações , COVID-19/economia , COVID-19/reabilitação , Estudos Transversais , Alemanha/epidemiologia , Seguro/economia , Síndrome Pós-COVID-19 Aguda/economia , Síndrome Pós-COVID-19 Aguda/epidemiologia , Síndrome Pós-COVID-19 Aguda/reabilitação
20.
BMC Public Health ; 23(1): 2493, 2023 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-38093210

RESUMO

BACKGROUND: Concussion may lead to persisting post-concussive symptoms affecting work ability and employment. This study examined the transitions between labour market states an individual can experience after the acute phase of concussion. The aim was to describe the incidence of favourable and adverse transitions between different labour market states (e.g., employment, sick leave) in relation to socioeconomic and health characteristics in individuals with concussion relative to matched controls. METHODS: This Danish nationwide register-based cohort study extracted 18-60-year-old individuals between 2003-2007 with concussion from the Danish National Patient Register (ICD-10 S06.0). Controls were matched on age, sex, and municipality. Patients and controls were followed for 5 years starting three months after injury. Exclusion criteria were neurological injuries and unavailability to the labour market in the inclusion period (2003-2007) and 5-years before injury (1998-2002). Labour market states were defined from transfer income data in the Danish Register for Evaluation of Marginalization. Incidence rates of transitions between these labour market states were analysed in multistate models. Transitions were bundled in favourable and adverse transitions between labour market states and the difference in incidence rates between individuals with concussion relative to matched controls were assessed with hazard ratios from Cox regression models. RESULTS: Persons with concussion (n = 15.580) had a lower incidence of favourable transitions (HR 0.88, CI 0.86-0.90) and a higher incidence of adverse transitions (HR 1.30, CI 1.27-1.35), relative to matched controls (n = 16.377). The effect of concussion differed depending on health and socioeconomic characteristics. Notably, individuals between 30-39 years (HR 0.83, CI 0.79-0.87), individuals with high-income (200.000-300.000 DKK) (HR 0.83, CI 0.80-0.87), and wage earners with management experience (HR 0.60, CI 0.44-0.81) had a markedly lower incidence of favourable transitions compared to controls. Additionally, individuals with high income also had a higher incidence of adverse transitions (HR 1.46, CI 1.34-1.58) compared to controls. CONCLUSIONS: Concussion was associated with enhanced risk of adverse transitions between labour market states and lower occurrence of favourable transitions, indicating work disability, potentially due to persistent post-concussive symptoms. Some age groups, individuals with high income, and employees with management experience may be more affected.


Assuntos
Concussão Encefálica , Síndrome Pós-Concussão , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Estudos de Coortes , Emprego , Concussão Encefálica/epidemiologia , Licença Médica , Dinamarca/epidemiologia , Pensões
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