In sickness or in health? Register-based evidence on partners' mutual receipt of sickness allowance and disability pension.

Studies on partners' mutual receipt of benefits constitute a growing research field in the way individual health and health-related decisions depend on social relations. This paper provides the first study on the mutual receipt of sickness allowance. We analysed married and cohabiting couples' receipt of sickness allowance and disability pension by estimating discrete-time hazard models for individuals aged 40-65 years, using longitudinal register data from Finland. The data cover the period 1987-2011, and allowed us to explore socioeconomic and demographic variables at both the individual and couple level. We found strong and long-term interrelations in receipt behaviour and dependencies across benefit types. The risk of receiving sickness allowance increases by 50 per cent during the first years after the partner's first receipt of the same benefit, while the risk of receiving disability pension is twice as high even five years after the partner's receipt of the same. Women appear to be more instrumental than men in the production of health within the couple, even in a context of high level of state support, gender equality and female labour force participation. Their receipt of disability pension is more related to the male partner's receipt than vice versa. For sickness allowance receipt, the gender asymmetry is small. Mutual benefit receipt of benefits may relate not only to collateral health effects but also to shared preferences and partner selection. We cannot distinguish between the mechanisms. However, couples with more economic and social resources seem to be more efficient in joint decision making. Correlations are particularly strong in the immediate term, and for couples who are highly educated, for those with high income, and for those with children in the household. More effective policies may be needed to equalise information regarding benefits, and monitor the use, and potential misuse, of these health benefits.

"I will never be the granny with rosy cheeks": perceptions of aging in precarious and financially secure middle-aged Germans.

Nowadays people are growing old in a context where youth culture is the norm and where self-initiative is required in order to prepare for a good old age. However, planning old age may be more difficult for certain social groups with insecure work and living conditions. Precariousness, defined as bad financial conditions but also as having an insecure, unpredictable existence, has been little studied in the context of aging. This study brings its contribution by exploring how middle-aged adults with different social security backgrounds (insurance versus no insurance) think about aging. Episodic interviews were conducted to explore their concepts of aging, contexts of thinking about aging and perceptions of aging. These were compared between groups who have a secure old age ahead of them (N=10) versus those who have to struggle with an uncertain present and future (N=10). Also, differences between men (N=11) and women (N=9) were addressed. Results of the thematic analysis showed the predominance of fears related to aging as well as an emerging meaninglessness attached to old age. Starting from the different images of aging found in the two studied groups, the need for tailored interventions and policy are discussed.

The push and pull factors related to early retirees’ mental health status: a comparative study between Italy and Spain / Los factores que empujan y atraen a la jubilación anticipada y sus relaciones con la salud mental: un estudio comparativo entre Italia y España

In recent years, early retirement has attracted increasing attention in the literature. Using a larger Italian- Spanish sample, this study examines the push and pull factors related to early retirees’ mental health status, as well as the moderating effects of perceived self-efficacy on the relationships between reasons for early retirement and mental health. Analyses revealed that poor retirees’ mental health is positively correlated to the push factor Pressure from Employer and negatively related to the pull factor Pursue Own Interests. Thus, mental health status is better for Italian retirees than for their Spanish counterparts. The Italian sample shows that Pursue Own Interests was negatively related to poorer mental health particularly under the low self-efficacy condition. Findings suggest that mental health depends on both the motivating reasons that lead people to retire early and the personal resources available to them to manage this psychosocial transition (AU)

El interés por el estudio de la jubilación anticipada se ha incrementado en los últimos años. Utilizando una muestra ítalo-española este estudio examina los factores que empujan y atraen a la jubilación anticipada y sus relaciones con la salud mental, así como los efectos moderadores de la auto-eficacia en dichas relaciones. Los resultados muestran una relación positiva entre los peores niveles de salud mental y el factor de empuje Presión del Empleador y una relación negativa con el factor de atracción Perseguir Intereses Propios. Así, el estado de salud mental es mejor para los jubilados italianos que para sus homólogos españoles. En la muestra italiana Perseguir Intereses Propios se relaciona negativamente con los peores niveles de salud mental en la condición de baja auto-eficacia. Los resultados sugieren que la salud mental depende de las razones que motivan hacia la jubilación anticipada y los recursos personales para afrontar esta transición psicosocial (AU)

Annuity and lump-sum decisions in defined benefit plans: the role of plan rules.

Amidst growing concerns about workers outliving their retirement savings, a key question-both as a matter of national retirement policy and understanding the potential role of plan design and education in influencing individual decision-making-is how many retiring workers actually choose to annuitize (to take a stream of lifetime income) vs. opting for a lump-sum payment. The key finding of this study is that differences in defined benefit (DB) plan rules or features result in very different annuitization rates in DB plans. In fact, the results show that the rate of annuitization varies directly with the degree to which plan rules restrict the ability to choose a partial or lump-sum distribution. This study shows that annuitization rates vary significantly across these different plan types, which makes any attempt to combine the annuitization rates across these different plan types uninformative. Combining all the plans across the years 2005-2010, workers who made their payout decision between ages 50 and 75 had a minimum job tenure of five years, a minimum account balance of $5,000, and had an annuitization rate of 65.8 percent. But within this group of workers, those who had no plan restrictions on a lump-sum distribution had an annuitization rate of only 27.3 percent. In all the years studied, plans with no lump-sum distribution (LSD) options have the highest annuitization rates, very close to 100 percent. Traditional defined benefit and cash balance plans with no restrictionson LSDs had the lowest annuitization rates. In 2010, the annuitization rate for all plans combined was 65.5 percent, while for plans with no LSD option it was 98.8 percent, but the annuitization rate for defined benefit plans with no restrictions on LSDs was 44.3 percent, while for cash balance plans with no restrictions on LSDs it was 22.3 percent. For older workers across most plan types, annuitization rates increase steadily with account balance, but this is not the case for younger workers. Annuitization rates also increase with tenure, but for younger workers (20-50) with low tenure (less than 10 years), annuitization rates are very low. For older workers (50-75), annuitization rates are higher even in cases of low tenure. Annuitization rates are very low for those below age 40, but from that point onwards, annuitization rates increase for all types of plans. Annuitization rates appear to peak between 65 and 69, but then fall sharply.

Individual retirement account balances, contributions, and rollovers, 2010: the EBRI IRA database.

In 2010, IRA owners were more likely to be male, especially those whose accounts originated from a rollover or were a SEP/SIMPLE. Among all IRA owners in the database, nearly one-half (45.8 percent) were ages 45-64. The average and median IRA account balance in 2010 was $67,438 and $17,863, respectively, while the average and median IRA individual balance (all accounts from the same person combined) was $91,864 and $25,296. Individuals with a traditional-originating from rollovers had the highest average and median balance of $123,426 and $38,138, respectively. Roth owners had the lowest average and median balance at $22,437 and $11,471. The average and median individual IRA balance increased with age through age 70. The average amount contributed to an IRA in the database was $3,335 in 2010. The average contribution was highest for accounts owned by those ages 65-69, and more contributions were made to Roth accounts than to traditional accounts (both those originating from contributions and rollovers). However, the average contribution to a traditional account was higher, at $3,517, compared with $3,240 to a Roth account. Yet, a higher overall amount was contributed to Roths ($2.3 billion for Roths compared with $1.3 billion for traditional accounts). Focusing on those owning traditional or Roth IRAs, 9.3 percent of the accounts received contributions, and 12.1 percent of the individuals owning these IRA types contributed to them in 2010. Among traditional IRA owners, 5.2 percent contributed, while 24.0 percent of those owning a Roth contributed to it during 2010. Of those individuals contributing to an IRA, 43.5 percent contributed the maximum amount. Of those contributing to a traditional IRA, 48.7 percent maxed out their contribution, while 39.3 percent did so with a Roth. The average and median account balances increased from $54,863 and $15,756 respectively in 2008 to $67,438 and $17,863 in 2010. This represents an increase of 22.9 percent in the average account balance and 13.4 percent in the median balance. The total individual balances also increased for both the average (32.2 percent) and the median (26.2 percent).

Using administrative sickness absence data as a marker of future disability pension: the prospective DREAM study of Danish private sector employees.

OBJECTIVES: The aim of this study was to examine duration of sickness absence as a risk marker for future disability pension among all private sector employees in Denmark 1998-2004. METHODS: All private sector employees receiving sickness absence compensation from the municipality in 1998, a total of 225 056 persons (39.2% women 61.8% men, age range 18-65, mean age 37.2), were followed in a national register to determine granted disability pension during the period 1 January 2001 through 31 December 2004. The authors excluded pensions in 1999 and 2000 to determine the status of sickness absence duration as an early risk marker. RESULTS: 5694 persons (2.5%) received disability pension during follow-up, more men (53.4%) than women (46.6%). There was a strong graded association between increasing length of absence and increasing risk of future disability pension. Significant differences were found between the younger and older age strata: men below 40 experiencing more than 26 weeks of sickness absence had a 16-fold risk of disability pension. The corresponding figure for men 40 years or older was approximately 7. For women, the corresponding figures were 12.6 and 6.7 respectively. CONCLUSION: The findings suggest that administratively collected data on sickness absence compensation are an important predictor of disability pension among private sector employees. The use of information on sick leave may improve the effectiveness of early interventions by policy makers, case managing authorities, employers and physicians.

The prognosis for individuals on disability retirement. An 18-year mortality follow-up study of 6887 men and women sampled from the general population.

BACKGROUND: Several studies have shown a markedly higher mortality rate among disability pensioners than among non-retired. Since most disability pensions are granted because of non-fatal diseases the reason for the increased mortality therefore remains largely unknown. The aim of this study was to evaluate potential explanatory factors. METHODS: Data from five longitudinal cohort studies in Sweden, including 6,887 men and women less than 65 years old at baseline were linked to disability pension data, hospital admission data, and mortality data from 1971 until 2001. Mortality odds ratios were analyzed with Poisson regression and Cox's proportional hazards regression models. RESULTS: 1,683 (24.4%) subjects had a disability pension at baseline or received one during follow up. 525 (7.6%) subjects died during follow up. The subjects on disability pension had a higher mortality rate than the non-retired, the hazards ratio (HR) being 2.78 (95%CI 2.08-3.71) among women and 3.43 (95%CI 2.61-4.51) among men. HR was highest among individuals granted a disability pension at young ages (HR >7), and declined parallel to age at which the disability pension was granted. The higher mortality rate among the retired subjects was not explained by disability pension cause or underlying disease or differences in age, marital status, educational level, smoking habits or drug abuse. There was no significant association between reason for disability pension and cause of death. CONCLUSION: Subjects with a disability pension had increased mortality rates as compared with non-retired subjects, only modestly affected by adjustments for psycho-socio-economic factors, underlying disease, etcetera. It is unlikely that these factors were the causes of the unfavorable outcome. Other factors must be at work.

Disability in society-medical and non-medical determinants for disability pension in a Norwegian total county population study.

The objective of this study was to describe sociomedical determinants and developments for the medically based disability pension in Norway by linking individual based data from a county health survey to data on disability from the National Insurance Administration. Two cross-sectional total population health surveys with an approximate 10-year interval were conducted in Nord-Trøndelag county, HUNT I (1984-86) and HUNT II (1995-97), which allows for analyses of changes over time, supplied with official incidence data on disability pension. The large-scale variations and overall increasing incidence rates of disability pension in Norway during the last 20 years also applied to the county of Nord-Trøndelag. The prevalence of disability pension generally increased in the population from the mid-1980s to the mid-1990s. A striking finding was a consistent pattern of increasing prevalence of disability pension with decreasing socio-economic status and education. A geographic pattern for disability pension prevalence on a municipality level suggested that structural and cultural factors were important in determining the level of disability in society. Medical determinants alone cannot explain either the dramatic variations or the overall increased incidence rates of disability pension in the last two decades in Norway. The results demonstrate the importance of social, non-medical and contextual determinants for disability pension, how these determinants result in important prevalence differences by socio-economic status, and their impact on the level of disability in society.

Retirement savings plans for radiologists, part 2: a comparison of academic and private practice retirement benefits.

A survey on retirement benefits was conducted involving 42 academic radiology departments and 42 private practice radiology groups. In this article, we present and discuss the survey results and provide recommendations for improving the retirement benefits for radiologists in both private practice and academic settings. A previous article, in last month's issue, provides details of how the various retirement plans mentioned in this article operate.

Retirement benefits as a recruitment tool.

Using data from "Retirement Plan Trends in Today's Healthcare Market-2003," a new report, this gatefold shows how hospitals can use retirement benefits to attract and retain staff, a matter of vital importance as the U.S. work force ages.

Time trends in disability pensioning for rheumatoid arthritis, osteoarthritis and soft tissue rheumatism in Norway 1968-97.

AIMS: Disability pensioning with musculoskeletal diagnoses increased more than general disability pensioning in Norway during 1968-97. Incidences of disability pensioning for three main musculoskeletal diseases - rheumatoid arthritis, osteoarthritis and soft tissue rheumatism - during the period 1968-97 were assessed. Changes in incidence were related to changes in Norwegian society with respect to prevalence of these diseases, the number of individuals having high probability of disability pensioning for these diseases, the labour market and legal amendments that may have changed the probability of being granted a disability pension among these patients. METHODS: Data on all new disability pensioners aged 50-66 years registered by the National Insurance Administration during 1968-97 and the total population of Norway excluding disability pensioners were used to calculate annual incidence rates of disability pension for the selected musculoskeletal diagnoses. RESULTS: The incidence of disability pension for soft tissue rheumatism and osteoarthritis increased during the study period, and both increased more than the incidence of disability pension in general. The incidence of disability pension for rheumatoid arthritis decreased when compared with disability pensioning in general. The year an upward or downward trend started is similar for osteoarthritis and soft tissue rheumatism for men and women in the age groups studied. CONCLUSION: Changes in prevalence of a disease seem to be an important factor in explaining differences in time trends of disability pensioning with different diagnoses. Changes in unemployment, female employment, number of manual workers or the legal system do not appear to be related to the increases in incidence of disability pensioning with musculoskeletal diseases.