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1.
J Aging Soc Policy ; 32(4-5): 488-498, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32538320

RESUMO

The COVID-19 economic crisis makes it vitally important that workers who earned defined benefit pensions receive them at retirement. Unfortunately, billions of dollars that could help cushion the financial shock are sitting unclaimed, because the people who they belong to cannot locate the company responsible for paying them. As defined benefit pension plans have been terminated, merged and moved over the years, large numbers of deferred vested participants have not been notified about their benefits. The widespread and growing practice of insurance company pension buy-outs can be especially problematic for participants without notice. Broader use of electronic disclosures for pensions also threatens to make the situation worse. In the wake of COVID-19, policy makers should take steps to ensure that pension benefits are part of the economic recovery.


Assuntos
Infecções por Coronavirus/epidemiologia , Pensões/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Aposentadoria/economia , Betacoronavirus , Recessão Econômica/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Pandemias , Previdência Social/organização & administração , Estados Unidos/epidemiologia
2.
BMC Public Health ; 20(1): 618, 2020 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-32370787

RESUMO

BACKGROUND: A maintained psychological wellbeing is important in order to continue working longer and remain active into older age. However, little is known about impact of different organizational factors, such as downsizing, on the mental health of older workers exiting the labor market. The aim in this study was to investigate trajectories of purchases of psychotropic drugs in relation to labor market exit later in life in a context with and without downsizing. METHOD: People living in Sweden, born 1941-1951, exiting paid work via unemployment, sickness absence/disability pension, or old-age pension were followed from 2005 to 2013 regarding purchases of psychotropic drugs. Individuals employed at a workplace closing down or downsizing with ≥18% between two subsequent years were compared to employees exiting from workplaces without downsizing or workplace closure. Generalized estimating equations was applied to derive trajectories of annual prevalence of purchased antidepressants, sedatives and anxiolytics from 4 years before to 4 years after a labour market exit. RESULTS: During the period around the exit, old-age retirees experiencing a downsizing/workplace closure did not decrease their purchases of sedatives (OR 1.01 95% CI 0.95-1.07) while the unexposed decreased their purchases during this period (OR 0.95 95% CI 0.92-0.98). Similar differences concerning sedatives and antidepressants between exposed and unexposed were seen for those exiting via sickness absence or disability pension. Furthermore, a significant difference in purchases of anxiolytics was observed between those exposed to downsizing (OR 1.10 95% CI 0.97-1.24) and the unexposed (OR 0.98 95% CI 0.91-1.06) exiting via old-age retirement during the time before the exit. CONCLUSION: Downsizing or workplace closure, although weakly, was associated with higher prevalence of psychotropic drugs certain years around the labor market exit. The results support the idea that involuntary labor market exit in mature adulthood may negatively affect the development of mental health.


Assuntos
Depressores do Sistema Nervoso Central/administração & dosagem , Pensões/estatística & dados numéricos , Aposentadoria/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Ansiolíticos/uso terapêutico , Antidepressivos/uso terapêutico , Depressores do Sistema Nervoso Central/uso terapêutico , Pessoas com Deficiência , Emprego/psicologia , Feminino , Humanos , Hipnóticos e Sedativos/uso terapêutico , Estudos Longitudinais , Masculino , Saúde Mental , Pessoa de Meia-Idade , Ocupações , Inovação Organizacional , Estudos Prospectivos , Aposentadoria/psicologia , Suécia , Desemprego/psicologia , Local de Trabalho
3.
J Laryngol Otol ; 134(5): 387-397, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32468973

RESUMO

BACKGROUND: Hearing loss affects over 1.3 billion individuals worldwide, with the greatest burden among adults. Little is known regarding the association between adult-onset hearing loss and employment. METHODS: Seven databases (PubMed, Embase, Cochrane Library, ABI/Inform Collection, Business Source Ultimate, Web of Science and Scopus) were searched through to October 2018. The key word terms used related to hearing loss and employment, excluding paediatric or congenital hearing loss and deaf or culturally deaf populations. RESULTS: The initial search resulted in 13 144 articles. A total of 7494 articles underwent title and abstract screening, and 243 underwent full-text review. Twenty-five articles met the inclusion criteria. Studies were set in 10 predominantly high-income countries. Seven of the 25 studies analysed regionally or nationally representative datasets and controlled for key variables. Six of these seven studies reported associations between hearing loss and employment. CONCLUSION: The highest quality studies currently available indicate that adult-onset hearing loss is associated with unemployment. However, considerable heterogeneity exists, and more rigorous studies that include low- and middle-income countries are needed.


Assuntos
Efeitos Psicossociais da Doença , Emprego/estatística & dados numéricos , Perda Auditiva/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Emprego/economia , Perda Auditiva/economia , Humanos , Pessoa de Meia-Idade , Pensões/estatística & dados numéricos , Pessoas com Deficiência Auditiva/estatística & dados numéricos , Desemprego/estatística & dados numéricos
5.
BMC Public Health ; 20(1): 165, 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32013933

RESUMO

BACKGROUND: Spirometry is widely used in medical surveillance in occupational health and as a diagnostic test for obstructive and restrictive lung disease. We evaluated the effect of spirometry parameters on the risk of all-cause disability pension in a follow-up study of an occupationally active general population-based cohort. METHODS: We measured the pulmonary function of 3386 currently working participants of the Health 2000 Survey in the clinical phase at baseline using spirometry. We obtained the retirement events of the cohort from the nationwide register for 2000-2011. Cox proportional hazards models were used to determine disability pensions. RESULTS: At baseline, we identified 111 (3.3%) participants with obstructive spirometry, 95 (2.8%) with restrictive spirometry, and 3180 controls without restriction or obstruction. The age, sex, educational level, body-mass index, co-morbidities (1 or ≥ 2), and the smoking-adjusted hazard ratio of disability pension was 1.07 (95% confidence interval, CI 0.64-1.78) for those with obstructive spirometry, and 1.44 (95% CI 0.89-2.32) for those with restrictive spirometry. As continuous variables, and divided into quartiles, the risk of the lowest quartile of forced ventilation capacity (FVC)% of predicted was 1.49 (95%CI 1.10-2.01) and forced expiratory volume in one second (FEV1)% of predicted 1.66 (95%CI: 1.23-2.24) in comparison to the highest quartile in the adjusted models. CONCLUSIONS: Obstructive or restrictive spirometry did not predict disability pension when dichotomized classified variables (normal compared to abnormal) were used. As continuous variables and when divided into quartiles, lower lung volumes showed an increase in the risk of disability pension. Physicians should take this into account when they use spirometry as a prognostic factor of work disability.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Pneumopatias/epidemiologia , Pulmão/fisiopatologia , Pensões/estatística & dados numéricos , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Risco , Espirometria
6.
Neurology ; 94(21): e2213-e2221, 2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-32024674

RESUMO

OBJECTIVE: To determine whether patients with cluster headache have more sickness absence and disability pension days compared to matched references and possible associations with sociodemographic characteristics. METHODS: We performed a registry study of all patients who had received specialized health care for cluster headache (ICD-10 code G44.0) aged 16-64 years and living in Sweden in 2010 (n = 3,240; 34% women) and matched references from the total population (n = 16,200) regarding their sickness absence and disability pension days in 2010. RESULTS: Mean number of sickness absence days in 2010 was 16.13 (95% confidence interval, 14.05-18.20) among patients with cluster headache and 6.54 (5.97-7.11) among references. When combining sickness absence and disability pension days, patients with cluster headache had 63.15 (58.84-67.45) days, references 34.08 (32.59-35.57) days. Among patients, women had twice as many sickness absence days than men: 23.71 (19.36-28.06) vs 12.41 (10.19-14.63). When adding disability pension days, those numbers were 83.71 (75.57-91.84) vs 52.56 (47.62-57.51). Patients with cluster headache had significantly more sickness absence days in all ages compared to the reference group. Patients with elementary education had more sickness absence/disability pension days (85.88 [75.34-96.42]) compared to those with high school (64.89 [58.82-70.97]) and college/university (41.42 [34.70-48.15]) education. CONCLUSION: This nationwide study shows that patients with cluster headache have significantly more sickness absence and disability pension days compared to matched references. Furthermore, among patients, women had more sickness absence and disability pension days than men.


Assuntos
Cefaleia Histamínica/epidemiologia , Avaliação da Deficiência , Pensões/estatística & dados numéricos , Sistema de Registros , Licença Médica/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Suécia/epidemiologia , Adulto Jovem
7.
PLoS One ; 15(2): e0229221, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32097437

RESUMO

OBJECTIVES: Comorbidity is prevalent in older working ages and might affect employment exits. This study aimed to 1) assess the associations between comorbidity and different employment exit routes, and 2) examine such associations by gender. METHODS: We used data from employed adults aged 50-62 in the Stockholm Public Health Survey 2002 and 2006, linked to longitudinal administrative income records (N = 10,416). The morbidity measure combined Limiting Longstanding Illness and Common Mental Disorder-captured by the General Health Questionnaire-12 (≥4)-into a categorical variable: 1) No Limiting Longstanding Illness, no Common Mental Disorder, 2) Limiting Longstanding Illness only, 3) Common Mental Disorder only, and 4) comorbid Limiting Longstanding Illness+Common Mental Disorder. Employment status was followed up until 2010, treating early retirement, disability pension and unemployment as employment exits. Competing risk regression analysed the associations between morbidity and employment exit routes, stratifying by gender. RESULTS: Compared to No Limiting Longstanding Illness, no Common Mental Disorder, comorbid Limiting Longstanding Illness+Common Mental Disorder was associated with early retirement in men (subdistribution hazard ratio = 1.73, 95% confidence intervals: 1.08-2.76), but not in women. For men and women, strong associations for disability pension were observed with Limiting Longstanding Illness only (subdistribution hazard ratio = 11.43, 95% confidence intervals: 9.40-13.89) and Limiting Longstanding Illness+Common Mental Disorder (subdistribution hazard ratio = 14.25, 95% confidence intervals: 10.91-18.61), and to a lesser extent Common Mental Disorder only (subdistribution hazard ratio = 2.00, 95% confidence intervals: 1.31-3.05). Women were more likely to exit through disability pension than men (subdistribution hazard ratio = 1.96, 95% confidence intervals: 1.60-2.39). Common Mental Disorder only was the only morbidity category associated with unemployment (subdistribution hazard ratio = 1.70, 95% confidence intervals: 1.36-2.15). CONCLUSIONS: Strong associations were observed between specific morbidity categories with different employment exit routes, which differed by gender. Initiatives to extend working lives should consider older workers' varied health needs to prevent inequalities in older age.


Assuntos
Emprego/estatística & dados numéricos , Pensões/estatística & dados numéricos , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/fisiopatologia , Aposentadoria/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Idoso , Pessoas com Deficiência , Feminino , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Suécia/epidemiologia
8.
PLoS One ; 15(2): e0229285, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32092090

RESUMO

OBJECTIVE: The number of young adults on disability pension (DP) is increasing in European countries, creating a need to understand the related risk factors. This study aimed to determine whether adverse perinatal conditions are associated with receiving a DP early in life. METHODS: This longitudinal cohort study consisted of all persons (N = 453,223) born in Sweden during 1973-1977, observed from 1991 through 2010 when they were aged between 16 and 37 years. Statistics Sweden provided linked national data on the children and their parents. We used logistic regression to assess the association between perinatal health conditions (birth defect, Apgar score, and small for gestational age) and receiving a DP, adjusting for maternal education and the sex of the child. RESULTS: New recipients of DP were significantly more likely to have had a birth defect (adjusted odds ratio [AOR] 2.74, 95% CI: 2.49-3.00), to have had low Apgar score (AOR 2.12, 95% CI: 1.77-2.52), to have been small for gestational age (AOR 1.73, 95% CI: 1.54-1.94) and to be females (AOR 1.55, 95% CI: 1.46-1.64). Higher maternal education was associated with lower odds of receiving a DP (AOR 0.74, 95% CI: 0.69-0.79) for those with high school education and (AOR 0.67, 95% CI: 0.59-0.75) for those with university education. Age-stratified analysis confirmed increased odds of receiving a DP among those with birth defects and small for gestational age, but this effect reduced with increasing age. Apgar score was significantly associated with starting to receive a DP at ages 16-18 and 19-29, but not at ages 30-33. Women had lower odds of receiving a DP at ages 16-18 (AOR 0.73, 95% CI: 0.64-0.85); however, this reversed from age 19 and upwards (AOR 1.53, 95% CI: 1.41-1.67) and (AOR 2.16, 95% CI: 1.95-2.40) for the age groups of 19-29 and 30-33, respectively. Persons with high maternal education were less likely to receive a DP regardless of age at receiving a DP. CONCLUSION: Having a birth defect was the strongest indicator of receiving a DP during early adulthood, followed by small for gestational age and low Apgar score. Overall, the effects of the studied perinatal health conditions were pronounced in those who received a DP at 16-18 years, but this effect weakened with increasing age at receiving a DP. Our findings suggest that policies and programs geared at promoting optimal health at birth might contribute to a reduction in receiving a DP.


Assuntos
Pessoas com Deficiência , Pensões/estatística & dados numéricos , Perinatologia , Adolescente , Adulto , Fatores Etários , Estudos de Coortes , Anormalidades Congênitas , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Estudos Longitudinais , Fatores de Risco , Suécia , Adulto Jovem
9.
Soc Psychiatry Psychiatr Epidemiol ; 55(6): 697-704, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32055893

RESUMO

PURPOSE: This study aimed to assess the role of refugee status and specific mental disorders regarding subsequent labour market marginalisation. METHODS: Prospective cohort study of all refugees (n = 216,930) and Swedish-borns (n = 3,841,788), aged 19-60 years, and resident in Sweden in 2009. Hazard ratios (HRs) with 95% Confidence Intervals (CIs)  for long-term unemployment (> 180 days) and disability pension (DP) were calculated with Cox regression analyses. RESULTS: Mental disorders were more prevalent in refugees compared to Swedish-born individuals, with greatest differences seen for post-traumatic stress disorder (PTSD; refugees 1.3%; Swedish-born individuals 0.1%). Regarding long-term unemployment, refugees without a mental disorder had an adjusted HR (aHR) of 2.68 (95% CI 2.65-2.71) compared to Swedish-born individuals without mental disorders, which was above the aHR of refugees (aHR 2.33, 95% CI 2.29-2.38) and Swedish-born individuals (aHR 1.44, 95% CI 1.43-1.45) with mental disorders. Regarding DP, compared to Swedish-born individuals without mental disorders, the aHRs were 1.44 (95% CI 1.34-1.54) for refugees without, but 6.11 (95% CI 5.84-6.39) for refugees with mental disorders. Swedish-born individuals with mental disorder had an aHR of 3.96 (95% CI 3.85-4.07). With regard to specific disorders, the aHRs for refugees, as compared to Swedish-born individuals without mental disorders, were markedly increased for all disorders (e.g. PTSD: long-term unemployment aHR: 2.03 (95% CI 1.89-2.18); DP 7.07 (95% CI 6.42-7.78). CONCLUSION: Mental disorders are more prevalent in refugees than in Swedish-born individuals but do not appear to increase their risk of long-term unemployment. Refugee status and mental disorders strongly contribute to the risk of DP, indicating that factors beyond medical considerations contribute to their granting of DP.


Assuntos
Transtornos Mentais/psicologia , Pensões/estatística & dados numéricos , Refugiados/psicologia , Marginalização Social/psicologia , Desemprego/psicologia , Adulto , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Prevalência , Modelos de Riscos Proporcionais , Estudos Prospectivos , Sistema de Registros , Suécia/epidemiologia , Desemprego/estatística & dados numéricos , Adulto Jovem
10.
J Gerontol B Psychol Sci Soc Sci ; 75(4): 837-848, 2020 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-31628753

RESUMO

OBJECTIVES: How individuals and families accumulate retirement resources during working years is a key aspect of aging with implications for later life. This study examines how much, and by what mechanisms, savings in retirement plans vary by race/ethnicity. METHOD: Using representative survey data and linked W-2 tax records, we estimate the probability of participation in employer-sponsored defined contribution (DC) retirement plans with probit regression, and contribution levels with ordinary least squares (OLS) models. We use Heckman models to adjust for potential sample selection. RESULTS: Black and Hispanic workers have lower participation and contributions in employer-sponsored DC retirement plans than do white workers, while Asian Americans have higher levels. The bulk of racial/ethnic differences is attributed to socioeconomic position, especially education and labor market circumstances like earnings. Differentials are also associated with family circumstances, namely for black workers. After accounting for education, labor market, and family covariates, social-psychological factors appear to explain only small portions of differences, especially for black and Hispanic. DISCUSSION: This study clarifies how racial/ethnic disparities in socioeconomic circumstances generate advantages and disadvantages in retirement wealth accumulation. Lower DC retirement plan participation and contributions among minorities in work life represent an underappreciated earlier-life channel through which racial inequalities in income and wealth in later life are generated.


Assuntos
Emprego/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Financiamento Pessoal/estatística & dados numéricos , Pensões/estatística & dados numéricos , Aposentadoria/estatística & dados numéricos , Afro-Americanos/estatística & dados numéricos , Idoso , Emprego/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Aposentadoria/psicologia , Estados Unidos
11.
Scand J Public Health ; 48(2): 172-180, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31044651

RESUMO

Aims: Examining the non-medical determinants of applying for and being awarded disability pension is important for assessing the functionality of the disability pension system. We examined how demographic and socioeconomic factors as well as factors related to the disability process associate with the probability of applying for disability pension and the probability of applicants being awarded pension in 2009 and 2014. Methods: 70% random samples of Finnish non-retired residents aged 18-64 in 2009 (n = 2,076,881) and in 2014 (n = 2,097,790) were analysed with logistic regression analysis. The application rates were 0.9% in 2009 and 0.7% in 2014, and the rates of awarded pensions were 80.6% in 2009 and 72.2% in 2014. Results: Being an upper-level non-manual employee and having more employment during the preceding four calendar years decreased the odds of applying for disability pension but increased the odds of being awarded one. Older age increased the odds of both applying for and being awarded pension. Compared to applications based on mental disorders, those applying due to neoplasms and diseases of the circulatory system had increased odds of being awarded pension whereas those applying due to musculoskeletal diseases or injuries had decreased odds. Only minor temporal changes were found in the determinants of applying for or being awarded disability pension. Conclusions: With a greater probability of disability pension applications but also a lower probability of being awarded pension, the occupational disability process involves a comprehensive disadvantage for lower socioeconomic status groups.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Pensões/estatística & dados numéricos , Adolescente , Adulto , Feminino , Finlândia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
12.
Scand J Public Health ; 48(2): 125-133, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31057049

RESUMO

Background: Knowledge is needed on associations between job demands and job control and long-term sickness absence (SA) and unemployment. We explored associations of job demands and job control with SA/disability pension (DP) and unemployment among women and men in paid work. Methods: We included all 2,194,694 individuals living in Sweden in 2001, aged 30-54 years, and in paid work. The Swedish Job Exposure Matrix (JEM) was used to ascertain levels of job demands and job control. Individuals were categorized into nine groups based on combinations of high, medium, or low values on both demands and control. Using multinomial logistic regression, we estimated odds ratios (OR) with 95% confidence intervals (CI) for the association of job demands and job control with risk of long-term SA/DP (>183 net days) and long-term unemployment (>183 days). Results: Regarding SA/DP, among women the risk was highest for those in occupations with low demands and low control (OR=1.32; 95% CI: 1.28-1.36), whereas among men the risk was highest among those in occupations with high demands and low control (OR=1.22; 1.11-1.34). Regarding unemployment, among women the risk was highest among those in occupations with low demands and medium control (OR=1.30; 1.24-1.37), whereas among men the risk was highest for those in occupations with low demands and high control (OR=1.54; 1.46-1.62). Conclusions: Using a JEM among all in a population rather than for specific occupations gives a more comprehensive view of the associations between job demands/job control and long-term SA/DP and unemployment, respectively.


Assuntos
Absenteísmo , Pessoas com Deficiência/estatística & dados numéricos , Controle Interno-Externo , Pensões/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Suécia
13.
Scand J Public Health ; 48(4): 405-411, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29366393

RESUMO

Aims: Study objectives were to investigate how changes in social insurance legislation influenced the incidence of disability pension. Methods: The study included 295,636 male construction workers who attended health examinations between 1971 and 1993, aged 20-60 years and without previous disability pension. Via the Swedish National Insurance Agency national register we identified 66,046 subjects who were granted disability pension up until 2010. The incidence rates were calculated and stratified according to age and diagnosis. Results: The incidence rate of disability pension was fairly stable until the 1990s when large variations occurred, followed by a strong decreasing trend from the early 2000s to 2010. Trends in incidence rates, stratified by age and diagnosis, showed a consistent decrease in cardiovascular disease for all age groups. In subjects aged 30-49 years there was a high peak around 2003 for musculoskeletal diseases and psychiatric diseases. For the age group 50-59 years, musculoskeletal diagnosis, the most common cause of disability pension, had a sharp peak around 1993 and then a decreasing trend. In the 60-64 age group, the incidence rate for psychiatric diagnosis was stable, while incidence rates for musculoskeletal diagnosis varied during the 1990s. Conclusions: There are considerable variations in the incidence rate of disability pension over time, with different patterns depending on age and diagnosis. Changes in social insurance legislation, as well as in administration processes, seem to influence the variation.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Pensões/estatística & dados numéricos , Previdência Social/legislação & jurisprudência , Adulto , Estudos de Coortes , Indústria da Construção , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Suécia/epidemiologia , Adulto Jovem
14.
J Neurol Neurosurg Psychiatry ; 91(1): 67-74, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31727727

RESUMO

OBJECTIVE: To assess the risk of losing income from salaries and risk disability pension for multiple sclerosis patients with a clinically stable disease course 3 years after the start of disease-modifying therapy (DMT). METHODS: Data from the Danish Multiple Sclerosis Registry were linked to other Danish nationwide population-based databases. We included patients who started treatment with a DMT between 2001 and 2014. Patients were categorised into a clinically stable group (No Evidence of Disease Activity (NEDA-2)) and a clinically active group (relapse activity or 6-month confirmed Expanded Disability Status Scale worsening). Outcomes were: (1) loss of regular income from salaries and (2) a transfer payment labelled as disability pension. We used a Cox proportional hazards model to estimate confounder-adjusted HRs, and absolute risks were plotted using cumulative incidence curves accounting for competing risks. RESULTS: We included 2406 patients for the income analyses and 3123 patients for the disability pension analysis. Median follow-up from index date was ~5 years in both analyses. The NEDA-2 group had a 26% reduced rate of losing income (HR 0.74; 95% CI 0.60 to 0.92). HRs were calculated for 5-year intervals in the disability pension analysis: year 0-5: a 57% reduced rate of disability pension for the NEDA-2 group (HR 0.43; 95% CI 0.33 to 0.55) and year 5-10: a 36% reduced rate (HR 0.64; 95% CI 0.40 to 1.01). CONCLUSION: Clinically stable disease course (NEDA-2) is associated with a reduced risk of losing income from salaries and a reduced risk of disability pension.


Assuntos
Avaliação da Deficiência , Renda , Esclerose Múltipla/economia , Esclerose Múltipla/patologia , Pensões/estatística & dados numéricos , Adolescente , Adulto , Bases de Dados Factuais , Dinamarca/epidemiologia , Progressão da Doença , Determinação de Ponto Final , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/epidemiologia , Recidiva , Sistema de Registros , Medição de Risco , Salários e Benefícios , Adulto Jovem
15.
Scand J Public Health ; 48(2): 181-189, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30973068

RESUMO

Aims: Frequent attendance in healthcare services is associated with ill-health and chronic illnesses. More information is needed about the phenomenon's connection with disability pensions (DPs). Methods: The study group comprised 59,676 patients divided into occasional- (1yFAs) and persistent frequent attenders (pFAs) and non-frequent attenders (non-FAs). Odds ratios for DP were analysed for these groups taking into account preceding sickness absence days. The awarded DPs were obtained from the Finnish Centre for Pensions and data on primary care visits were obtained from Pihlajalinna, a nationwide occupational healthcare provider. Results: 1yFAs and pFAs have more DPs than non-FAs. During follow-up, 14.9% of pFAs, 9.6% of 1yFAs and 1.6% of non-FAs had a DP decision of any kind. pFAs receive more partial and fixed-term decisions than the other groups and most permanent DPs are granted to 1yFAs. Musculoskeletal disorders are the most common reason for illness-based retirement in all groups but 1yFAs and pFAs have proportionally more mental disorders leading to DP. The group of non-FAs, on the other hand, has more DPs granted based on neoplasms. Both 1yFAs and pFAs have an increased risk of DP but the effect is diluted after taking into account preceding sick-leave. Conclusions: Frequent attendance of healthcare services, both occasional and persistent, is associated with increased risk of future DP. The association is linked to increased sickness absences. Frequent attenders should be identified and their rehabilitative needs evaluated. Frequency of consultation could be used in selecting candidates for early rehabilitation before sickness absences develop.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Pensões/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Finlândia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Medição de Risco , Adulto Jovem
16.
Scand J Public Health ; 48(4): 460-467, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30813841

RESUMO

Aim: To investigate the influence of physical and psychosocial working conditions on the risk of disability pension among eldercare workers. Methods: After responding to a questionnaire in 2005, 4699 healthy female eldercare workers - free from chronic musculoskeletal pain, depressive symptoms and long-term sickness absence - were followed for 11 years in the Danish Register for Evaluation of Marginalization. Time-to-event analyses estimated the hazard ratio (HR) for disability pension from physical exertion during work, emotional demands, influence at work, role conflicts, and quality of leadership. Analyses were mutually adjusted for these work environmental factors as well as for age, education, smoking, leisure physical activity and body mass index. Results: During follow-up, 7.6% received disability pension. Physical exertion and emotional demands were associated with risk of disability pension, and both interacted with age. In age-stratified analyses, older eldercare workers (mean age 53 years at baseline) with moderate and high physical exertion (reference: low) were at increased risk with HRs of 1.51, 95% CI [1.06-2.15] and 2.54, 95% CI [1.34-4.83], respectively. Younger eldercare workers (mean age 36 years at baseline) with moderate emotional demands (reference: low) were at decreased risk with an HR of 0.57, 95% CI [0.37-0.85]. Conclusions: While a higher level of physical exertion is a risk factor for disability pension among older female eldercare workers, a moderate level of emotional demands is associated with lower risk among the younger workers. The age of the worker may be an important factor when providing recommendations for promoting a long and healthy working life.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Emprego/psicologia , Emprego/estatística & dados numéricos , Pensões/estatística & dados numéricos , Esforço Físico , Adulto , Dinamarca , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários
17.
PLoS One ; 14(12): e0226198, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31834901

RESUMO

BACKGROUND: Pregnancy is associated with a temporarily increased sickness absence (SA) risk. This association may vary by the level of occupational gender segregation; however, knowledge in this area is limited. We studied whether trends in SA and disability pension (DP) in the years before and after first childbirth among women with one or more childbirths and with no childbirth during the study period varied by occupational gender segregation. METHODS: We conducted a population-based register study involving nulliparous women aged 18-39 years, living in Sweden in 2002-2004 (n = 364,411). We classified participants in three childbirth groups as: (1) no childbirth in 2005 or in the next 3.75 years, (2) first childbirth in 2005 and no births in the subsequent 3.75 years, and (3) first childbirth in 2005 and at least one additional birth in the subsequent 3.75 years, and into five categories based on the rate of women in their occupations. We compared crude and standardized mean annual net SA and DP days during the three years before and the three years after 2005 across the childbirth and occupational gender segregation categories. RESULTS: Women in extremely male-dominated occupations had or tended to have somewhat higher mean combined SA and DP days than women in gender-integrated occupations; women in female-dominated occupations had comparable or tended to have slightly higher mean SA and DP days than women in gender-integrated occupations. Except for the year before the first childbirth, women who gave birth, especially those who gave several births, had generally a lower mean combined standardized SA and DP days than nulliparous women. We found no substantial differences in trends in SA and DP around the time of first childbirth according to occupational gender segregation. CONCLUSIONS: Trends in SA and DP around the time of first childbirth did not vary by occupational gender segregation.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Ocupações/estatística & dados numéricos , Parto , Pensões/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Absenteísmo , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Gravidez , Fatores Sexuais , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-31615149

RESUMO

Many European countries have implemented pension reforms to increase the statutory retirement age with the aim of increasing labor supply. However, not all older workers may be able or want to work to a very high age. Using a nation-wide register data of labor market transitions, we investigated in this natural experiment the effect of an unexpected change in the Dutch pension system on labor market behaviors of older workers. Specifically, we analyzed transitions in labor market positions over a 5-year period in two nation-wide Dutch cohorts of employees aged 60 years until they reached the retirement age (n = 23,703). We compared transitions between the group that was still entitled to receive early retirement benefits to a group that was no longer entitled to receive early retirement benefits. Results showed that the pension reform was effective in prolonging work participation until the statutory retirement age (82% vs. 61% at age 64), but also to a larger proportion of unemployment benefits in the 1950 cohort (2.0%-4.2%) compared to the 1949 cohort (1.4%-3.2%). Thus, while ambitious pension reforms can benefit labor supply, the adverse effects should be considered, especially because other studies have shown a link between unemployment and poor health.


Assuntos
Emprego/estatística & dados numéricos , Pensões/estatística & dados numéricos , Aposentadoria/legislação & jurisprudência , Aposentadoria/estatística & dados numéricos , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Políticas
19.
BMJ Open ; 9(10): e028001, 2019 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-31594869

RESUMO

OBJECTIVES: To assess disparities in mortality by socioeconomic status in Germany. DESIGN AND PARTICIPANTS: We analyse a large administrative dataset of the German Pension Fund (DRV), including 27 million person-years of exposure and 42 000 deaths in 2013. The data cover the economically active population, stratified by sex and by East and West. OUTCOME MEASURES: Age-standardised mortality rates and Poisson regression mortality rate ratios (MRRs). RESULTS: The risk of dying increases with decreasing income: the MRRs of the lowest to the highest income quintile are 4.66 (95% CI 4.48 to 4.85) among men and 3.06 (95% CI 2.90 to 3.23) among women. The impact of income attenuates after controlling for education and other explanatory variables, especially for females. In the fully controlled model for females, individual income is a weaker predictor of mortality, but there is a clear educational mortality gradient. In the fully controlled model, the MRRs of the unemployed to the employed are 2.09 (95% CI 2.03 to 2.15) among men and 2.01 (95% CI 1.92 to 2.10) among women. The risk of dying is around half as high among foreigners as among German citizens. The socioeconomic disparities are greater among East than West German men. CONCLUSIONS: Low socioeconomic status is a major determinant of excess adult mortality in Germany. The persisting East-West differences in male adult mortality can be explained by the higher socioeconomic status of men living in the West, rather than by contextual differences between East and West. These differences can be further monitored using DRV data.


Assuntos
Escolaridade , Emprego , Mortalidade , Pensões/estatística & dados numéricos , Fatores Socioeconômicos , Adulto , Estudos Transversais , Emprego/economia , Emprego/estatística & dados numéricos , Feminino , Administração Financeira/métodos , Administração Financeira/estatística & dados numéricos , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Classe Social
20.
Soc Sci Med ; 240: 112576, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31586779

RESUMO

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.


Assuntos
Avaliação da Deficiência , Comportamento de Doença , Pensões/classificação , Parceiros Sexuais , Adulto , Idoso , Feminino , Finlândia , Humanos , Renda/classificação , Renda/estatística & dados numéricos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pensões/estatística & dados numéricos , Fatores Socioeconômicos
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