Childhood adversity, adult socioeconomic status and risk of work disability: a prospective cohort study

Abstract

ObjectivesTo examine the combined effects of childhood adversities and low adult socioeconomic status (SES) on the risk of future work disability.MethodsIncluded were 34 384 employed Finnish Public Sector study participants who responded to questions about childhood adversities (none vs any adversity, eg, parental divorce or financial difficulties) in 2008, and whose adult SES in 2008 was available. We categorised exposure into four groups: neither (reference), childhood adversity only, low SES only or both. Participants were followed from 2009 until the first period of register-based work disability (sickness absence >9 days or disability pension) due to any cause, musculoskeletal or mental disorders; retirement; death or end of follow-up (December 2011). We ran Cox proportional hazard models adjusted for behavioural, health-related and work-related covariates, and calculated synergy indices for the combined effects.ResultsWhen compared with those with neither exposure, HR for work disability from any cause was increased among participants with childhood adversity, with low SES, and those with both exposures. The highest hazard was observed in those with both exposures: HR 2.53, 95% CI 2.29 to 2.79 for musculoskeletal disability, 1.55, 95% CI 1.36 to 1.78 for disability due to mental disorders and 1.29, 95% CI 1.20 to 1.39 for disability due to other reasons. The synergy indices did not indicate synergistic effects.ConclusionsThese findings indicate that childhood psychosocial adversity and low adult SES are additive risk factors for work disability.

Pathways from parental mental disorders to offspring's work disability due to depressive or anxiety disorders in early adulthood—The 1987 Finnish Birth Cohort

“…Some predictors of mental health-related work disability have been identified (Halonen et al, 2017 them. The association between parents' mental disorders and offspring's early work disability due to mental disorders may be direct as indicated by the evidence on heritability of mental disorders (Franic, Middeldorp, Dolan, Ligthart, & Boomsma, 2010;Kendler, Ohlsson, Lichtenstein, Sundquist, & Sundquist, 2018).…”

“…The association between parents' mental disorders and offspring's early work disability due to mental disorders may be direct as indicated by the evidence on heritability of mental disorders (Franic, Middeldorp, Dolan, Ligthart, & Boomsma, 2010;Kendler, Ohlsson, Lichtenstein, Sundquist, & Sundquist, 2018). Although there is evidence for early risk factors for work disability in general (Gravseth et al, 2007;Halonen et al, 2017;von Bondorff et al, 2015), surprisingly few studies have examined work disability in early adulthood and their possible risk factors from adolescence. Although there is evidence for early risk factors for work disability in general (Gravseth et al, 2007;Halonen et al, 2017;von Bondorff et al, 2015), surprisingly few studies have examined work disability in early adulthood and their possible risk factors from adolescence.…”

“…However, the association is also likely affected by the offspring's circumstances in childhood and adolescence. Although there is evidence for early risk factors for work disability in general (Gravseth et al, 2007;Halonen et al, 2017;von Bondorff et al, 2015), surprisingly few studies have examined work disability in early adulthood and their possible risk factors from adolescence. Relationships with work disability in early adulthood have been reported for low educational achievement (Gravseth et al, 2007;Johansson, Leijon, Falkstedt, Farah, & Hemmingsson, 2012), chronic disease (Gravseth et al, 2007), anxious and depressive symptoms (Narusyte, Ropponen, Alexanderson, & Svedberg, 2017), mental disorders (Helgesson et al, 2017), and severe social disadvantage in the family (Harkko, Kouvonen, & Virtanen, 2016).…”

Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001–2011

“…Some researchers have suggested that SPA should directly reflect life expectancy differences, 38 where retirement eligibility age is determined by the type of job. 39 Alternatively, the eligibility age requirement could be dropped, so that State Pension eligibility is solely determined by 14 accumulation of years of full-time equivalent work. 38 The recent Independent Review of the State Pension argued for keeping a uniform SPA out of the principle of universality for the pension benefit, but to mitigate disadvantage through a means-tested one year early SPA for those who are unable to work through ill health or caring responsibilities.…”

“…8 This can be seen in the higher rate of disability pension uptake for lower social class groups. [9][10][11][12][13][14] With the tightening of eligibility rules for disability benefits, 15 a rising SPA could therefore have a disproportionate impact on people in lower social class groups, who are more likely to leave employment early due to health and unemployment reasons, 16;17 but are not eligible for incapacity benefit and must wait until increasingly older ages to qualify for a state pension. 18 However, no studies that have examined whether lower social class groups tend to have shorter or longer amounts of time between stopping work and death, compared to higher social class groups, or whether these social class differences exist for people in good and poor health.…”