Disability pension by occupational class - the impact of work-related factors: The Hordaland Health Study Cohort

Abstract

BackgroundThe social gradient in disability pension is well recognized, however mechanisms accounting for the gradient are largely unknown. The aim of this study was to examine the association between occupational class and subsequent disability pension among middle-aged men and women, and to what extent work-related factors accounted for the association.MethodsA subsample (N = 7031) of the population-based Hordaland Health Study (HUSK) conducted in 1997-99, provided self-reported information on health and work-related factors, and were grouped in four strata by Erikson, Goldthorpe and Portocareros occupational class scheme. The authors obtained follow-up data on disability pension by linking the health survey to national registries of benefit (FD-trygd). They employed Cox regression analysis and adjusted for gender, health (medical conditions, mental health, self-perceived health, somatic symptoms) and work-related factors (working hours, years in current occupation, physical demands, job demands, job control).ResultsA strong gradient in disability pension by occupational class was found. In the fully adjusted model the risk (hazard ratio) ranged from 1.41 (95% CI 0.84 to 2.33) in the routine non-manual class, 1.87 (95% CI 1.07 to 3.27) in the skilled manual class and 2.12 (95% CI 1.14 to 3.95) in the unskilled manual class, employing the administrator and professional class as reference. In the gender and health-adjusted model work-related factors mediated the impact of occupational class on subsequent disability pension with 5% in the routine non-manual class, 26% in the skilled manual class and 24% in the unskilled manual class. The impact of job control and physical demands was modest, and mainly seen among skilled and unskilled manual workers.ConclusionsWorkers in the skilled and unskilled manual classes had a substantial unexplained risk of disability pension. Work-related factors only had a moderate impact on the disability risk. Literature indicates an accumulation of hazards in the manual classes. This should be taken into account when interpreting the gradient in disability pension.

The effect of ill health and socioeconomic status on labor force exit and re-employment: a prospective study with ten years follow-up in the Netherlands

“…Therefore, one should be careful with generalizing the current findings from the Netherlands to other countries with different welfare state regimes (40). However, as described earlier, socioeconomic differences in labor force exit have also been found in other European studies (9,11,15,17).…”

“…A low level of education, occupational status, and income seem to be strong determinants of disability in both genders (9)(10)(11)(12)(13)(14). A recent Norwegian study (15) showed that there was a socioeconomic gradient in disability pension corresponding to socioeconomic gradients in health.…”

Risky Professions? Risk of Disability in Professions in Norway

“…Studies also show a clear negative association between socioeconomic status and disability pension (Allebeck & Mastekaasa, 2004;Bjørn-gaard et al, 2009). The risk of disability pension is higher in groups with low education (Bruusgaard, Smeby, & Claussen, 2010;Johansson, Leijon, Falkstedt, Farah, & Hemmingsson, 2012) or low socioeconomic status (Haukenes, Mykletun, Knudsen, Hansen, & Maeland, 2011;Østby, Ørstavik, Knudsen, ReichbornKjennerud, & Mykletun, 2011). Ross and Wu (1995) point to three categories of explanations for the relationship between education and health: (a) work and economic conditions (e.g., employment, full-time jobs, income, economic hardship), (b) social-psychological resources (e.g., personal control, social support), and (c) health-related aspects of lifestyle (e.g., exercise, alcohol consumption, smoking, preventive medical care).…”

Arbeit und gesundheitliche Ungleichheit

“…Von sozialpolitischem Interesse ist zudem, dass bei der krankheitsbedingten Frühberentung eine Ungleichverteilung je nach beruflicher Position registriert wird. Bödeker et al 2006 [18] zeigten bspw. anhand von Routinedaten der Deutschen Rentenversicherung, dass gering qualifizierte Berufe sowohl im Dienstleistungs-als auch im produktiven Sektor erhöhte krankheitsbedingte Früh-berentungsraten mit sich bringen [18].…”

“…Bödeker et al 2006 [18] zeigten bspw. anhand von Routinedaten der Deutschen Rentenversicherung, dass gering qualifizierte Berufe sowohl im Dienstleistungs-als auch im produktiven Sektor erhöhte krankheitsbedingte Früh-berentungsraten mit sich bringen [18]. Auch diese Beobachtung beschränkt sich nicht auf Deutschland [19][20][21][22].…”