Socioeconomic factors in disability retirement due to mental disorders in Finland

Karolaakso, Tino; Autio, Reija; Näppilä, Turkka; Nurmela, Kirsti; Pirkola, Sami

doi:10.1093/eurpub/ckaa132

Cited by 13 publications

(10 citation statements)

References 32 publications

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“…There is a growing concern in Finland related to increasing rates and widening gender gap in sickness absences and disability pensions related to mental disorders [ 74 , 75 ] Therefore, it is important to study factors contributing to psychological distress in the working population and to identify factors that may relate to these gender differences.…”

Section: Introductionmentioning

confidence: 99%

Factors contributing to psychological distress in the working population, with a special reference to gender difference

et al. 2021

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Background Psychological distress refers to non-specific symptoms of stress, anxiety and depression, and it is more common in women. Our aim was to investigate factors contributing to psychological distress in the working population, with a special reference to gender differences. Methods We used questionnaire data from the nationally representative Finnish Regional Health and Well-being Study (ATH) collected in the years 2012–2016 (target population participants aged 20 +, n = 96,668, response rate 53%), restricting the current analysis to those persons who were working full-time and under 65 of age (n = 34,468). Psychological distress was assessed using the Mental Health Inventory-5 (MHI-5) (cut-off value <=52). We studied the following factors potentially associated with psychological distress: sociodemographic factors, living alone, having children under18 years of age, lifestyle-related factors, social support, helping others outside of the home and work-related factors. We used logistic regression analysis to examine association between having work-family conflict with the likelihood for psychological distress. We first performed the models separately for men and women. Then interaction by gender was tested in the combined data for those independent variables where gender differences appeared probable in the analyses conducted separately for men and women. Results Women reported more psychological distress than men (11.0% vs. 8.8%, respectively, p < 0.0001). Loneliness, job dissatisfaction and family-work conflict were associated with the largest risk of psychological distress. Having children, active participation, being able to successfully combine work and family roles, and social support were found to be protective factors. A significant interaction with gender was found in only two variables: ignoring family due to being absorbed in one’s work was associated with distress in women (OR 1.30 (95% CI 1.00–1.70), and mental strain of work in men (OR 2.71 (95% CI 1.66–4.41). Conclusions Satisfying work, family life and being able to successfully combine the two are important sources of psychological well-being for both genders in the working population.

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Section: Introductionmentioning

confidence: 99%

Factors contributing to psychological distress in the working population, with a special reference to gender difference

et al. 2021

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“…These clusters can be easily explained based on morbidity and mortality data in Finland. Cardiovascular diseases are still the major cause of death [ 62 ], and mental disorders are the main cause of disability pensions, followed by musculoskeletal disorders [ 63 ].…”

Section: Resultsmentioning

confidence: 99%

Clustering Diagnoses From 58 Million Patient Visits in Finland Between 2015 and 2018

Fränti¹,

Sieranoja²,

Wikström³

et al. 2022

JMIR Med Inform

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Background Multiple chronic diseases in patients are a major burden on the health service system. Currently, diseases are mostly treated separately without paying sufficient attention to their relationships, which results in the fragmentation of the care process. The better integration of services can lead to the more effective organization of the overall health care system. Objective This study aimed to analyze the connections between diseases based on their co-occurrences to support decision-makers in better organizing health care services. Methods We performed a cluster analysis of diagnoses by using data from the Finnish Health Care Registers for primary and specialized health care visits and inpatient care. The target population of this study comprised those 3.8 million individuals (3,835,531/5,487,308, 69.90% of the whole population) aged ≥18 years who used health care services from the years 2015 to 2018. They had a total of 58 million visits. Clustering was performed based on the co-occurrence of diagnoses. The more the same pair of diagnoses appeared in the records of the same patients, the more the diagnoses correlated with each other. On the basis of the co-occurrences, we calculated the relative risk of each pair of diagnoses and clustered the data by using a graph-based clustering algorithm called the M-algorithm—a variant of k-means. Results The results revealed multimorbidity clusters, of which some were expected (eg, one representing hypertensive and cardiovascular diseases). Other clusters were more unexpected, such as the cluster containing lower respiratory tract diseases and systemic connective tissue disorders. The annual cost of all clusters was €10.0 billion, and the costliest cluster was cardiovascular and metabolic problems, costing €2.3 billion. Conclusions The method and the achieved results provide new insights into identifying key multimorbidity groups, especially those resulting in burden and costs in health care services.

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“…The data combined medical, socioeconomic, and sociodemographic information on the study subjects. A previous RETIRE publication [ 8 ] described the formation of the original dataset including all mental disorders. We used a subset of the original data, and our dataset included all Finnish citizens granted a temporary or permanent DP for the first time between 2010 and 2015 due to CMD (ICD-10: F32–F34 depressive disorders and F40–43 anxiety, stress-related, and adjustment disorders, N = 22,501) [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Socioeconomic status (SES) is often defined by the factors: income, education, and occupation, to reflect a person’s social, material, and psychological resources [ 7 , 8 ]. Low SES is associated with poorer mental health [ 7 , 9 ] and higher work disability due to mental disorders [ 8 , 10 ]. People with lower SES, especially lower education, tend to use mental health services less willingly than people with higher SES [ 11 – 13 ], even though the need may be higher [ 7 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension

Leppänen

Kampman

Autio

et al. 2022

BMC Health Serv Res

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Background Research in high-income countries has identified low socioeconomic status as a risk factor for disability pension (DP) due to common mental disorders (CMDs). Psychotherapy is an evidence-based treatment for the majority of CMDs along with medication and it is often targeted to prevent work disability. This study examines socioeconomic differences in the use of rehabilitative psychotherapy in Finland, where citizens have universal health coverage, but psychotherapy is partly dependent on personal finance. Methods The study subjects (N = 22,501) were all the Finnish citizens granted a DP due to CMD between 2010 and 2015 and a comparison group (N = 57,732) matched based on age, gender, and hospital district. Socioeconomic differences in psychotherapy use were studied using logistic regression models. Socioeconomic status was defined by education, income, and occupation. Age, gender, and family status were also examined. Results A lower level of education, lower occupational status (blue-collar worker), male gender, and older age, were associated with less frequent psychotherapy use, in both groups. Education was the strongest component of socioeconomic status associated with psychotherapy use, but the role of income was not straightforward. Unemployment when approaching DP, but not otherwise, was a risk factor for not receiving rehabilitative psychotherapy. Socioeconomic disparities were not any smaller among CMD patients approaching DP than in the comparison group. Conclusion This study demonstrates the disparity in the provision of psychotherapy for CMD patients, even on the verge of DP with an acute need for services. This disparity is partly related to a complex interplay of socioeconomic factors and the service system characteristics. Factors predisposing to unequal access to mental health services are presumably diverse and should be studied further.

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Socioeconomic factors in disability retirement due to mental disorders in Finland

Cited by 13 publications

References 32 publications

Factors contributing to psychological distress in the working population, with a special reference to gender difference

Factors contributing to psychological distress in the working population, with a special reference to gender difference

Clustering Diagnoses From 58 Million Patient Visits in Finland Between 2015 and 2018

Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension

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