The joint contribution of cardiovascular disease and socioeconomic status to disability retirement: A register linkage study

Virtanen, Marianna; Lallukka, Tea; Ervasti, Jenni; Rahkonen, Ossi; Lahelma, Eero; Pentti, Jaana; Pietiläinen, Olli; Vahtera, Jussi; Kivimäki, Mika

doi:10.1016/j.ijcard.2016.12.166

Cited by 22 publications

(19 citation statements)

References 33 publications

(46 reference statements)

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“… 4 Poor health is more common among individuals with low education or occupational grade, 24 compared with high, and the association of poor health with health-related exit from work is strongest in low grade occupations. 6 Retirement outcomes may also be influenced by time-varying sociocultural or institutional factors within country, such as changes to statutory pension ages or attitudes towards retirement. We therefore additionally adjusted for birth cohort.…”

Section: Methodsmentioning

confidence: 99%

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Occupational and educational inequalities in exit from employment at older ages: evidence from seven prospective cohorts

et al. 2018

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ObjectivesPast studies have identified socioeconomic inequalities in the timing and route of labour market exit at older ages. However, few studies have compared these trends cross-nationally and existing evidence focuses on specific institutional outcomes (such as disability pension and sickness absence) in Nordic countries. We examined differences by education level and occupational grade in the risks of work exit and health-related work exit.MethodsProspective longitudinal data were drawn from seven studies (n=99 164). Participants were in paid work at least once around age 50. Labour market exit was derived based on reductions in working hours, changes in self-reported employment status or from administrative records. Health-related exit was ascertained by receipt of health-related benefit or pension or from the reported reason for stopping work. Cox regression models were estimated for each study, adjusted for baseline self-rated health and birth cohort.ResultsThere were 50 003 work exits during follow-up, of which an average of 14% (range 2–32%) were health related. Low level education and low occupational grade were associated with increased risks of health-related exit in most studies. Low level education and occupational grade were also associated with an increased risk of any exit from work, although with less consistency across studies.ConclusionsWorkers with low socioeconomic position have an increased risk of health-related exit from employment. Policies that extend working life may disadvantage such workers disproportionally, especially where institutional support for those exiting due to poor health is minimal.

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Section: Methodsmentioning

confidence: 99%

“…Furthermore, low SEP may amplify the adverse influence of poor health on health-related work exit. 6 …”

Section: Introductionmentioning

confidence: 99%

Occupational and educational inequalities in exit from employment at older ages: evidence from seven prospective cohorts

et al. 2018

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“…For each participant, we obtained International Classification of Occupations (ISCO) codes for year 2008 from the employers’ registers. We dichotomised the occupational positions25 into ‘high’ (=ISCO classes 1–3; including managers, professionals and technicians) and ‘low’ (=ISCO classes 4–9; including clerical, service and manual workers) category like in a previous study 26…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2017

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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.

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“…To investigate whether the association between pain and SA is moderated by occupational class, we split the sample into two groups: employees in high and low occupational classes. Following previous procedures,25 employees in administrative/managerial, professional and semiprofessional occupations were categorised as ‘high occupational class’ (54% at the baseline) and employees in routine non-manual, and manual occupations were grouped into ‘low occupational class’ (46%). Occupational class was derived from the employer’s personnel register and, for the very few with no such register-based information, completed from questionnaires.…”

Section: Methodsmentioning

confidence: 99%

Within-individual analysis of pain and sickness absence among employees from low and high occupational classes: a record linkage study

et al. 2019

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ObjectivesPain is linked to an increased risk of sickness absence (SA); however, the extent to which unmeasured time-invariant differences explain this association is yet unknown. Therefore, we determined the within-individual associations between pain and short-term (in the survey year) and long-term (2 years following the survey years) SA risk in high and low occupational classes while controlling for the potential bias due to unobservable time-invariant characteristics.MethodsThe Helsinki Health Study data consisting of midlife public sector employees with mailed surveys from up to four time points, and SA record linkage were used (3983 persons). The within-individual estimates were calculated using hybrid negative binomial regression models.ResultsAcute/subacute pain was associated with a 13% increase in the rate of short-term SA days (incidence rate ratio 1.13 [95% CI 1.01 to 1.27]), while the association was somewhat stronger for chronic pain (1.32 [1.19–1.47]). For the employees in the low occupational class, these associations were robust (1.29 [1.10–1.50] for acute/subacute and 1.43 [1.23–1.66] for chronic pain), whereas only chronic pain was associated with SA among those in the high occupational class (1.25 [1.08–1.46]). Chronic pain was also associated with SA days in the long term without occupational class differences. Similar results were obtained for multisite pain (pain in several locations).ConclusionsThese results indicate that particularly chronic and multisite pain have a within-individual link to SA but ignoring unobservable differences between those reporting pain and those not might yield overstated effect sizes. Pain might have a different relation to SA in low and high occupational classes.

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The joint contribution of cardiovascular disease and socioeconomic status to disability retirement: A register linkage study

Cited by 22 publications

References 33 publications

Occupational and educational inequalities in exit from employment at older ages: evidence from seven prospective cohorts

Occupational and educational inequalities in exit from employment at older ages: evidence from seven prospective cohorts

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

Within-individual analysis of pain and sickness absence among employees from low and high occupational classes: a record linkage study

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