Upmark M, Lundberg I, Sadigh J, Bigert C
Karolinska Institutet, Department of Public Health Sciences, Stockholm, Sweden.
Scand J Public Health. 2001 Jun;29(2):96-103.
This study investigates whether conditions present or established in youth and adolescence among young men contribute to the differences in the risk of an early disability pension (DP) among social classes.
The study is based on data from a nationwide survey of the 49,285 Swedish males born between 1949 and 1951 who were conscripted into military service between 1969 and 1970. Data on socioeconomic groups were based on information of occupation and educational level reported in the census of 1975 held by Statistics Sweden. Potential psychosocial and behavioural risk factors were linked to records from the Swedish Social Insurance Board up until 1993. The analyses were based upon those 33,609 conscripts with information on all background variables who reported an occupation and who were not granted a DP in 1975.
The strongest social class difference in the distribution of risk indicators was found for low ranking on the psychometric tests and for having been in a remedial class. In the univariate analyses, the highest odds ratios were noted for unskilled manual workers. In the multivariate model, with all the background variables included, the increased risk ratios for lower socioeconomic groups decreased considerably for a DP irrespective of diagnosis, and diminished for a DP with an alcohol-related diagnosis.
It is concluded that conditions present or established in youth and adolescence are of major importance to understand the strong social class gradient in disability pensions among young men. It is suggested that the increased risks for skilled and unskilled manual workers compared with non-manual employees might be interpreted according to the concept of unfavourable life careers.
本研究调查青年男性在青年期和青春期出现或形成的状况是否会导致社会阶层之间早期残疾抚恤金(DP)风险的差异。
该研究基于对1949年至1951年出生、于1969年至1970年应征入伍的49285名瑞典男性进行的全国性调查数据。社会经济群体的数据基于瑞典统计局1975年人口普查中报告的职业和教育水平信息。潜在的心理社会和行为风险因素与瑞典社会保险局截至1993年的记录相关联。分析基于33609名应征入伍者,他们拥有所有背景变量的信息,报告了职业且在1975年未获得残疾抚恤金。
在心理测试得分低和曾就读于补习班方面,发现风险指标分布中社会阶层差异最为明显。在单变量分析中,非技术体力劳动者的优势比最高。在包含所有背景变量的多变量模型中,无论诊断如何,社会经济地位较低群体领取残疾抚恤金的风险比增加幅度大幅下降,而因酒精相关诊断领取残疾抚恤金的风险比则有所降低。
得出的结论是,青年期和青春期出现或形成的状况对于理解青年男性残疾抚恤金方面强大的社会阶层梯度至关重要。有人提出,与非体力劳动者相比,技术和非技术体力劳动者风险增加可根据不利生活历程的概念来解释。