Krokstad Steinar, Westin Steinar
Department of Community Medicine and General Practice, Norwegian University of Science and Technology, HUNT Research Centre, Neptunveien 1, 7650 Verdal, Norway.
Soc Sci Med. 2004 May;58(10):1837-48. doi: 10.1016/S0277-9536(03)00409-X.
The objective of this study was to describe sociomedical determinants and developments for the medically based disability pension in Norway by linking individual based data from a county health survey to data on disability from the National Insurance Administration. Two cross-sectional total population health surveys with an approximate 10-year interval were conducted in Nord-Trøndelag county, HUNT I (1984-86) and HUNT II (1995-97), which allows for analyses of changes over time, supplied with official incidence data on disability pension. The large-scale variations and overall increasing incidence rates of disability pension in Norway during the last 20 years also applied to the county of Nord-Trøndelag. The prevalence of disability pension generally increased in the population from the mid-1980s to the mid-1990s. A striking finding was a consistent pattern of increasing prevalence of disability pension with decreasing socio-economic status and education. A geographic pattern for disability pension prevalence on a municipality level suggested that structural and cultural factors were important in determining the level of disability in society. Medical determinants alone cannot explain either the dramatic variations or the overall increased incidence rates of disability pension in the last two decades in Norway. The results demonstrate the importance of social, non-medical and contextual determinants for disability pension, how these determinants result in important prevalence differences by socio-economic status, and their impact on the level of disability in society.
本研究的目的是通过将来自某县健康调查的个体数据与国家保险管理局的残疾数据相联系，描述挪威基于医疗的残疾抚恤金的社会医学决定因素和发展情况。在北特伦德拉格郡进行了两次间隔约10年的横断面全人群健康调查，即HUNT I（1984 - 86年）和HUNT II（1995 - 97年），这使得能够对随时间的变化进行分析，并提供了残疾抚恤金的官方发病率数据。挪威过去20年中残疾抚恤金的大规模变化和总体发病率上升情况在北特伦德拉格郡也同样存在。从20世纪80年代中期到90年代中期，残疾抚恤金在人群中的患病率普遍上升。一个显著的发现是，随着社会经济地位和教育程度的降低，残疾抚恤金患病率呈现出持续上升的模式。市级层面上残疾抚恤金患病率的地理分布模式表明，结构和文化因素在决定社会中的残疾水平方面很重要。仅医学决定因素无法解释挪威过去二十年中残疾抚恤金的巨大变化或总体发病率上升情况。结果表明了社会、非医学和背景决定因素对残疾抚恤金的重要性，这些决定因素如何因社会经济地位导致重要的患病率差异，以及它们对社会残疾水平的影响。
