Overland S, Glozier N, Henderson M, Maeland J G, Hotopf M, Mykletun A
University of Bergen, Research Centre for Health Promotion, Christiesgate 13, N-5015 Bergen, Norway.
Occup Environ Med. 2008 Nov;65(11):769-73. doi: 10.1136/oem.2007.037861.
Up to one in eight of the working age population receives permanent disability benefits. As little is known about the consequences of this major event, analysis aimed to compare health status before and after disability pension award.
Data from the population based Hordaland Health Study (HUSK) in Norway 1997-99 (n = 18 581) were linked to official disability benefits registries. The study identified 1087 participants who were awarded a disability pension before, during and after the health survey. These were grouped into different strata defined by temporal proximity between disability pension award and health survey participation. The study then compared health status across these strata covering the 7 years before to the 7 years after the award.
The study found an inverse U-shaped trend with an increase in reported symptoms (anxiety, depression, pain distribution, sleep problems and somatic symptoms) approaching the award, and a reversing of this trajectory afterwards (p<0.05 for the non-linear trend for all symptoms). We found no similar trend for the more objective health measures blood pressure, physical diagnoses and prescribed medication. For most measures, similar levels of health problems were found 3-7 years before compared to 3-7 years after the award.
When comparing the strata defined by time to the event of disability pension award, there was an increase in symptoms around the time of the disability pension award, with a subsequent return towards pre-award levels. The design precludes any firm conclusions as to what causes the observed results, but possible explanations include temporary adverse health effects from the process itself, the beneficial effects of being removed from harmful work conditions, and recovery after increasing health problems leading up to disability pension award.
在工作年龄人口中，多达八分之一的人领取永久性残疾福利。由于对这一重大事件的后果知之甚少，本分析旨在比较残疾抚恤金发放前后的健康状况。
1997 - 1999年挪威基于人群的霍达兰健康研究（HUSK）（n = 18581）的数据与官方残疾福利登记处相关联。该研究确定了1087名在健康调查之前、期间和之后获得残疾抚恤金的参与者。这些参与者被分为不同的层次，这些层次由残疾抚恤金发放与健康调查参与之间的时间接近程度定义。然后，该研究比较了这些层次在发放前7年至发放后7年的健康状况。
该研究发现了一种倒U形趋势，即接近发放时报告的症状（焦虑、抑郁、疼痛分布、睡眠问题和躯体症状）增加，之后这种趋势逆转（所有症状的非线性趋势p<0.05）。对于更客观的健康指标血压、身体诊断和处方药，我们没有发现类似的趋势。对于大多数指标，在发放前3 - 7年与发放后3 - 7年发现的健康问题水平相似。
在比较由残疾抚恤金发放事件的时间定义的层次时，在残疾抚恤金发放时症状增加，随后恢复到发放前的水平。该设计排除了对观察结果原因得出任何确凿结论的可能性，但可能的解释包括该过程本身产生的暂时不良健康影响、摆脱有害工作条件的有益影响以及在导致残疾抚恤金发放的健康问题增加后恢复。
