Polvinen A, Laaksonen M, Gould R, Lahelma E, Leinonen T, Martikainen P
Finnish Centre for Pensions, Finland
Finnish Centre for Pensions, Finland.
Scand J Public Health. 2015 Mar;43(2):159-68. doi: 10.1177/1403494814562597. Epub 2014 Dec 10.
Socioeconomic inequalities in both disability retirement and mortality are large. The aim of this study was to examine socioeconomic differences in cause-specific mortality after disability retirement due to different diseases.
We used administrative register data from various sources linked together by Statistics Finland and included an 11% sample of the Finnish population between the years 1987 and 2007. The data also include an 80% oversample of the deceased during the follow-up. The study included men and women aged 30-64 years at baseline and those who turned 30 during the follow-up. We used Cox regression analysis to examine socioeconomic differences in mortality after disability retirement.
Socioeconomic differences in mortality after disability retirement were smaller than in the population in general. However, manual workers had a higher risk of mortality than upper non-manual employees after disability retirement due to mental disorders and cardiovascular diseases, and among men also diseases of the nervous system. After all-cause disability retirement, manual workers ran a higher risk of cardiovascular and alcohol-related death. However, among men who retired due to mental disorders or cardiovascular diseases, differences in social class were found for all causes of death examined. For women, an opposite socioeconomic gradient in mortality after disability retirement from neoplasms was found. Conclusions: The disability retirement process leads to smaller socioeconomic differences in mortality compared with those generally found in the population. This suggests that the disability retirement system is likely to accurately identify chronic health problems with regard to socioeconomic status.
残疾退休和死亡率方面的社会经济不平等现象显著。本研究旨在探讨因不同疾病导致残疾退休后，特定病因死亡率的社会经济差异。
我们使用了芬兰统计局将各种来源的行政登记数据关联起来的数据，涵盖了1987年至2007年期间11%的芬兰人口样本。数据还包括随访期间80%的死亡者过采样。该研究纳入了基线时年龄在30 - 64岁以及随访期间满30岁的男性和女性。我们使用Cox回归分析来研究残疾退休后死亡率的社会经济差异。
残疾退休后死亡率的社会经济差异小于总体人群中的差异。然而，体力劳动者在因精神障碍和心血管疾病导致残疾退休后，其死亡风险高于非体力劳动者，男性因神经系统疾病导致残疾退休后也是如此。在全因残疾退休后，体力劳动者心血管疾病和与酒精相关死亡的风险更高。然而，在因精神障碍或心血管疾病退休的男性中，在所研究的所有死因方面都发现了社会阶层差异。对于女性，在因肿瘤导致残疾退休后的死亡率方面发现了相反的社会经济梯度。结论：与总体人群中通常发现的情况相比，残疾退休过程导致死亡率方面的社会经济差异较小。这表明残疾退休制度可能在社会经济地位方面准确识别慢性健康问题。
