Research Unit for Health Sciences, ZHAW School of Health Professions, Technikumstrasse 81, 8400, Winterthur, Switzerland.
Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland.
BMC Public Health. 2019 Jun 26;19(1):831. doi: 10.1186/s12889-019-7098-1.
There has been an overall decreasing trend in the inflow into disability pension in Switzerland since 2003 with the exception of young adults. Disablement in young adulthood reflects a particularly critical phenomenon given the potentially far-reaching long-term social, economic and health consequences. The aim of this study was therefore to identify factors for disability pension in young adults aged 18-39, living in Switzerland.
We used the 2010-2015 cross-sections of the Social protection and labour market; a unique dataset linking microdata from the Swiss Labour Force Survey, the Swiss Central Compensation Office Register, and the Unemployment Insurance Register. Multiple logistic regression was employed to explore the association between demographic, socioeconomic, and health factors and disability pension in young adults living in Switzerland with long-term activity limitation (N = 5306). Alternative specifications of the benchmark model were estimated as robustness checks; and subsample analyses were conducted excluding (i) those aged 18-24 and (ii) those with partial disability pension.
Our regression results showed that those living without a working partner (OR 2.11; 95% CI 1.51-2.94) and without a child aged 0-14 (OR 2.15; 95% CI 1.48-3.12), born in Switzerland (OR 2.68; 95% CI 1.87-3.84), of higher age (OR 1.16; 95% CI 1.12-1.19), having completed at most lower secondary school (OR 3.26; 95% CI 2.24-4.76), lacking income throughout the four-year period prior to interview (OR 3.94; 95% CI 2.70-5.75), suffering from chronic illness (OR 4.52; 95% CI 2.83-7.19), and severe long-term activity limitation (OR 4.52; 95% CI 2.83-7.19) had higher odds of DP. Our findings were robust to alternative specifications and subsamples; and the alternative specifications revealed differences by learnt occupation, with highest odds for those without an occupational qualification (OR 5.93; 95% CI 3.72-9.46; p-value 0.000) and for those in 'Manufacturing' (OR 3.59; 95% CI 1.91-6.71) relative to 'Health, education, culture, and science'.
Most importantly, our results showed that educational and employment factors are of high relevance, as well as chronic morbidity and severe long-term activity limitation. From a policy perspective, early intervention should thus focus on the attainment of vocational and academic qualifications beyond the lower secondary level, facilitating school-to-work transition and labour market integration.
自 2003 年以来,瑞士的残疾抚恤金流入呈总体下降趋势,但年轻成年人除外。年轻人的残疾反映了一个特别关键的现象,因为这可能会产生深远的长期社会、经济和健康后果。因此,本研究的目的是确定瑞士 18-39 岁年轻人残疾抚恤金的相关因素。
我们使用了 2010-2015 年社会保护和劳动力市场的横断面数据;这是一个独特的数据集,将瑞士劳动力调查、瑞士中央赔偿办公室登记处和失业保险登记处的微观数据联系起来。我们采用多变量逻辑回归来探讨与长期活动受限相关的人口统计学、社会经济和健康因素与瑞士年轻成年人残疾抚恤金之间的关联(N=5306)。作为稳健性检验,对基准模型进行了替代规格估计;并进行了亚组分析,排除了(i)18-24 岁的人和(ii)部分残疾抚恤金领取者。
我们的回归结果表明,那些没有工作伴侣(OR 2.11;95%CI 1.51-2.94)和没有 0-14 岁孩子(OR 2.15;95%CI 1.48-3.12)、在瑞士出生(OR 2.68;95%CI 1.87-3.84)、年龄较大(OR 1.16;95%CI 1.12-1.19)、完成至多中学后教育(OR 3.26;95%CI 2.24-4.76)、在访谈前四年期间没有收入(OR 3.94;95%CI 2.70-5.75)、患有慢性病(OR 4.52;95%CI 2.83-7.19)和长期严重活动受限(OR 4.52;95%CI 2.83-7.19)的人领取残疾抚恤金的几率更高。我们的发现对替代规格和亚组分析都是稳健的;替代规格显示了不同的职业学习情况,其中没有职业资格的人(OR 5.93;95%CI 3.72-9.46;p 值<0.000)和从事“制造业”的人(OR 3.59;95%CI 1.91-6.71)的几率最高,而从事“卫生、教育、文化和科学”的人(OR 2.12;95%CI 1.54-2.92)的几率最低。
最重要的是,我们的结果表明,教育和就业因素非常重要,慢性发病和严重的长期活动受限也是如此。因此,从政策角度来看,早期干预应侧重于获得中学后教育和学术资格,促进从学校到工作的过渡和劳动力市场的融入。