National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Washington, DC.
National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, Ohio.
Am J Ind Med. 2020 Aug;63(8):676-684. doi: 10.1002/ajim.23121. Epub 2020 May 23.
The cost of the Social Security Disability Insurance (DI) program has increased over time though recent reports showed that disability incidence and prevalence rates have started declining. We explored whether occupation was one of the risk factors for the rising number of disabled workers who received DI benefits during 1992-2016.
We used a cohort of 16 196 Health and Retirement Survey respondents between the age of 51 and 64 years who were followed from their date of entry until they received DI benefits, died, reached full retirement age, or reached the end of the follow-up period (2016). We used the extended stratified Cox proportional hazard model. Because one-third of the respondents in our cohort did not report their longest-held occupation, we used a multiple-imputation method.
The hazard of receiving DI benefits was 51%, 78%, 81%, and 85% higher among workers with longest-held occupations in sales, mechanics and repair, protective services, and personal services, respectively than among workers with longest-held occupations in the reference managerial occupation. The hazard of receiving DI benefits was more than double among workers with longest-held occupations in the construction trade and extractors, transportation operation, machine operators, handlers, and food preparation than among workers with the longest-held occupation in the reference managerial occupation.
Improving the overall working conditions in these occupations would help reduce worker suffering and the number of applicants for DI benefits, thereby reducing the burden of workplace injury and illness on the DI program.
尽管最近的报告显示残疾发生率和患病率已开始下降,但社会保障残疾保险(DI)计划的成本随着时间的推移而增加。我们探讨了职业是否是导致接受 DI 福利的残疾工人人数增加的一个风险因素,这些工人在 1992 年至 2016 年期间获得了 DI 福利。
我们使用了年龄在 51 至 64 岁之间的 16196 名健康与退休调查受访者的队列,从他们的入职日期开始,对他们进行跟踪,直到他们获得 DI 福利、死亡、达到完全退休年龄或达到随访期结束(2016 年)。我们使用了扩展分层 Cox 比例风险模型。由于我们队列中的三分之一受访者未报告他们的最长任期职业,因此我们使用了多次插补方法。
在销售人员、机械师和维修人员、保护服务人员和个人服务人员中,最长任期职业的工人获得 DI 福利的风险分别比参考管理职业的工人高 51%、78%、81%和 85%。在建筑行业和提取行业、运输运营、机器操作员、处理人员和食品制备行业中,最长任期职业的工人获得 DI 福利的风险是参考管理职业工人的两倍多。
改善这些职业的整体工作条件将有助于减少工人的痛苦和 DI 福利申请人的数量,从而减轻工作场所伤害和疾病对 DI 计划的负担。