Demography Unit, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland.
PLoS One. 2023 Jan 17;18(1):e0280532. doi: 10.1371/journal.pone.0280532. eCollection 2023.
In working ages, sickness absence is strongly related to persons' health condition. We studied how birth order was associated with receipt of sickness allowance, distinguishing between mental disorders, musculoskeletal disorders and injuries.
A follow-up study based on the entire Finnish population was conducted for sibling groups born 1969-1982, in which each sibling was observed from age 35 years in the period 2004-2018. Focus was on within-family variation in first-time sickness allowance receipt.
Results of stratified Cox regressions revealed that each increase in birth order was associated with a slightly higher risk of sickness absence from any cause. For mental disorders, associations were stronger; the hazard ratio as compared to first borns was 1.03 (95% CI: 0.98-1.08) of second borns, 1.10 (0.99-1.22) of third borns, and 1.52 (1.25-1.85) of fourth or higher borns. Corresponding numbers for musculoskeletal disorders were 1.12 (1.07-1.17), 1.19 (1.09-1.30) and 1.15 (0.96-1.38), and for injuries 1.06 (1.01-1.12), 1.09 (1.21-1.14) and 0.96 (0.77-1.20), respectively.
Birth order effects were generally stronger for women than men, and to some extent influenced by educational level, occupation, income, and family composition. Possible latent mechanisms behind the associations may relate to within-family dynamics at childhood.
在工作年龄段，病假与个人健康状况密切相关。我们研究了出生顺序如何与病假津贴的领取相关，区分了精神障碍、肌肉骨骼疾病和损伤。
我们对 1969 年至 1982 年出生的所有芬兰人群进行了一项基于队列的随访研究，对每个兄弟姐妹从 35 岁开始进行了 2004 年至 2018 年期间的观察。重点是家庭内首次领取病假津贴的差异。
分层 Cox 回归的结果表明，出生顺序每增加一次，任何原因导致的病假风险就会略微增加。对于精神障碍，关联更强；与第一胎相比，第二胎的风险比为 1.03（95%CI：0.98-1.08），第三胎为 1.10（0.99-1.22），第四胎或更高胎次为 1.52（1.25-1.85）。相应的肌肉骨骼疾病的数字为 1.12（1.07-1.17）、1.19（1.09-1.30）和 1.15（0.96-1.38），损伤分别为 1.06（1.01-1.12）、1.09（1.21-1.14）和 0.96（0.77-1.20）。
出生顺序的影响在女性中通常比男性更强，在一定程度上受到教育水平、职业、收入和家庭构成的影响。关联背后可能存在潜在的机制，与童年时期的家庭内动态有关。
