Academic journal article Scandinavian Journal of Work, Environment & Health

Regional Differences in Disability Retirement: Explaining Between-County Differences in Finland

Academic journal article Scandinavian Journal of Work, Environment & Health

Regional Differences in Disability Retirement: Explaining Between-County Differences in Finland

Article excerpt

Laaksonen M, Gould R. Regional differences in disability retirement: explaining between-county differences in Finland. Scand J Work Environ Health. 2013;39(6):609-617. doi:10.5271/sjweh.3373

Objectives This study aimed to examine between-county differences in disability retirement due to main diagnosis groups and explain these differences by individual-level demographic and work-related factors and municipality-level characteristics.

Methods A 20% random sample of the Finnish social insured population aged 25-62 years at the end of 2006 was followed for disability retirement until the end of 2011. Individual-level demographic and work-related covariates were derived from the registers of the Finnish Centre for Pensions and complemented by municipality- level covariates from the national SotkaNet databank. Standardized disability retirement rates were calculated and logistic regression analysis was used to examine between-county differences during the 5-year follow-up.

Results In the county with the highest incidence, disability retirement was nearly twice as common as in the county with the lowest incidence. The between-county differences were larger in disability retirement due to cardiovascular and musculoskeletal diseases than other causes. Adjusting for demographic and work-related characteristics explained a third of the differences. Further adjustment for municipal characteristics explained up to 60% of the differences. Flowever, in regions of Northern and Eastern Finland with the highest incidence of disability retirement, 20-30% excess incidence remained even after all adjustments.

Conclusions Large differences exist in disability retirement between Finnish counties. Disability retirement due to musculoskeletal diseases has the highest impact on the overall differences. Demographic structure and work-related characteristics but also municipality-level characteristics contribute to these differences.

Key terms area; cardiovascular disease; mental disorder; musculoskeletal disease; prospective cohort study; work-related factor; municipality characteristic.

In recent years increasing attention has been paid to rapid population aging, which leads to a larger proportion of retirees compared to active employees. Increasing the average retirement age has been considered crucial to ease pressures on social security and welfare systems due to an aging population (1-3). Disability retirement often occurs at relatively young age and considerably lowers the effective retirement age. In Finland, more than 20 000 employees retire due to disability each year, which cor- responds to nearly one third of all retirees. In 2011, the average age of disability retirement was 53 years among both men and women (4). Postponing disability retire- ment thus is an important component among the possible measures of increasing retirement age.

Understanding the variation in disability retirement rates across population groups may reveal possibilities for effective targeting of the means aimed at reducing disability retirement. Previous research has shown that the risk of disability retirement varies by characteristics such as age and gender (5, 6) as well as occupational class and various work-related factors (7, 8). However, remarkably little attention has been paid to differences between geographical areas, even if large variation has been described between regional entities such as prov- inces or counties and between urban and rural munici- palities (9, 10). For instance, between Finnish counties the proportion of disability pension recipients of the population aged 16-64 years varied from 4.6 to 11.0%, while the average was 7.3%. Between municipalities the proportions ranged from less than 4 to 20.1% (11). With respect to the aim of increasing the retirement age, these differences also need attention.

Studies that have examined regional differences in disability retirement are few. A study comparing 24 municipalities in Nord-Trondelag county in Norway found a clear geographical pattern with age-standardized disability retirement rates around 80 in the eastern inland regions and as high as 135 in the western and coastal regions. …

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