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The impact of longstanding illness and common mental disorder on competing employment exits routes in older working age: A longitudinal data-linkage study in Sweden.
Harber-Aschan, Lisa; Chen, Wen-Hao; McAllister, Ashley; Koitzsch Jensen, Natasja; Thielen, Karsten; Andersen, Ingelise; Diderichsen, Finn; Barr, Ben; Burström, Bo.
Afiliación
  • Harber-Aschan L; Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, Stockholm, Sweden.
  • Chen WH; Social Analysis and Modelling Division, Statistics Canada, Ottawa, Canada.
  • McAllister A; Department of Global Public Health, Equity and Health Policy Research Group, Karolinska Institutet, Stockholm, Sweden.
  • Koitzsch Jensen N; Melbourne School of Global and Population Health, Disability and Health Unit, The University of Melbourne, Melbourne, Australia.
  • Thielen K; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
  • Andersen I; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
  • Diderichsen F; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
  • Barr B; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
  • Burström B; Department of Public Health and Policy, University of Liverpool, Liverpool, England, United Kingdom.
PLoS One ; 15(2): e0229221, 2020.
Article en En | MEDLINE | ID: mdl-32097437
OBJECTIVES: Comorbidity is prevalent in older working ages and might affect employment exits. This study aimed to 1) assess the associations between comorbidity and different employment exit routes, and 2) examine such associations by gender. METHODS: We used data from employed adults aged 50-62 in the Stockholm Public Health Survey 2002 and 2006, linked to longitudinal administrative income records (N = 10,416). The morbidity measure combined Limiting Longstanding Illness and Common Mental Disorder-captured by the General Health Questionnaire-12 (≥4)-into a categorical variable: 1) No Limiting Longstanding Illness, no Common Mental Disorder, 2) Limiting Longstanding Illness only, 3) Common Mental Disorder only, and 4) comorbid Limiting Longstanding Illness+Common Mental Disorder. Employment status was followed up until 2010, treating early retirement, disability pension and unemployment as employment exits. Competing risk regression analysed the associations between morbidity and employment exit routes, stratifying by gender. RESULTS: Compared to No Limiting Longstanding Illness, no Common Mental Disorder, comorbid Limiting Longstanding Illness+Common Mental Disorder was associated with early retirement in men (subdistribution hazard ratio = 1.73, 95% confidence intervals: 1.08-2.76), but not in women. For men and women, strong associations for disability pension were observed with Limiting Longstanding Illness only (subdistribution hazard ratio = 11.43, 95% confidence intervals: 9.40-13.89) and Limiting Longstanding Illness+Common Mental Disorder (subdistribution hazard ratio = 14.25, 95% confidence intervals: 10.91-18.61), and to a lesser extent Common Mental Disorder only (subdistribution hazard ratio = 2.00, 95% confidence intervals: 1.31-3.05). Women were more likely to exit through disability pension than men (subdistribution hazard ratio = 1.96, 95% confidence intervals: 1.60-2.39). Common Mental Disorder only was the only morbidity category associated with unemployment (subdistribution hazard ratio = 1.70, 95% confidence intervals: 1.36-2.15). CONCLUSIONS: Strong associations were observed between specific morbidity categories with different employment exit routes, which differed by gender. Initiatives to extend working lives should consider older workers' varied health needs to prevent inequalities in older age.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pensiones / Trastornos Psicóticos / Jubilación / Desempleo / Empleo Tipo de estudio: Observational_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Patient_preference Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2020 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pensiones / Trastornos Psicóticos / Jubilación / Desempleo / Empleo Tipo de estudio: Observational_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Patient_preference Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2020 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos