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      The Level and Development of Unemployment before Disability Retirement: A Retrospective Study of Finnish Disability Retirees and Their Controls

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          Abstract

          A weakening work ability may lead to a higher risk of gradual exclusion from working life, which may be manifested in increasing levels of unemployment. This study examined development of unemployment prior to disability retirement by educational level and occupational class in different diagnostic groups. The study population comprised 70% of Finnish residents aged 25–64 years who retired due to disability in 2011–2015 (n = 54,387). Growth curve models were used to analyze the level and development of pre-retirement unemployment among the retirees due to mental disorders, musculoskeletal diseases and all other somatic diseases and their gender- and age-matched controls drawn from the non-retired population. During six pre-retirement years, disability retirees had on average 39 annual excess unemployment days compared to their non-retiring controls. Excess unemployment was particularly high among those retiring due to mental disorders. On average, unemployment increased by 5.5 days per each year of approaching disability retirement, after controlling for aging and secular trends. The increase was largest among those who retired due to mental disorders. Excess unemployment was higher among the less educated and among manual workers, in particular among those retiring due to mental disorders or somatic diseases other than musculoskeletal diseases. Increased efforts to maintain and improve work ability among the unemployed is crucial in diminishing disability retirement at the population level. As the level of unemployment is elevated already several years before disability retirement, work ability problems among the unemployed should be tackled in the early stages.

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          Most cited references19

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          Unemployment and ill health: understanding the relationship.

          To review research relevant to understanding the psychological, social, and biological pathways by which unemployment may affect health risk; to consider the importance of four specific mechanisms; and to indicate some directions for future research. Studies were chosen to illustrate the development of four major hypotheses regarding the relationship between unemployment and ill health, as well as the present state of knowledge. The review therefore includes some much-cited "classics" drawn from a long time span. Where recent reviews already exist relevant to individual mechanisms, these are referred to. Recent (since 1987) reports were sought by searching the BIDS data base. Particular effort was made to locate studies which enabled alternative hypotheses to be evaluated, and to point out where existing evidence is inconsistent or incomplete, indicating the need for further research. To understand the relationship between unemployment and ill health and mortality, four mechanisms need to be considered: the role of relative poverty; social isolation and loss of self esteem; health related behaviour (including that associated with membership of certain types of "subculture"); and the effect that a spell of unemployment has on subsequent employment patterns.
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            Job strain and the risk of disability pension due to musculoskeletal disorders, depression or coronary heart disease: a prospective cohort study of 69 842 employees

            Observational studies suggest that high job strain is a risk factor for retirement on health grounds, but few studies have analysed specific diagnoses. We examined job strain's association with all-cause and cause-specific disability pensions. Survey responses to questions about job strain from 48,598 (response rate, 68%) public sector employees in Finland from 2000 to 2002 were used to determine work unit- and occupation-based scores. These job strain scores were assigned to all the 69,842 employees in the same work units or occupations. All participants were linked to the disability pension register of the Finnish Centre of Pensions with no loss to follow-up. Cox proportional hazard models were used to calculate HRs and their 95% CIs for disability pensions adjusted by demographic, work unit characteristics and baseline health in analyses stratified by sex and socioeconomic position. During a mean follow-up of 4.6 years, 2572 participants (4%) were granted a disability pension. A one-unit increase in job strain was associated with a 1.3- to 2.4-fold risk of requiring a disability pension due to musculoskeletal diseases in men, women and manual workers, depending on the measure of job strain (work unit or occupation based). The risk of disability pension due to cardiovascular diseases was increased in men with high job strain but not in women nor in any socioeconomic group. No consistent pattern was found for disability pension due to depression. High job strain is a risk factor for disability pension due to musculoskeletal diseases.
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              Economic Contraction and Mental Health

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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                08 March 2020
                March 2020
                : 17
                : 5
                : 1756
                Affiliations
                [1 ]Finnish Centre for Pensions (ETK-Eläketurvakeskus), 00065 Helsinki, Finland
                [2 ]The Social Insurance Institution of Finland (KELA), 00520 Helsinki, Finland
                Author notes
                [* ]Correspondence: mikko.laaksonen@ 123456etk.fi ; Tel.: +358-29-411-2156
                Author information
                https://orcid.org/0000-0002-6979-9872
                Article
                ijerph-17-01756
                10.3390/ijerph17051756
                7084885
                32182683
                6ed2df5e-9825-4ddd-aac5-0c8a34e72709
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 24 January 2020
                : 06 March 2020
                Categories
                Article

                Public health
                unemployment,disability retirement,work ability,socioeconomic
                Public health
                unemployment, disability retirement, work ability, socioeconomic

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