BACKGROUND: Non-medical factors may contribute substantially to the risk of becoming disabled, despite the common medically based criteria for disability pension. This study seeks to identify medical and non-medical determinants for the national medically-based disability pension in a Norwegian total population. MATERIAL AND METHODS: The baseline data were obtained through a comprehensive health screening programme, the Nord-Trøndelag Health Study in 1984-86 (HUNT I). Participants were people without disability pension, 20-66 years old in 1984-86. Information on disability pensioning was obtained from the National Insurance Administration database in 1995. Data analysis was performed by life table and Cox regression analysis. RESULTS: The incidence of disability pension showed great variations by age and gender; there was an increase over the follow-up period, especially among people below 50. We found a consistent pattern of increasing risk of disability pension with decreasing socio-economic status and education. Low educational level, low perceived health, occupational related factors, and any long-standing health problem were found to be the strongest independent risk factors for disability pension. INTERPRETATION: Non-medical factors are strong risk factors for disability pension. These factors are usually not addressed by individually based health or rehabilitation programmes. Thus, when it comes to addressing the causes of incidence of disability pension in the population, the results suggest a population approach.
BACKGROUND: Non-medical factors may contribute substantially to the risk of becoming disabled, despite the common medically based criteria for disability pension. This study seeks to identify medical and non-medical determinants for the national medically-based disability pension in a Norwegian total population. MATERIAL AND METHODS: The baseline data were obtained through a comprehensive health screening programme, the Nord-Trøndelag Health Study in 1984-86 (HUNT I). Participants were people without disability pension, 20-66 years old in 1984-86. Information on disability pensioning was obtained from the National Insurance Administration database in 1995. Data analysis was performed by life table and Cox regression analysis. RESULTS: The incidence of disability pension showed great variations by age and gender; there was an increase over the follow-up period, especially among people below 50. We found a consistent pattern of increasing risk of disability pension with decreasing socio-economic status and education. Low educational level, low perceived health, occupational related factors, and any long-standing health problem were found to be the strongest independent risk factors for disability pension. INTERPRETATION: Non-medical factors are strong risk factors for disability pension. These factors are usually not addressed by individually based health or rehabilitation programmes. Thus, when it comes to addressing the causes of incidence of disability pension in the population, the results suggest a population approach.
Authors: Stein Knardahl; Håkon A Johannessen; Tom Sterud; Mikko Härmä; Reiner Rugulies; Jorma Seitsamo; Vilhelm Borg Journal: BMC Public Health Date: 2017-02-08 Impact factor: 3.295