| 1. |
- Månsson, Nils-Ove, et al.
(författare)
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Alcohol consumption and disability pension among middle-aged men
- 1999
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Ingår i: Annals of Epidemiology. - 1047-2797. ; 9:6, s. 341-348
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To analyze the relation between alcohol consumption and the risk of disability pension among middle-aged men. METHODS: In the mid-seventies, complete birth-year cohorts of middle-aged male residents in Malmo, Sweden, were invited to participate in a general health survey. The 3751 men with complete data who constituted the cohort in this study were followed for 11 years. Alcohol consumption was estimated from the scores obtained from a test designed to identify subjects with alcohol related problems. RESULTS: Of the 498 men granted disability pension during follow-up, 48 stated to be teetotalers. The cumulative incidence of disability pension among teetotalers was 19%, whereas, it was 12% and 16%, respectively, among men with low and high alcohol consumption. The adjusted relative risk (RR) for acquiring a disability pension (using the group with low alcohol consumption as reference) was 1.8 among abstainers and 1.3 among men with high alcohol consumption. CONCLUSIONS: Alcohol overconsumption, as well as teetotalism, showed a positive relation to disability pension, and a moderate alcohol intake was found to be beneficial with respect to the risk of future disability pension.
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| 2. |
- Månsson, Nils-Ove, et al.
(författare)
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Body mass index and disability pension in middle-aged men--non-linear relations
- 1996
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 1464-3685 .- 0300-5771. ; 25:1, s. 80-85
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Obesity has, in a number of studies, been found to correlate to disability and mortality, primarily due to diseases of the circulatory and musculoskeletal systems. In addition, an excess mortality among underweight subjects has been observed in previous studies. METHODS: Five complete birth-year cohorts (1926-1930) of male residents in Malmo (n = 7697) were invited to the survey at the Department of Preventive Medicine, Malmo General Hospital, and 5926 (77%) attended with complete data. Each subject was followed from inclusion, defined by the date of examination, until the end of the calendar year when he turned 58, a total study period of approximately 11 years. Data on about 300 questionnaire items and laboratory tests were determined at the health survey visit. Nationwide Swedish data registers were used for surveillance. RESULTS: Of the participants, 4.7% were underweight, 37.7% overweight, 7.3% obese and 50.3% normal weight; 849 (14.3%) had been granted disability pension at the end of follow-up, 717 after screening. After adjustment for smoking there was a J-shaped relation between body mass index (BMI) and incidence of disability pension, the relative risk ( with the normal group as reference) among underweight men being 1.9. For the overweight subjects it was 1.3 and for the obese 2.8, all differences were significant. Disease of the musculoskeletal and circulatory systems and mental disorders accounted for 67.2% of all main diagnoses resulting in disability pensions during follow-up. A total of 377 (6.4%) men died during follow-up. Diseases of the circulatory system, neoplasms, injury/poisoning and diseases of the respiratory system accounted for 91.8% of the deaths. CONCLUSIONS: Both underweight, overweight and obesity were related to risk of disability pension, with a J-shaped risk relationship.
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| 3. |
- Månsson, Nils-Ove
(författare)
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Disability pension. Epidemiological and financial aspects.
- 1997
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- During the last decades, the incidence of disability pension in Sweden has increased continuously and it peaked in 1993 at approximately 62,000 new pensions. Early retirement due to occupational disability often constitutes a problem for the society as well as for the individual. The aim of this thesis was to analyse aspects on the risk of disability pension, to describe changes in health after the decision on disability pension and to estimate the financial expenditure. A total of 7,697 men, comprising five complete birth-year cohorts (1926-1930) of male residents in Malmö, Sweden, were invited to a screening programme in the mid-1970’s. Decisions on disability pension and mortality data were identified from national computerised data bases. At the end of follow-up (the calendar year when the men turned 58), 18% had been granted disability pension, the incidence higher (31%) among those who refrained to participate in the screening program. Frequent causes for disability pension, altogether accounting for 74% of the cases, were musculoskeletal diseases, mental disorders (including alcohol dependence) and diseases of the circulatory system. Alcohol dependence was more common among non-participants. Mental disorders predominated in younger age groups and musculoskeletal diseases in older ones. Compared with normal body mass index, obesity in particular, but also under- and overweight, were associated with higher risk of disability pension. For those who were not teetotallers, alcohol consumption was estimated from the scores obtained at an alcohol screening test. Low alcohol consumption was related to low risk of disability pension while high alcohol consumption and high risk of disability pension showed a positive relation. Teetotallers were at higher risk of disability pension than those with low alcohol consumption, although conclusions regarding this association must be drawn with great prudence. Socioeconomic status, as defined by occupation, was associated with risk of disability pension. Compared with higher level white collar workers, blue collar workers in particular but also lower level white collar workers were at higher risk. During the period when the disability pensions were granted, an increase in circulatory disease was observed while the prevalence of psychiatric disease and use of hypnotics remained practically unchanged. The proportion of men with complaints of back problems was considerably higher after pension than before. A registration of the decisions on all new disability pensions in Malmöhus county was made during a period of three months. During the first two and a half years after the decision, a small number of the pensions were terminated mainly due to deaths but also because of pensions that were discontinued. The rankings of the diagnosis categories on the one hand and their respective financial costs on the other, were equal. However, the proportions of the costs were lower for musculoskeletal diseases and higher for mental disorders compared with the respective proportions of the diagnoses. For unemployed subjects, mental disorders made the largest contribution to the financial costs.
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| 4. |
- Månsson, Nils-Ove, et al.
(författare)
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Disability pension in Malmohus county: aspects on long-term financial effects
- 1998
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Ingår i: Scandinavian Journal of Social Medicine. - : SAGE Publications. - 0300-8037. ; 26:2, s. 102-105
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to estimate the financial costs of disability pension in order to compare the financial burden and the numerical distribution of disability pension by main diagnostic groups. During three months all new disability pensions (n = 944) granted in Malmohus county were registered. During a follow-up of approximately two and a half years, 40 subjects died and 15 pensions expired. The predominating diagnoses were musculoskeletal diseases, mental disorders including alcohol dependence, cardiovascular and neurological diseases. To analyse whether these proportions changed when the extent of the pension, age at pension and the retirement allowance were considered, the present value of the total retirement allowances was calculated. The ranking of the four predominating diagnosis categories was not affected by the extent of the pension or the age at which the pension was granted. Thus, musculoskeletal diseases still predominated, although the proportion decreased. Among unemployed subjects, mental disorders made the largest contribution to the total expenditure. The results gained may be used in further research where alternatives to disability pension for different groups of patients and/or diagnoses are investigated.
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| 5. |
- Månsson, Nils-Ove, et al.
(författare)
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Socioeconomic inequalities and disability pension in middle-aged men
- 1998
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Ingår i: International Journal of Epidemiology. - 1464-3685. ; 27:6, s. 1019-1025
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The issue of inequalities in health has generated much discussion and socioeconomic status is considered an important variable in studies of health. It is frequently used in epidemiological studies, either as a possible risk factor or a confounder and the aim of this study was to analyse the relation between socioeconomic status and risk of disability pension. METHODS: Five complete birth year cohorts of middle-aged male residents in Malmo were invited to a health survey and 5782 with complete data constituted the cohort in this prospective study. Each subject was followed for approximately 11 years and nationwide Swedish data registers were used for surveillance. RESULTS: Among the 715 men (12%), granted disability pension during follow-up, three groups were distinguished. The cumulative incidence of disability pension among blue collar workers was 17% and among lower and higher level white collar workers, 11% and 6% respectively. With simultaneous adjustment for biological risk factors and job conditions, the relative risk for being granted a disability pension (using higher level white collar workers as reference) was 2.5 among blue collar workers and 1.6 among lower level white collar workers. CONCLUSIONS: Socioeconomic status, as defined by occupation, is a risk factor for being granted disability pension even after adjusting for work conditions and other risk factors for disease.
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