Bright waters, dark moods – explaining regional differences in early retirement with psychiatric disorders

• Social insurance costs have increased dramatically in Sweden and are now higher than the total costs for all health care in the country. Aim The aim of this study was to describe the regional differences in early retirement with psychiatric disorders over the last 20 years and to analyse these differences in relation to the socio demographic distribution of the population in different regions. Method The study was performed as an ecological study comparing the rates of early retirement in Sweden, in the city of Göteborg and the county of Bohuslän, both located on the Swedish west coast. The study population was all sickness insured individuals aged 16–64 years. Data on early retirement was collected from the National Social Insurance register. Population data was collected from Statistics Sweden. Diagnoses were classified according to ICD. Longitudinal data covering the last 20 years was used. Results We found that the regional differences in early retirement with psychiatric disorders were consistent over the studied years. In 1980 the proportion of early retirement with psychiatric disorders was 25% of all early retirements in the city of Göteborg to be compared with 17% in the county of Bohuslän and 15% in Sweden overall. This proportion changed over the years and was in 1998 37% in Göteborg, 25% in Bohuslän and 24% in Sweden. These data also show the large increase of early retirement with psychiatric disorders in relation to other diagnostic groups. Standard mortality ratio 1993 with Sweden as reference was 1.14 in Bohuslän and 2.55 in Göteborg. Corresponding figures for women were 1.30 and 2.29. Conclusion Regional differences remained after controlling for age and sex distribution of the population. From a preliminarily analysis it appears as the high rate in Göteborg cannot be explained as an effect of urbanity. More knowledge is needed to understand why regional differences exist.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Nyckelord

disability pensin

regional differences

Publikations- och innehållstyp

vet (ämneskategori)

kon (ämneskategori)