Can high psychological job demands, low decision latitude, and high job strain predict disability pensions? A 12-year follow-up of middle-aged Swedish workers
- 1.6k Downloads
The aim of this study was to investigate whether job strain, psychological demands, and decision latitude are independent determinants of disability pension rates over a 12-year follow-up period.
We studied 3,181 men and 3,359 women, all middle-aged and working at least 30 h per week, recruited from the general population of Malmö, Sweden, in 1992. The participation rate was 41 %. Baseline data include sociodemographics, the Job Content Questionnaire, lifestyle, and health-related variables. Disability pension information was obtained through record linkage from the National Health Insurance Register.
Nearly 20 % of the women and 15 % of the men were granted a disability pension during the follow-up period. The highest quartile of psychological job demands and the lowest quartile of decision latitude were associated with disability pensions when controlling for age, socioeconomic position, and health risk behaviours. In the final model, with adjustment also for health indicators and stress from outside the workplace, the hazard ratios for high strain jobs (i.e. high psychological demands in combination with low decision latitude) were 1.5 in men (95 % CI, 1.04–2.0) and 1.7 in women (95 % CI, 1.3–2.2). Stratifying for health at baseline showed that high strain tended to affect healthy but not unhealthy men, while this pattern was reversed in women.
High psychological demands, low decision latitude, and job strain were all confirmed as independent risk factors for subsequent disability pensions. In order to increase chances of individuals remaining in the work force, interventions against these adverse psychosocial factors appear worthwhile.
KeywordsDisability leave Stress, physiological Stress, psychological Gender Longitudinal studies
This study was supported by grants from the Swedish Medical Research Council, the Swedish Council for Social Research, the Medical Faculty at Lund University, the National Institute of Public Health, and the Swedish Work Environment Fund.
Conflict of interest
The authors declare that they have no conflict of interest.
- Armor D, Polich J (1982) Measurement of alcohol consumption. In: Pattison EM, Kaufman E (eds) Encyclopedic handbook of alcoholism. Gardner Press, New York, pp 72–80Google Scholar
- Claussen B (1998) Restricting the influx of disability beneficiaries by means of law: experiences in Norway. Scand J Soc Med 26:1–7Google Scholar
- Government Offices of Sweden (2010) Sickness insurance in Sweden 2009. http://www.sweden.gov.se/. Accessed 25 April 2011
- Kaplan GA, Camacho T (1983) Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort. Am J Epidemiol 117:292–304Google Scholar
- OECD (2003) Transforming disability into ability: policies to promote work and income security for disabled people. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860194/?tool=pubmed. Accessed 25 April 2011
- Östergren PO, Hanson BS, Balogh I, Ektor-Andersen J, Isacsson A, Orbaek P et al (2005) Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmö shoulder and neck study cohort. J Epidemiol Commun Health 59:721–728CrossRefGoogle Scholar
- Punnett L, Cherniack M, Henning R, Morse T, Faghri P, CPH-NEW Research Team (2009) A conceptual framework for integrating workplace health promotion and occupational ergonomics programs. Public Health Rep Suppl 1:16–25Google Scholar
- SHARE (2009) Tackling the demographic challenge: the survey of health, ageing, and retirement in Europe. http://www.share-project.org/t3/share/fileadmin/SHARE_Brochure/share_broschuere_web_final.pdf. Accessed 25 April 2011
- Statistics Sweden (1982) Swedish socioeconomic classification. (in Swedish). http://www.scb.se/Pages/PublishingCalendarViewInfo____259924.aspx?PublObjId=6607
- Sundquist J, Al-Windi A, Johansson SE, Sundquist K (2007) Sickness absence poses a threat to the Swedish welfare state: a cross-sectional study of sickness absence and self-reported illness. BMC Public Health 7:45. http://www.biomedcentral.com/1471-2458/7/45. Accessed 6 May 2011
- Swedish Social Insurance Agency (2010) Social insurance in figures 2009. http://www.forsakringskassan.se/irj/go/km/docs/fk_publishing/Dokument/Publikationer/Socialforsakingen_%20i_siffror/socialforsakringen_i_siffror_2009_eng.pdf. Accessed 25 April 2011
- Theorell T, Harms-Ringdahl K, Ahlberg-Hulten G, Westin B (1991) Psychosocial job factors and symptoms from the locomotor system—a multicausal analysis. Scand J Rehabil Med 23:165–173Google Scholar