Scandinavian Journal of Work, Environment & Health (Nov 2013)
Regional differences in disability retirement: explaining between-county differences in Finland
Abstract
OBJECTIVES: This study aimed to examine between-county differences in disability retirement due to main diagnosis groups and explain these differences by individual-level demographic and work-related factors and municipality-level characteristics. METHODS: A 20% random sample of the Finnish social insured population aged 25-62 years at the end of 2006 was followed for disability retirement until the end of 2011. Individual-level demographic and work-related covariates were derived from the registers of the Finnish Centre for Pensions and complemented by municipality-level covariates from the national SotkaNet databank. Standardized disability retirement rates were calculated and logistic regression analysis was used to examine between-county differences during the 5-year follow-up. RESULTS: In the county with the highest incidence, disability retirement was nearly twice as common as in the county with the lowest incidence. The between-county differences were larger in disability retirement due to cardiovascular and musculoskeletal diseases than other causes. Adjusting for demographic and work-related characteristics explained a third of the differences. Further adjustment for municipal characteristics explained up to 60% of the differences. However, in regions of Northern and Eastern Finland with the highest incidence of disability retirement, 20–30% excess incidence remained even after all adjustments. CONCLUSIONS: Large differences exist in disability retirement between Finnish counties. Disability retirement due to musculoskeletal diseases has the highest impact on the overall differences. Demographic structure and work-related characteristics but also municipality-level characteristics contribute to these differences.
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