Sickness allowance is paid for short-term sickness absence and is thus an indicator of temporary ill health, but it is also associated with a heightened risk of receiving disability pension. Using event history analysis, we examined the long-term risk for disability pension receipt after first observed receipt of medically certified sickness allowance in each single year after sickness allowance was first recorded. Utilizing longitudinal data from the Finnish population register, covering the period 1989–2010, we observed 110,675 individuals aged 16–40 years at baseline. Using discrete-time hazard models, we estimated how the first observed receipt of sickness allowance was related to the risk of receiving disability pension, with an average follow-up time of 20.6 years. In this population, about 40 percent received sickness allowance and 10 percent received disability pension. In the first years after sickness allowance receipt, there was a substantial difference between long-term and short-term sickness allowance recipients in the hazard of becoming a disability pensioner. This difference levelled out over time, but even 20 years after the first observed sickness allowance receipt, the hazard of disability retirement was more than 15 times higher than that of non-recipients of sickness allowance. Patterns were similar for men and women. First observed receipt of sickness allowance is a powerful predictor for disability pension receipt, also in the very distant future. Thus, it can be used to monitor people with heightened risk of becoming more permanently ill and falling outside the labour market.

Individuals’ labour market status and health are known to be highly correlated. To investigate this association beyond prime working ages, we study how all-cause mortality at ages 65–70 relates to different labour market positions at ages 50–64. The data stem from random samples of the Finnish population, which make it possible to follow 33,000 individuals in the period 1987–2011. Hazard models are estimated to quantify the associations. For both men and women, disability pensioners have a hazard of dying at age 65+ that is approximately twice that of persons who were employed, and this ratio still exceeds 1.5 when socioeconomic and demographic variables are included. Also male unemployment, but not female, is associated with an elevated mortality risk, but this interrelation depends greatly on socioeconomic position.

Swedish speakers in Finland have higher life expectancy and lower disability retirement rates than Finnish speakers. Although disability retirement is an important mortality predictor, no previous study has analysed the ethnolinguistic mortality gradient in light of the difference in disability pension receipt. We study how being a disability pensioner in ages 50–64 relates to mortality in ages 65–70 and whether the two ethnolinguistic groups differ in this respect. We use Cox regressions on longitudinal population register data covering 1987–2011. Disability pensioners have a mortality hazard that is about twice that of employed persons. We find this pattern to be highly similar for both ethnolinguistic groups. Our results highlight that in order to understand mortality variation across population subgroups, adequate control for previous labour market position is needed. The Finnish welfare system seems to respond appropriately in identifying disability pensioners with equally impaired health in both ethnolinguistic groups.

The Swedish-speaking ethnolinguistic minority in Finland has a health advantage over the Finnish-speaking majority in terms of lower levels of sickness allowance and disability pension receipt. We examine whether this differential has consequences within the social security system by analysing the long-term risk for disability pension after sickness allowance receipt. With longitudinal population-register data covering the period 1989–2010, we observed 110,390 individuals aged 16–40 years at baseline. Using discrete-time hazard models, we estimated how first observed receipt of sickness allowance relates to disability pension receipt in the Finnish- and Swedish-speaking groups. Receipt of sickness allowance was found to be an important predictor for future disability pension receipt, but there were no systematic differences between the two ethnolinguistic groups in this respect, and the results were highly similar for men and women. These findings suggest that the social security system in Finland is non-discriminatory and provides equal treatment of both ethnolinguistic groups despite their overall health differential.

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