This paper describes the development of population health and disability insurance utilization for older workers in Sweden and analyzes the relation between the two. We use three different measures of population health: (1) the mortality rate (measured between 1950 and 2009); (2) the prevalence of different types of health deficiencies obtained from Statistics Sweden's Survey on Living Conditions (ULF, 1975-2005); (3) the utilization of health care from the inpatient register (1968-2008). We also study the development of the relative health between disability insurance recipients and non-recipients. Finally, we study the effect of the introduction of less strict eligibility criteria for older workers in 1970 and 1972 as well as the subsequent abolishment of these rules in 1991 and 1997, respectively.
This paper describes the development of population health and disability insurance utilization for older workers in Sweden and analyzes the relation between the two. We use three different measures of population health: (1) the mortality rate (measured between 1950 and 2009); (2) the prevalence of different types of health deficiencies obtained from Statistics Sweden's Survey on Living Conditions (ULF, 1975-2005); (3) the utilization of health care from the inpatient register (1968-2008). We also study the development of the relative health between disability insurance recipients and non-recipients. Finally, we study the effect of the introduction of less strict eligibility criteria for older workers in 1970 and 1972 as well as the subsequent abolishment of these rules in 1991 and 1997, respectively.
BackgroundDriving under the influence (DUI) programs are a unique setting to reduce disparities in treatment access to those who may not otherwise access treatment. Providing evidence‐based therapy in these programs may help prevent DUI recidivism.MethodsWe conducted a randomized clinical trial of 312 participants enrolled in 1 of 3 DUI programs in California. Participants were 21 and older with a first‐time DUI offense who screened positive for at‐risk drinking in the past year. Participants were randomly assigned to a 12‐session manualized cognitive behavioral therapy (CBT) or usual care (UC) group and then surveyed 4 and 10 months later. We conducted intent‐to‐treat analyses to test the hypothesis that participants receiving CBT would report reduced impaired driving, alcohol consumption (drinks per week, abstinence, and binge drinking), and alcohol‐related negative consequences. We also explored whether race/ethnicity and gender moderated CBT findings.ResultsParticipants were 72.3% male and 51.7% Hispanic, with an average age of 33.2 (SD = 12.4). Relative to UC, participants receiving CBT had lower odds of driving after drinking at the 4‐ and 10‐month follow‐ups compared to participants receiving UC (odds ratio [OR] = 0.37, p = 0.032, and OR = 0.29, p = 0.065, respectively). This intervention effect was more pronounced for females at 10‐month follow‐up. The remaining 4 outcomes did not significantly differ between UC versus CBT at 4‐ and 10‐month follow‐ups. Participants in both UC and CBT reported significant within‐group reductions in 2 of 5 outcomes, binge drinking and alcohol‐related consequences, at 10‐month follow‐up (p < 0.001).ConclusionsIn the short‐term, individuals receiving CBT reported significantly lower rates of repeated DUI than individuals receiving UC, which may suggest that learning cognitive behavioral strategies to prevent impaired driving may be useful in achieving short‐term reductions in impaired driving.
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