The Level and Development of Unemployment before Disability Retirement: A Retrospective Study of Finnish Disability Retirees and Their Controls

Abstract

A weakening work ability may lead to a higher risk of gradual exclusion from working life, which may be manifested in increasing levels of unemployment. This study examined development of unemployment prior to disability retirement by educational level and occupational class in different diagnostic groups. The study population comprised 70% of Finnish residents aged 25-64 years who retired due to disability in 2011-2015 (n = 54,387). Growth curve models were used to analyze the level and development of pre-retirement unemployment among the retirees due to mental disorders, musculoskeletal diseases and all other somatic diseases and their gender-and age-matched controls drawn from the non-retired population. During six pre-retirement years, disability retirees had on average 39 annual excess unemployment days compared to their non-retiring controls. Excess unemployment was particularly high among those retiring due to mental disorders. On average, unemployment increased by 5.5 days per each year of approaching disability retirement, after controlling for aging and secular trends. The increase was largest among those who retired due to mental disorders. Excess unemployment was higher among the less educated and among manual workers, in particular among those retiring due to mental disorders or somatic diseases other than musculoskeletal diseases. Increased efforts to maintain and improve work ability among the unemployed is crucial in diminishing disability retirement at the population level. As the level of unemployment is elevated already several years before disability retirement, work ability problems among the unemployed should be tackled in the early stages.

Incidence and Length of Sickness Absence among Hierarchical Occupational Classes and Non-Wage-Earners: A Register Study of 1.6 Million Finns

“…The unemployed, on the other hand, are known to be in poorer health than the employed population [ 25 ]. Furthermore, those with unemployment background have a greater risk of sickness absence and disability retirement [ 26 , 48 ]. In our study, however, the unemployed did not stand out as a group of especially high cumulative incidence of sickness absence, although unemployed men had a higher incidence than upper non-manual employees did.…”

Changes in Unemployment Affect Sickness Absence and Disability Retirement Rates: A Municipality-Level Panel Study

“…A large number of studies have demonstrated a positive individual-level association of unemployment with sickness absence and disability retirement [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. However, many macro-level studies—especially those looking at trends in unemployment and sickness absence—have shown that sickness absence rates tend to decrease when unemployment increases, and vice versa [ 19 , 20 , 21 , 22 , 23 ].…”

“…Unemployment and disability risks are also interrelated. Several studies have shown that unemployment is positively associated with an individual’s risks of later sickness absence and disability retirement [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. The literature has attributed this positive association to causation and selection that are at work simultaneously: unemployment may have adverse effects on health (=causation), but on the other hand, health problems and weak work ability also increase the risk of unemployment (=selection) [ 12 , 13 , 14 , 15 ].…”

Health-related selection into employment among the unemployed

“…Some of the unemployed also have limited capacity for work and may either remain home to focus on unpaid labor, or they wait to exit from the labor force (e.g. while their disability pension awaits approval) [ 17 , 20 ].…”