Early Determinants of Work Disability in an International Perspective.
Ontology highlight
ABSTRACT:
SUBMITTER: Borsch-Supan A
PROVIDER: S-EPMC7584547 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
Publications
Early Determinants of Work Disability in an International Perspective.
Börsch-Supan Axel A Bucher-Koenen Tabea T Hanemann Felizia F
Demography 20201001 5
This study explores the interrelated roles of health and welfare state policies in the decision to take up disability insurance (DI) benefits due to work disability (WD), defined as the (partial) inability to engage in gainful employment as a result of physical or mental illness. We exploit the large international variation of health, self-reported WD, and the uptake of DI benefits in the United States and Europe using a harmonized data set with life history information assembled from SHARE, ELS ...[more]
Similar Datasets
Project description:BackgroundPersons with a lower socioeconomic position spend more years with disability, despite their shorter life expectancy, but it is unknown what the important determinants are. This study aimed to quantify the contribution to educational inequalities in years with disability of eight risk factors: father's manual occupation, low income, few social contacts, smoking, high alcohol consumption, high body-weight, low physical exercise and low fruit and vegetable consumption.MethodsWe collected register-based mortality and survey-based disability and risk factor data from 15 European countries covering the period 2010-14 for most countries. We calculated years with disability between the ages of 35 and 80 by education and gender using the Sullivan method, and determined the hypothetical effect of changing the prevalence of each risk factor to the prevalence observed among high educated ('upward levelling scenario'), using Population Attributable Fractions.ResultsYears with disability among low educated were higher than among high educated, with a difference of 4.9 years among men and 5.5 years among women for all countries combined. Most risk factors were more prevalent among low educated. We found the largest contributions to inequalities in years with disability for low income (men: 1.0 year; women: 1.4 year), high body-weight (men: 0.6 year; women: 1.2 year) and father's manual occupation (men: 0.7 year; women: 0.9 year), but contributions differed by country. The contribution of smoking was relatively small.ConclusionsDisadvantages in material circumstances (low income), circumstances during childhood (father's manual occupation) and high body-weight contribute to inequalities in years with disability.
| S-EPMC8277222 | biostudies-literature
Project description:IntroductionPituitary tumors may have a considerable impact on patients' functional status, including paid employment, yet research in this area is sparse.ObjectiveTo describe work disability and its determinants in patients treated for a pituitary tumor.MethodsCross-sectional study including patients treated for a pituitary tumor in the working age (18-65 years), who completed five validated questionnaires assessing work disability [Short Form-Health and Labour Questionnaire, Work Role Functioning Questionnaire 2.0 (WRFQ)], health-related quality of life (HRQoL) and utility (Short Form-36, EuroQoL) and disease burden (Leiden Bother and Needs Questionnaire-Pituitary). Additional data were extracted from the medical records (age, gender, tumor type, treatment, date of diagnosis) and self-reports (marital status, education, endocrine status). Associations of disease-specific and sociodemographic characteristics, HRQoL, and disease burden with (not) having a paid job were examined through multivariate logistic regression.ResultsWe included 241 patients (61% female, median age 53 years, median time since diagnosis 11 years), of whom 68 (28%) were without a paid job. Patients who had acromegaly, Cushing's disease, (pan)hypopituitarism, radiotherapy, were single, less educated, lower HRQoL, and increased disease burden were more often without a paid job (p < 0.05). Among those with paid jobs, 41% reported health-related absenteeism in the previous year. The three work incapacitating problems reported by the largest proportion of patients were within the mental and social domain (WRFQ).ConclusionWork disability among patients treated for a pituitary tumor is substantial. As impact on social functioning is high, it is strongly advised to incorporate work disability during clinical guidance of patients.
| S-EPMC6244796 | biostudies-literature
Project description:BackgroundYoung adults that are not in education, training or employment represent a problem across European countries. While some are cases of temporary transitions or short-term inactivity, others represent a more vulnerable group at risk of early work disability. Early exclusion from the labor market represents long lives exposed to detrimental effects of unemployment on health and well-being, and constitutes an economic burden for society. There is need for more knowledge about young adults who are at risk of early work disability but have not yet reached the point of more permanent exclusion. This study aims to investigate social and health-related problems in a Norwegian sample of young adults at risk of early work disability, and their self-perceived causes of illness.MethodsBaseline data from participants in the SEED-trial (N = 96), a randomized controlled trial comparing individual placement and support to traditional vocational rehabilitation in young adults at risk of early work disability, were analyzed. Background, health behaviors, adverse social experiences, disability level, physical and mental health, social support, coping, and self-perceived causal attributions of illness were measured. Gender differences were analyzed using chi-square and t-tests.ResultsMean age was 24, and 68% were men. One third reported reading and writing difficulties, and 40% had less than high-school education. The majority had experienced bullying (66%) or violence (39%), and 53% reported hazardous alcohol use. Psychological distress was the most prevalent health problem (52%), and women generally had more physical and mental health problems than men. Self-perceived causal attributions of illness were mainly related to relational problems, followed by health behaviors, heredity/genetics, and external environmental factors.ConclusionsThe study provides a deeper insight into a vulnerable group with substantial challenges related to adverse social experiences, psychological distress, and alcohol use, who emphasized relational problems as the main causal factor for their illness. Findings suggest a need for broader focus on psychological and social factors in vocational rehabilitation efforts targeting young adults at risk of early work disability. Furthermore, gender-specific approaches may be warranted and should be followed up in future studies.Trial registrationClinicaltrials.gov: NCT02375074 . Retrospectively registered December 3rd 2014.
| S-EPMC6192296 | biostudies-literature
Project description:OBJECTIVES:To determine the prevalence, correlates, and predictors of work disability (WD) in the Genetics versus ENvironment In Scleroderma Outcome Study (GENISOS). We hypothesized that WD in systemic sclerosis (SSc) is a function of demographic, clinical, and psychosocial factors. METHODS:Patients enrolled in the GENISOS cohort were subdivided in 3 groups: work disabled, working, and retired or homemakers. The latter group (n = 29) was excluded from further analysis. We used logistic regression analysis with a forward hierarchical variable selection strategy to investigate the independent correlates of WD at enrollment. Cox regression proportional Hazard's model with a similar variable selection strategy was utilized to determine the predictors of WD in those working at enrollment. RESULTS:Overall, 284 patients with a mean age of 48.7 years and disease duration of 2.5 (±1.6) years were enrolled into the GENISOS cohort, consisting of 83.5% female, 46.8% white, 28.9% Hispanic, and 20.4% African American. Patients were longitudinally followed in 1438 study visits. At enrollment, 124 patients (43.7%) were work disabled, whereas 131 (46.1%) were working. Lower level of education (P < 0.001), higher Medsger Lung Severity Index (P = 0.012), higher Fatigue Severity Score (P = 0.008), and less social support (P < 0.001) correlated independently with WD. Of those working at baseline, 35 (26.7%) eventually developed WD. Non-white ethnicity (P = 0.038), lower DLCO % predicted value (P = 0.038), and higher Fatigue Severity Score (P = 0.009) at enrollment independently predicted WD on follow-up visits. CONCLUSIONS:WD is a major problem among SSc patients and its prevalence is substantially higher than other rheumatic conditions. Demographic, clinical, and psychosocial factors correlate with WD cross-sectionally and predict WD longitudinally in these patients.
| S-EPMC3153604 | biostudies-literature
Project description:BackgroundIn social insurance, the evaluation of work disability is becoming stricter as priority is given to the resumption of work, which calls for a guarantee of quality for these evaluations. Evidence-based guidelines have become a major instrument in the quality control of health care, and the quality of these guidelines' development can be assessed using the AGREE instrument. In social insurance medicine, such guidelines are relatively new. We were interested to know what guidelines have been developed to support the medical evaluation of work disability and the quality of these guidelines.MethodsFive European countries that were reported to use guidelines were approached, using a recent inventory of evaluations of work disability in Europe. We focused on guidelines that are disease-oriented and formally prescribed in social insurance medicine. Using the AGREE instrument, these guidelines were appraised by two researchers. We asked two experts involved in guideline development to indicate if they agreed with our results and to provide explanations for insufficient scores.ResultsWe found six German and sixteen Dutch sets of disease-oriented guidelines in official use. The AGREE instrument was applicable, requiring minor adaptations. The appraisers reached consensus on all items. Each guideline scored well on 'scope and purpose' and 'clarity and presentation'. The guidelines scored moderately on 'stakeholder involvement' in the Netherlands, but insufficiently in Germany, due mainly to the limited involvement of patients' representatives in this country. All guidelines had low scores on 'rigour of development', which was due partly to a lack of documentation and of existing evidence. 'Editorial independence' and 'applicability' had low scores in both countries as a result of how the production was organised.ConclusionDisease-oriented guidelines in social insurance medicine for the evaluation of work disability are a recent phenomenon, so far restricted to Germany and the Netherlands. The AGREE instrument is suitably applicable to assess the quality of guideline development in social insurance medicine, but some of the scoring rules need to be adapted to the context of social insurance. Existing guidelines do not meet the AGREE criteria to a sufficient level. The way patients' representatives can be involved needs further discussion. The guidelines would profit from more specific recommendations and, for providing evidence, more research is needed on the functional capacity of people with disabilities.
| S-EPMC2754463 | biostudies-literature
Project description:ObjectiveTo examine whether work-limiting disability may modify intergenerational economic mobility in the United States.MethodsUsing the Panel Study of Income Dynamics, common metrics of intergenerational mobility are estimated by parent work-limiting disability. These include rank slope coefficients capturing persistence of socioeconomic status and absolute upward economic mobility capturing expected child outcomes.ResultsParent-child pairs with work-limiting disability experience five to twelve percentiles lower absolute economic mobility at the 25th percentile of parent income. More severe and/or chronic conditions have larger disparities and higher parent income is associated with smaller disparities. Women may experience larger mobility differences, while non-Hispanic black children may face a higher likelihood of parents experiencing work limitations.ConclusionsWork-limiting disability appears to modify children's economic opportunity. This contributes to the understanding of disparate access to opportunity in the United States while also identifying economic disadvantages associated with disability for subsequent generations.
| S-EPMC7676749 | biostudies-literature
Project description:OBJECTIVE:Aspects of antineutrophil cytoplasmic antibodies-associated vasculitis (AAV) prioritized by patients with AAV were described using the International Classification of Function, Disability, and Health (ICF). METHODS:Items identified during 14 individual interviews were incorporated into an ICF-based questionnaire administered to participants of 2 vasculitis patient symposia: 36 in the United Kingdom and 63 in the United States. RESULTS:Categories identified as at least "moderately relevant" by ? 5% of subjects included 44 body functions, 14 body structures, 35 activities and participation, 31 environmental factors, and 38 personal factors. CONCLUSION:Identified categories differ from those identified by the current Outcome Measures in Rheumatology (OMERACT) core set and those prioritized by vasculitis experts.
| S-EPMC6726580 | biostudies-literature
Project description:Telework has been promoted for decades as one of the traffic demand management policies to alleviate congestion during peak periods and reduce work-related trips, along with other benefits. However, less clear is the role played by life stages (i.e., gender, marital status and parenthood) on telework behavior. This study investigated to which extent telework frequency associated with life stages, and how these associations could be explained based on the work-life conflict perspective. Representative data were obtained from German Microcensus 2010 (N = 188,081 participants). The outcome variable was measured as ordered telework participation levels (i.e., never, infrequently and frequently). After testing for multicollinearity, a zero-inflated ordered probit regression model was applied to assess the associations between telework and family-life stages, while adjusting for individual, household, job-related and environmental characteristics. Results suggest that life stages associate with telework behavior in a complex way. Three patterns have been distinguished. Specifically, irrespective of gender and marital status, parents are less likely to telework compared to those without children. Regarding individuals without children, single individuals are more likely to telework than married ones, and males more likely than females. In contrast, for individuals with children, the partnered parents are more likely to telework than single parents, and females more likely than males. Our findings suggest that as the most important feature in family-life stages, children play a vital role in telework behavior. It not only increases both work-to-family conflict and family-to-work conflict, but also triggers housework re-division within couples and aggravates gender differences. Policies that support formal childcare resources could relieve the family-to-work conflict and encourage people to work at home.
| S-EPMC7509537 | biostudies-literature
Project description:Medical certification is one of the basic administrative mechanisms used by social policies aimed at income protection. The assessment of work disability is central to the income protection application. Yet, there is evidence suggesting that determining work disability related to mental disorders is challenging. Although essential to the disability application process, few studies have looked at physician and other clinician experiences with the process. However, this type of information is critical to developing processes to support providers who participate in the assessments. This purpose of this paper is to explore the experiences of physicians and other clinicians assessing public long-term work disability related to mental disorders.This is an exploratory and descriptive study using qualitative methods. Clinician input was gathered through focus groups and individual in-depth interviews. Verbatim transcripts were analyzed to identify recurrent and significant themes that arose during the focus groups and individual interviews.Many of the experiences that the clinicians in this sample discussed related to the difficulty of trying to fill the roles of advocate and medical expert as well as the challenge of determining the impact of functional capacity and work ability. The findings also highlight the current gap in knowledge about the factors that affect successful functioning in general and at work in particular.Given the challenges created by the current state of knowledge, it may be useful to consider a category of "partial disability". In addition, the fact that work disability depends on the interaction between the experience of the mental disorder and specific job requirements and the fact that people applying for public long-term disability are not working, it might be helpful to offer a clear description and guidelines of the meaning of work ability.
| S-EPMC4366073 | biostudies-other
Project description:OBJECTIVES:In this article, we examine the connection between trajectories of work disability and economic precarity in late midlife. We conceptualize work disability as a possible mechanism linking early and later life economic disadvantage. METHODS:We model trajectories of work disability characterized by timing and stability for a cohort of Baby Boomers (22-32 in 1981) using 32 years of data from the Panel Study of Income Dynamics and latent class analysis. Measures of childhood disadvantage are included as predictors of work disability trajectories, which are subsequently included in logistic regression models predicting four economic outcomes (poverty, asset poverty, home ownership, and pension ownership) at ages 54-64. RESULTS:Childhood disadvantage selected individuals into five distinct classes of work disability that differed in timing and stability. All of the disability trajectories were associated with an increased risk of economic insecurity in late midlife compared to the never work disabled. DISCUSSION:This study contributes to the aging literature through its incorporation of the early life origins of pathways of disability and their links to economic outcomes approaching retirement. Findings suggest work disability is anchored in early life disadvantage and is associated with economic insecurity later in life.
| S-EPMC6748769 | biostudies-literature