Sickness absence, disability pension and economic situation after a spontaneous subarachnoid haemorrhage among people of working age: a Swedish longitudinal nationwide cohort study

ObjectivesThe aim was to describe the course of sickness absence (SA), disability pension (DP) and work-related economic situation defined as earnings (EA) and disposable income (DI), after spontaneous subarachnoid haemorrhage (SAH). Associations of SA, DP, EA and DI with demographic factors were also studied.DesignA longitudinal cohort study of all 1932 people in Sweden who in January 2005 to December 2010 had a first time SAH when aged 17 to 64 years and survived during the 3-year follow-up. Microdata from four nationwide administrative registers were used.Main outcome measuresPrimary outcome was the presence of SA and DP and how this changed during the study period of 5 years (the year before, the year of SAH and the following 3 years). The secondary outcome was the development of the income variables EA and DI. Demographic factors analysed were sex, age, source of bleeding, country of birth, family situation, educational level and type of living area.ResultsThe year before the SAH, 7.9% of women and 4.6% of men had some SA registered (p<0.004). A model consisting of female sex, higher education and living single predicted having SA that year. At the end of the follow-up, 39.2% of women and 28.3% of men had SA and/or DP (p<0.0001). A model consisting of female sex, living in a village/ rural area and having a defined bleeding source for the SAH was predicting having SA and/or DP at end of follow-up. The levels of EA decreased, while DI increased during follow-up and were at the end of follow-up associated with age, sex, type of living area, country of birth, educational level and family situation. The women’s EA was lower than the men’s during all years.ConclusionsSAH influenced future SA, DP, as well as EA. Both SA, DP and the economic variables studied were predicted by models including sex.

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Trajectories of sickness absence and disability pension in colorectal cancer: a Swedish cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.697 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L Chen ◽

K Alexanderson

Keyword(s):

Colorectal Cancer ◽

Cohort Study ◽

Sickness Absence ◽

Educational Level ◽

Disability Pension ◽

Population Based ◽

Work Situation ◽

Working Age ◽

Future Work ◽

Very High

Abstract Background Working-aged colorectal cancer (CRC) patients have a much better survival nowadays, indicating the importance of their future work situation. We aimed to investigate trajectories of sickness absence and disability pension (SADP) days before and after CRC diagnosis and in references, and risk factors associated with different trajectories. Methods A longitudinal, population-based matched cohort study of 4735 CRC survivors in Sweden aged 19-62 when first diagnosed with CRC in 2008-2011, and 18,230 matched references was conducted, using microdata linked from several nationwide registers. The annual SADP net days for 2 years before through 5 years after diagnosis date were computed. A group-based trajectory model was used to depict SADP trajectories. Associations between trajectory membership, and sociodemographic and clinical variables were tested by chi2 test and multinomial logistic regression. Results Four trajectories of SADP days/year for CRC survivors were identified: “only increase around diagnosis” (52% of all, n = 2481), “slight increase after diagnosis” (27%), “high then decrease moderately after diagnosis” (13%), and “constantly very high” (8%). Educational level (R2=0.022), Charlson's Comorbidity Index (R2=0.029), and prediagnostic mental disorders (R2=0.066) were the strongest factors determining the SADP trajectory groups. In references, three trajectories (”constantly low” (80% of all), “constantly moderate and decrease gradually” (12%), and “very high then decrease overtime” (8%)) were identified. Conclusions Approximately 80% of CRC survivors return to a low level of SADP (0-60 days/year) at 5 years postdiagnosis. Prediagnostic status of mental disorders, somatic comorbidity, and low educational level are good indicators of future high SADP levels for CRC survivors. Key messages Most of working-age colorectal cancer survivors have low levels of sickness absence and disability pension days five years after their diagnosis. Trajectory analyses based on population-based register data can be used as a good approach in understanding future work situation regarding sick leave among working-age cancer survivors.

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Future risk for disability pension among people with sickness absence due to otoaudiological diagnoses: a population-based cohort study with a 12-year follow-up

Scandinavian Journal of Public Health ◽

10.1177/1403494811399652 ◽

2011 ◽

Vol 39 (5) ◽

pp. 501-507 ◽

Cited By ~ 4

Author(s):

Klas Gustafsson ◽

Gunnel Backenroth-Ohsako ◽

Ulf Rosenhall ◽

Elisabeth Ternevall-Kjerulf ◽

Mats Ulfendahl ◽

...

Keyword(s):

Cohort Study ◽

Sickness Absence ◽

Disability Pension ◽

Population Based ◽

Future Risk ◽

Risk For Disability

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Gender segregation of occupations and sustainable employment: A prospective population-based cohort study

Scandinavian Journal of Public Health ◽

10.1177/1403494818785255 ◽

2018 ◽

Vol 47 (3) ◽

pp. 348-356 ◽

Cited By ~ 3

Author(s):

Lena Gonäs ◽

Anders Wikman ◽

Marjan Vaez ◽

Kristina Alexanderson ◽

Klas Gustafsson

Keyword(s):

Cohort Study ◽

Labour Market ◽

Sickness Absence ◽

Disability Pension ◽

Population Based ◽

Gender Segregation ◽

Labour Market Situation ◽

Market Situation ◽

Male Dominated

Background: Although the labour market is characterized by a strong numerical gender segregation of occupations, there is little knowledge about the associations of this with the future labour market situation for an individual person. Objectives: This study aimed to elucidate whether working in a gender-segregated or gender-integrated occupation is associated with future labour market attachment and sickness absence or disability pensions among women and men. Methods: We used a population-based prospective cohort study with univariate and multiple logistic regression analyses stratified by gender, including all people living in Sweden aged 20–56 years and in paid work in 2003 ( n=3,239,989). They were followed up eight years later with regard to employment status, sickness absence and disability pension. Results: Women and men employed in extremely female-dominated occupations in 2003 had the highest employment levels and the lowest unemployment levels at follow up in 2011. When adjusting for age, level of education and sector of employment, the highest odds ratios (ORs) for not being employed in 2011 were found for women working in extremely male-dominated occupations in 2003 (OR 1.27; 95% CI 1.21–1.33) and for men in female-dominated occupations (OR 1.42; 95% CI 1.39–1.45) relative to those in gender-integrated occupations. Women in extremely male-dominated occupations had the highest ORs for sickness absence or the receipt of a disability pension at follow up (OR 1.26; 95% CI 1.17–1.36) and men in female-dominated occupations had the highest OR 1.15 (95% CI 1.11–1.20). Conclusions: For both women and men, the gender composition of the occupation they work in seems to be of importance for their future labour market attachment and sickness absence or receipt of a disability pension.

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Self-reported sickness absence and presenteeism as predictors of future disability pension: Cohort study with 11-year register follow-up

Preventive Medicine ◽

10.1016/j.ypmed.2021.106565 ◽

2021 ◽

pp. 106565

Author(s):

Rubén López-Bueno ◽

Thomas Clausen ◽

Joaquín Calatayud ◽

Rúni Blafoss ◽

Jonas Vinstrup ◽

...

Keyword(s):

Cohort Study ◽

Sickness Absence ◽

Disability Pension

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Childbirth, morbidity, sickness absence and disability pension: a population-based longitudinal cohort study in Sweden

BMJ Open ◽

10.1136/bmjopen-2020-037726 ◽

2020 ◽

Vol 10 (11) ◽

pp. e037726

Author(s):

Mo Wang ◽

Krisztina D. László ◽

Pia Svedberg ◽

Lotta Nylén ◽

Kristina Alexanderson

Keyword(s):

Cohort Study ◽

Sickness Absence ◽

Disability Pension ◽

Cox Regression ◽

Strong Association ◽

Positive Association ◽

Mortality And Morbidity ◽

Nulliparous Women ◽

Before And After

ObjectiveTo investigate associations of morbidity with subsequent sickness absence (SA) and disability pension (DP) among initially nulliparous women with no, one or several childbirths during follow-up.DesignLongitudinal register-based cohort study.SettingSweden.ParticipantsNulliparous women, aged 18 to 39 years and living in Sweden on 31 December 2004 and the three preceding years (n=492 504).Outcome measuresAnnual mean DP and SA days (in SA spells >14 days) in the 3 years before and after inclusion date in 2005.MethodsWomen were categorised into three groups: no childbirth in 2005 nor during the follow-up, first childbirth in 2005 but not during follow-up, and having first childbirth in 2005 and at least one more during follow-up. Microdata were obtained for 3 years before and 3 years after inclusion regarding SA, DP, mortality and morbidity (ie, hospitalisation and specialised outpatient healthcare, also excluding healthcare for pregnancy, childbirth and puerperium). HRs and 95% CIs for SA and DP in year 2 and 3 after childbirth were estimated by Cox regression; excluding those on DP at inclusion.ResultsAfter controlling for study participants’ prior morbidity and sociodemographic characteristics, women with one childbirth had a lower risk of SA and DP than those who remained nulliparous, while women with more than one childbirth had the lowest DP risk. Morbidity after inclusion that was not related to pregnancy, childbirth or the puerperium was associated with a higher risk of future SA and DP, regardless of childbirth group. Furthermore, morbidity both before and after childbirth showed a strong association with SA and DP (HR range: 2.54 to 13.12).ConclusionWe found a strong positive association between morbidity and both SA and DP among women, regardless of childbirth status. Those who gave birth had lower future SA and DP risk than those who did not.

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Trajectories of future sickness absence and disability pension days among individuals with a new sickness absence spell due to osteoarthritis diagnosis ≥21 days: a prospective cohort study with 13-month follow-up

BMJ Open ◽

10.1136/bmjopen-2019-030054 ◽

2019 ◽

Vol 9 (8) ◽

pp. e030054 ◽

Cited By ~ 1

Author(s):

Kristin Farrants ◽

Emilie Friberg ◽

Sara Sjölund ◽

Kristina Alexanderson

Keyword(s):

Cohort Study ◽

Sickness Absence ◽

Disability Pension ◽

Multinomial Logistic Regression ◽

Population Based ◽

Fast Decrease ◽

Working Age ◽

Icd 10 ◽

Using Data

IntroductionOsteoarthritis is one of the most common types of musculoskeletal diagnoses also among working-age populations, and often leads to long-term sickness absence (SA) spells or even disability pension (DP).The aimwas to identify future trajectories of days of SA and/or DP among people with a new SA spell due to osteoarthritis that became ≥21 long, and to investigate sociodemographic and morbidity characteristics of individuals in identified trajectories.MethodsThis is a prospective population-based cohort study using data from several Swedish registers. We studied future SA/DP among all 4894 individuals aged 16–64 years who, during the first 6 months of 2010, had an incident SA spell due to osteoarthritis (ICD-10 codes M15-19) ≥21 days. Using group-based trajectory modelling, we identified trajectories of mean SA/DP net days/month and 95% CIs for the 13 months from the 21st day of the index SA spell. Sociodemographic and morbidity characteristics were compared by χ2tests and multinomial logistic regression.ResultsWe identified five trajectories of SA/DP days: ‘fast decrease’ (36% of the cohort), ‘medium fast decrease’ (29%), ‘slow decrease’ (15%), ‘fluctuating’ (12%) and ‘late decrease’ (8%). Individuals in the two trajectories who still had SA/DP days at end of follow-up (late decrease and fluctuating) were more likely to be older, born outside the EU and have indicators of more severe morbidity than those in the other trajectories.ConclusionFive trajectories of future SA/DP days were identified; 80% of the cohort belonged to trajectories with no SA/DP by the end of follow-up. Identifying trajectories of future SA/DP provides new insights regarding the developments of SA/DP over time among people on SA due to osteoarthritis; not only days in the initial SA spell but also in new spells during follow-up need to be included for a better understanding.

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Physical capability in midlife and risk of disability pension and long-term sickness absence: prospective cohort study with register follow-up

Scandinavian Journal of Work Environment & Health ◽

10.5271/sjweh.3842 ◽

2019 ◽

Vol 45 (6) ◽

pp. 610-621

Author(s):

Emil Sundstrup ◽

Åse Marie Hansen ◽

Erik Lykke Mortensen ◽

Otto Melchior Poulsen ◽

Thomas Clausen ◽

...

Keyword(s):

Cohort Study ◽

Sickness Absence ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Disability Pension ◽

Physical Capability

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Sickness absence following breast cancer surgery: a two-year follow-up cohort study

Scandinavian Journal of Caring Sciences ◽

10.1111/scs.12502 ◽

2017 ◽

Vol 32 (2) ◽

pp. 715-724 ◽

Cited By ~ 4

Author(s):

Lena-Marie Petersson ◽

Marjan Vaez ◽

Marie I. Nilsson ◽

Fredrik Saboonchi ◽

Kristina Alexanderson ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Sickness Absence ◽

Cancer Surgery ◽

Breast Cancer Surgery

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Associations of sickness absence and disability pension due to mental and somatic diagnoses when aged 60–64 with paid work after the standard retirement age; a prospective population-based cohort study in Sweden

BMC Public Health ◽

10.1186/s12889-021-12382-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Aleksiina Martikainen ◽

Alice Svensson Alavi ◽

Kristina Alexanderson ◽

Kristin Farrants

Keyword(s):

Cohort Study ◽

Sickness Absence ◽

Disability Pension ◽

Sociodemographic Factors ◽

Population Based ◽

Outcome Variable ◽

Retirement Age ◽

Paid Work ◽

Diagnosis Group ◽

Lower Likelihood

Abstract Background The proportion of people working beyond age 65 is increasing. We aimed to explore whether sickness absence (SA) and disability pension (DP) due to mental, somatic, or both diagnoses when aged 60–64 were associated with being in paid work when aged 66–71. Methods This prospective population-based cohort study included all 98,551 individuals who in 2010 turned 65 years, lived in Sweden, and were in paid work at some point when aged 60–64. Data from three nationwide registers were used with 2010 as baseline, with SA or/and DP as the exposure variables (2005–2009) and paid work as the outcome variable (2011–2016). Logistic regression was conducted to calculate odds ratios (OR) with 95% confidence intervals (CI) for the association between exposures and outcome, controlling for sociodemographic factors. The analyses were also stratified by sex. Results Nearly half were in paid work during follow-up. Those with SA due to mental diagnoses had lower likelihood of being in paid work among both sexes (women OR: 0.76; 95% CI: 0.69–0.84; men 0.74; 0.65–0.84), while this association was smaller for SA due to somatic diagnoses (women 0.87; 0.84–0.91; men 0.92; 0.89–0.96). SA due to both mental and somatic diagnoses was associated with a lower likelihood of paid work for men (0.77; 0.65–0.91), but not women (0.98; 0.88–1.09). Regardless of diagnosis group and sex, DP had the strongest association with not being in paid work (women mental DP 0.39; 0.34–0.45; women somatic DP 0.38; 0.35–0.41; women mental and somatic DP 0.28; 0.15–0.56; men mental DP 0.36; 0.29–0.43; men somatic DP 0.35; 0.32–0.38; men mental and somatic DP 0.22; 0.10–0.51). Combined SA and/or DP demonstrated ORs in-between the diagnosis groups of SA and DP alone (e.g., mental SA and/or DP women and men combined 0.61; 0.57–0.65). Conclusions SA and DP were negatively associated with being in paid work after the standard retirement age of 65. The association was especially strong for DP, irrespective of diagnosis group. Moreover, compared to somatic diagnoses, SA due to mental diagnoses had a stronger association with not being in paid work. More knowledge is needed on how mental SA impedes extending working life.

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