759 Health problems in early adulthood predict disability retirement

Abstract

Introduction Disability retirement causes a substantial burden on the society and affects the well-being of individuals. Early health problems as determinants of disability retirement have received little attention. The aim was to study, whether interrupting compulsory military service is an early indicator of disability retirement among Finnish men and whether seeking medical advice during military service increases the risk of all-cause disability retirement and disability retirement due to mental disorders and musculoskeletal diseases. We also looked at secular trends in these associations. Methods We examined a nationally representative sample of 2069 men, who had entered their compulsory military service during 1967–1996. We linked military service health records with cause-specific register data on disability retirement from 1968 to 2008. We explored secular trends in three service time strata. Cox regression model were used to estimate proportional hazard ratios and their 95% confidence intervals. Result During the follow-up time 140 (6.8%) men retired due to disability, mental disorders being the most common cause. The men who interrupted service had a remarkably higher cumulative incidence of disability retirement (18.9%). The associations between seeking medical advice during military service and all-cause disability retirement were similar across the three service time cohorts (overall hazard ratio 1.40 per one standard deviation of the number of visits; 95% confidence interval 1.26–1.56). Visits due to mental problems predicted disability retirement due to mental disorders in the men who served between 1987 and 1996 and a tendency for a similar cause-specific association was seen for musculoskeletal diseases in the men who served in 1967–1976. Discussion Health problems, in particular mental problems, during late adolescence are strong determinants of disability retirement. Conscription examinations and military service provide access to the entire age cohort of men, where persons at risk for work disability can be identified and early preventive measures initiated.