Effects of sickness absence on disability pension risk: Finnish register study of two native groups

Abstract

Abstract Background Sickness absence and disability pension have a close connection and both describe the health of working-aged populations. The aim of this paper was to study if Swedish and Finnish speakers differ in the risk of disability pension after first-time sickness absence. This may reveal new aspects how to support health and work ability promotion activities. Methods The longitudinal register data used come from Statistics Finland. They consist of random samples of 5 % of all Finnish speakers and 20 % of all Swedish speakers, observed throughout the period 1989-2010. The analyses concerned non-retired individuals aged 16-60 years who were under risk of first-time sickness absence that extended 10 days. Discrete-time hazard models were estimated to both language groups to evaluate how first-time sickness absence, time since absence, length of absence, and various socio-economic control variables affected the disability pension risk. Results The disability pension risk was extremely high immediately after the sickness absence receipt and remained elevated thereafter approximately 20 times higher as compared to non-recipients. A strong interrelation between first-time sickness absence and the risk of subsequent disability pension was found for both language groups and the risk was persistent in the very long term. The risk pattern looked similar to both Swedish and Finnish speakers and we did not observe any differences between women and men. Conclusions Paid sickness absence is illustrative of strong health selection and a notable risk for reduced work ability even in the more distant future. The currently implemented policies in Finland, which require statements about rehabilitation plans soon after individuals have entered a sickness spell, can be considered beneficial for both the individual and society. Comparison of the language groups shows that the disability pension process after sickness absence is operating similarly to both groups. Key messages Sickness absence requiring medical certificate is an indicator of possible long-term work disability. Timing of rehabilitation process during the sickness absence is critical.