Health behaviours and psychosocial working conditions as predictors of disability pension due to different diagnoses: a population-based study

Annina Ropponen,Karri Silventoinen,Pia Svedberg,Jurgita Narusyte

doi:10.1186/s12889-020-09567-8

Abstract

BackgroundTo investigate whether the clustering of different health behaviours (i.e. physical activity, tobacco use and alcohol consumption) influences the associations between psychosocial working conditions and disability pension due to different diagnoses.MethodsA population-based sample of 24,987 Swedish twins born before 1958 were followed from national registers for disability pension until 2013. Baseline survey data in 1998–2003 were used to assess health behaviours and psychosocial Job Exposure Matrix for job control, job demands and social support. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI).ResultsDuring follow-up, 1252 disability pensions due to musculoskeletal disorders (5%), 601 due to mental diagnoses (2%) and 1162 due to other diagnoses (5%) occurred. In the models controlling for covariates, each one-unit increase in job demands was associated with higher (HR 1.16, 95%CI 1.01–1.33) and in job control with lower (HR 0.87, 95%CI 0.80–0.94) risk of disability pension due to musculoskeletal disorders among those with unhealthy behaviours. Among those with healthy behaviours, one-unit increase of social support was associated with a higher risk of disability pension due to mental and due to other diagnoses (HRs 1.29–1.30, 95%CI 1.04–1.63).ConclusionsJob control and job demands were associated with the risk of disability pension due to musculoskeletal disorders only among those with unhealthy behaviours. Social support was a risk factor for disability pension due to mental or other diagnoses among those with healthy behaviours. Workplaces and occupational health care should acknowledge these simultaneous circumstances in order to prevent disability pension.

Highlights

IntroductionTo investigate whether the clustering of different health behaviours (i.e. physical activity, tobacco use and alcohol consumption) influences the associations between psychosocial working conditions and disability pension due to different diagnoses
To investigate whether the clustering of different health behaviours influences the associations between psychosocial working conditions and disability pension due to different diagnoses
In the age- and sex-adjusted models, one-unit increase in job demands and job control predicted disability pension (DP) due to all studied diagnoses groups regardless of healthy or unhealthy behaviours. Only among those with unhealthy behaviours, one-unit increase in job demands was associated with higher (HR 1.16, 95%confidence intervals (CI) 1.01, 1.33) and one-unit increase in job control with lower (HR 0.87, 95%CI 0.80, 0.94) risk of DP due to MSD when the covariates were controlled (Table 2)

Summary

Introduction

To investigate whether the clustering of different health behaviours (i.e. physical activity, tobacco use and alcohol consumption) influences the associations between psychosocial working conditions and disability pension due to different diagnoses. A lot of research has been targeted to clarify the role of psychosocial working conditions in the risk of DP [8,9,10,11], but until recently, less attention has been paid on health behaviours and other factors potentially mediating or modifying these associations. The mixed results can be due to the limitation of data, e.g. occupational groups or industrial sectors [15, 16], and the lack of power or no possibility to control for unmeasured confounding such as familial (genetics and shared environment) factors [10, 11]

Objectives

Methods

Results

Discussion

Conclusion