title: The importance of social characteristics of communities for the medically based disability pension.
abstract: BACKGROUND
  The aim of this study was to look for any possible contextual effect of deprivation at municipality level on the risk of being granted the medically based disability pension, controlled for compositional effects due to spatial concentration of people with a high risk of disability.
  
  
  METHODS
  The material consists of the residentiary part of a total Norwegian county population aged 20-54 years without disability pension at baseline, n=40,083. This study was performed as a 10-year follow-up study. The relative risk of being granted a disability pension was estimated by logistic regression analyses as odds ratios (OR) between people living in different municipalities according to a municipality deprivation index at three levels, adjusted for individual factors.
  
  
  RESULTS
  The OR of disability pension was 1.36 (1.22, 1.51) for people residing in intermediate deprived municipalities and 1.48 (1.31, 1.67) for people residing in the most deprived municipalities compared to the most affluent municipalities, adjusted for gender and age. After adjustment for individual risk factors the OR was 1.26 (1.12, 1.41) and 1.18 (1.04, 1.35) respectively. Analyses stratified by gender showed that the increased risk of receiving a disability pension for men in the most deprived municipalities was explained by individual factors alone.
  
  
  CONCLUSIONS
  Relative municipality deprivation seems to account for an increase in the incidence of disability pension. This effect contributes to marginalization of people living in less affluent areas out of employment and thus to widening socioeconomic inequalities in the population.
authors.affiliation: Department of Community Medicine and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Steinar
authors.initials: S
authors.lastname: Krokstad
authors.forename: Per
authors.initials: P
authors.lastname: Magnus
authors.forename: Anders
authors.initials: A
authors.lastname: Skrondal
authors.forename: Steinar
authors.initials: S
authors.lastname: Westin
mesh_terms: D000328:Adult; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018868:Insurance, Disability / Q000706:statistics & numerical data*; D009111:Local Government; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009664:Norway; D016017:Odds Ratio; D010415:Pensions / Q000706:statistics & numerical data*; D011204:Poverty Areas; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D012959:Socioeconomic Factors