Obesity in young adulthood and later disability pension: a population-based cohort study of 366,929 Swedish men.
BACKGROUND
The prevalence of obesity has increased threefold among Swedish men during recent decades. Knowledge from Sweden on how obese men manage in working life and become disability pensioners is sparse. The aim of this nationwide and population-based cohort study was to investigate to what extent body mass index (BMI) in young adulthood predicts later disability pension.


METHODS
All Swedish men born 1952-59, who had their weight and height measured at age 18 years in the compulsory military conscription examinations, were followed up longitudinally from 1990 to 2001 with regard to receiving disability pension. Data on own socioeconomic position (1985), education and marital status (1990), parental socioeconomic position (1960), and education (1970) were obtained from censuses. For 366,929 men (81% of the eligible men) the hazard ratio for receiving disability pension was calculated with Cox regression controlling for own education, parental education, childhood and adult socioeconomic position, marital status, morbidity, and type of municipality.


RESULTS
Obesity in young adulthood increased the risk for disability pension later in life (1.35, 95% CI 1.19, 1.52) compared with men of normal weight. The relationship between BMI and disability pension was J-shaped with higher risks for underweight (1.14, 95% CI 1.09, 1.20) and obese men.


CONCLUSIONS
Obese men in Sweden are at higher risk of receiving disability pension. The relationship between BMI and disability pension is J-shaped. An important future task is to estimate the societal costs due to disability pension of obese people.
Karnehed
Nina
N
Child and Adolescent Public Health Epidemiology Group, Department of Public Health Sciences, Karolinska Institute, Sweden.
Rasmussen
Finn
F
Kark
Malin
M
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D004185:Disability Evaluation; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000150:complications / Q000191:economics / Q000453:epidemiology*; D010415:Pensions; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology