Disability pensioning: can ethnic divides be explained by occupation, income, mental distress, or health?
BACKGROUND
We aimed to test the hypothesis that differences in disability pensioning among different ethnic groups were attributable to differences in occupation, income, health, and mental distress.


METHODS
In a health survey conducted between 2000 and 2001 in Oslo, nearly half (48.7%; 11,072) of all inhabitants aged 40, 45 and 59-60 years participated. Survey data related to work, general health and mental distress were linked to disability pension data from the National Insurance Administration, and to income and country of origin data from Statistics Norway. A total of 9195 persons were eligible for disability pension at the end of 2000.


RESULTS
Approximately 5% received a disability pension in the 4 years following the health survey. An age- and gender-adjusted odds ratio of 2.27 (95% confidence interval (CI) 1.55-3.23) among immigrants from developing countries and Eastern Europe as compared to ethnic Norwegians was reduced to 0.88 (95% CI 0.46-1.67) after adjusting for occupation, working conditions, and income. The odds ratio was further reduced to 0.63 (95% CI 0.32-1.25) when self-reported health and mental distress were added to the model.


CONCLUSIONS
The higher risk of receiving a disability pension among immigrants from developing countries and Eastern Europe than among ethnic Norwegians was largely explained by work factors and level of income. The addition of mental distress and self-reported health to the multivariate model further reduced the risk, although not significantly different from ethnic Norwegians.
Department of General Practice and Community Medicine, University of Oslo, Oslo, Norway. bjorgulf.claussen@medisin.uio.no
Bjørgulf
B
Claussen
Odd Steffen
OS
Dalgard
Dag
D
Bruusgaard
D000328:Adult; D003906:Developing Countries; D004185:Disability Evaluation; D054242:Emigrants and Immigrants; D005061:Europe, Eastern / Q000208:ethnology; D006304:Health Status; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000208:ethnology; D008603:Mental Health; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology / Q000208:ethnology; D009790:Occupations; D010415:Pensions / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D017132:Workplace