title: Occupational social class and disability retirement among municipal employees--the contribution of health behaviors and working conditions.
abstract: OBJECTIVE
  The mechanisms through which a low socioeconomic position leads to disability retirement are not         yet established. We examined, on the one hand, the associations between occupational social class and disability         retirement due to all causes, musculoskeletal diseases, and mental disorders and, on the other hand, the contribution         of health behaviors and working conditions to these associations.
  
  
  METHODS
  Middle-aged municipal employees from the         Helsinki Health Study cohort baseline surveys in 2000-2002 (N=6516) were followed up until the end of 2010 for         disability retirement. Retirement data were obtained from the registers of the Finnish Centre for Pensions and social         class and covariates from the baseline surveys. Social class was categorized into managers and professionals,         semi-professionals, routine non-manual employees, and manual workers. Cox regression analysis was used to calculate         hazard ratios and their 95% confidence intervals.
  
  
  RESULTS
  The risk of disability retirement was generally higher among         those in lower social classes with a strong gradient for all causes, an even stronger gradient for musculoskeletal         diseases, and a weaker non-linear association for mental disorders. These associations were largely mediated through         physical workload among both women and men and hazardous exposures particularly among men. In mental disorders, job         control also mediated the association. Strenuous desktop work and job demands widened the social class differences         particularly among men and in mental disorders. The contribution of health behaviors was modest.
  
  
  CONCLUSIONS
  Improvements particularly in the physical working conditions but also the job control of those in lower social classes         are likely to reduce socioeconomic differences in disability retirement.
authors: Department of Social Research, PO Box 18, 00014, University of Helsinki, Finland. taina.leinonen@helsinki.fi
authors: Taina
authors: T
authors: Leinonen
authors: Olli
authors: O
authors: Pietiläinen
authors: Mikko
authors: M
authors: Laaksonen
authors: Ossi
authors: O
authors: Rahkonen
authors: Eero
authors: E
authors: Lahelma
authors: Pekka
authors: P
authors: Martikainen
mesh_terms: D015331:Cohort Studies; D006233:Persons with Disabilities; D005387:Finland; D015438:Health Behavior; D006801:Humans; D009790:Occupations; D016016:Proportional Hazards Models; D012179:Retirement; D012923:Social Class