title: Women's higher likelihood of disability pension: the role of health, family and work. A 5-7 years follow-up of the Hordaland Health Study.
abstract: BACKGROUND
  Women's higher risk of disability pension compared with men is found in countries with high female work participation and universal welfare schemes. The aim of the study was to examine the extent to which self-perceived health, family situation and work factors explain women's higher risk of disability pension. We also explored how these factors influenced the gender difference across educational strata.
  
  
  METHODS
  The population-based Hordaland Health Study (HUSK) was conducted in 1997-99 and included inhabitants born in 1953-57 in Hordaland County, Norway. The current study included 5,959 men and 6,306 women in paid work with valid information on education and self-perceived health. Follow-up data on disability pension, for a period of 5-7 years, was obtained by linking the health survey to a national registry of disability pension. Cox regression analyses were employed.
  
  
  RESULTS
  During the follow-up period 99 (1.7%) men and 230 (3.6%) women were awarded disability pension, giving a twofold risk of disability pension for women compared with men. Except for a moderate impact of self-perceived health, adjustment for family situation and work factors did not influence the gender difference in risk. Repeating the analyses in strata of education, the gender difference in risk of disability pension among the highly educated was fully explained by self-perceived health and work factors. In the lower strata of education there remained a substantial unexplained gender difference in risk.
  
  
  CONCLUSIONS
  In a Norwegian cohort of middle-aged men and women, self-perceived health, family situation and work factors could not explain women's higher likelihood of disability pension. However, analyses stratified by educational level indicate that mechanisms behind the gender gap in disability pension differ by educational levels. Recognizing the heterogeneity within gender may contribute to a deeper understanding of women's higher risk of disability pension.
authors.affiliation: Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, NO-5018, Bergen, Norway. Inger.Haukenes@isf.uib.no
authors.forename: Inger
authors.initials: I
authors.lastname: Haukenes
authors.forename: Sturla
authors.initials: S
authors.lastname: Gjesdal
authors.forename: Guri
authors.initials: G
authors.lastname: Rortveit
authors.forename: Trond
authors.initials: T
authors.lastname: Riise
authors.forename: John Gunnar
authors.initials: JG
authors.lastname: Maeland
mesh_terms: D000328:Adult; D059026:Diagnostic Self Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004522:Educational Status; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D010415:Pensions / Q000706:statistics & numerical data*; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D014937:Work / Q000706:statistics & numerical data*