title: Do working conditions explain the increased risks of disability pension among men and women with low education? A follow-up of Swedish cohorts.
abstract: OBJECTIVE
  Rates of disability pension are greatly increased among people with low education. This study examines the extent to which associations between education and disability pensions might be explained by differences in working conditions. Information on individuals at age 13 years was used to assess confounding of associations.
  
  
  METHODS
  Two nationally representative samples of men and women born in 1948 and 1953 in Sweden (22 889 participants in total) were linked to information from social insurance records on cause (musculoskeletal, psychiatric, and other) and date (from 1986-2008) of disability pension. Education data were obtained from administrative records. Occupation data were used for measurement of physical strain at work and job control. Data on paternal education, ambition to study, and intellectual performance were collected in school.
  
  
  RESULTS
  Women were found to have higher rates of disability pension than men, regardless of diagnosis, whereas men had a steeper increase in disability pension by declining educational level. Adjustment of associations for paternal education, ambition to study, and intellectual performance at age 13 had a considerable attenuating effect, also when disability pension with a musculoskeletal diagnosis was the outcome. Despite this, high physical strain at work and low job control both contributed to explain the associations between low education and disability pensions in multivariable models.
  
  
  CONCLUSIONS
  Working conditions seem to partly explain the increased rate of disability pension among men and women with lower education even though this association does reflect considerable selection effects based on factors already present in late childhood.
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, SE-171 77 Stockholm, Sweden. daniel.falkstedt@ki.se.
authors.forename: Daniel
authors.initials: D
authors.lastname: Falkstedt
authors.forename: Mona
authors.initials: M
authors.lastname: Backhans
authors.forename: Andreas
authors.initials: A
authors.lastname: Lundin
authors.forename: Peter
authors.initials: P
authors.lastname: Allebeck
authors.forename: Tomas
authors.initials: T
authors.lastname: Hemmingsson
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications*; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D010290:Parents / Q000193:education; D010415:Pensions / Q000706:statistics & numerical data*; D005082:Physical Exertion; D017009:Professional Autonomy; D012307:Risk Factors; D012737:Sex Factors; D013548:Sweden; D017132:Workplace / Q000458:organization & administration / Q000523:psychology