title: Economic difficulties and subsequent disability retirement.
abstract: BACKGROUND
  This study examined whether economic difficulties are associated with subsequent disability retirement while controlling for covariates.
  
  
  METHODS
  Survey data among middle-aged employees of the City of Helsinki in 2000-2002 were linked with the Finnish Centre for Pensions register data on all-cause disability retirement among women (n=4816) and men (n=1354) until the end of 2010. Additionally, disability retirement due to musculoskeletal diseases and mental disorders (ICD-10) was examined among women. Frequency in difficulties paying pills and buying food and clothes, and covariates (occupational class, income, housing tenure, and work- and health-related covariates) were self-reported at baseline. Hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated from Cox regression analysis.
  
  
  RESULTS
  Frequent economic difficulties were associated with all-cause disability retirement after adjusting for age among both women (HR=2.11; 95% CI 1.63-2.73) and men (HR=2.69; 95% CI 1.65-4.41). Adjustment for covariates somewhat attenuated the associations, but they remained. Economic difficulties were also associated with disability retirement due to both mental disorders (HR=3.29; 95% CI 1.98-5.46) and musculoskeletal diseases (HR=1.85; 95% CI 1.24-2.75) among women. Adjustments made a minor contribution to the risk of disability retirement due to mental disorders, whereas the risk of disability retirement due to musculoskeletal diseases reduced after considering socioeconomic circumstances. Conclusions: economic difficulties are independently associated with disability retirement. Thus, they should be considered in attempts to tackle early exit from the labour market due to disability.
authors.affiliation: Department of Public Health, University of Helsinki, Finland Centre of Expertise for Health and Work Ability & Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland tea.lallukka@ttl.fi.
authors.forename: Tea
authors.initials: T
authors.lastname: Lallukka
authors.affiliation: Department of Public Health, University of Helsinki, Finland.
authors.forename: Elina
authors.initials: E
authors.lastname: Mauramo
authors.affiliation: Department of Public Health, University of Helsinki, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Lahelma
authors.affiliation: Department of Public Health, University of Helsinki, Finland.
authors.forename: Ossi
authors.initials: O
authors.lastname: Rahkonen
mesh_terms: D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D012042:Registries; D012179:Retirement; D012307:Risk Factors; D012959:Socioeconomic Factors
keywords: Socioeconomic; financial problem; register-based