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PubMed1993

Public pensions and declining fertility in a small open economy: an intertemporal equilibrium approach.

"The aging of the population in several industrial countries has raised concern about the financing of pay-as-you-go public pension schemes. This paper employs a numerical applied general equilibrium model of the Netherlands to explore how a unilateral temporary decline in fertility affects a small open economy. It focuses on intergenerational distributional effects as well as on macroeconomic consequences for employment, saving, investment, and external trade and capital flows. Furthermore, it discusses several policy options involving the public pension schemes to cope with the intergenerational distributional and macroeconomic effects of the decline in fertility."

Birth Rate↗
PubMed1990

[Disability pensions in Norway 1977-87].

Trends in disability pensions in Norway were studied during the period 1977-87 on the basis of the official statistics. During this period, men and women alike experienced increased risk of disability. The risk was highest for women aged 30-39 years, 103%. In 1986/87 the cumulative incidence for a disability pension up to age 67 was 59% for women and 60% for men. The increase was strongest for musculo-skeletal disorders, followed by psychiatric disorders and injuries.

Adult↗
PubMed1980

[Sociological aspects of preparations for retirement as well as the spare time behaviour of pensioners (author's transl)].

On the basis of common experiences in the research cooperation in the gero-hygienic and social-gerontological fields the authors depict the sociological aspects of preparing for retirement and the spare time behaviour of old-age pensioners. The short-term preparation for retirement in the pre-retirement age of pensioners should be dealt with preferably by industrial medicine. Preparatory steps on reaching the retirement age must pass over into the territorial level. The transition to retirement age and spare-time behaviour are creative social processes in sociological respect. The sociopolitical and health measures in the USSR and in the GDR take this knowledge fully into account.

Aged↗
PubMed1995

Compensation and pension evaluations: psychotic, neurotic, and post-traumatic stress disorder Millon Clinical Multiaxial Inventory II profiles.

The purpose of the present work was to provide an examination of the three major VA adjudication classifications (post-traumatic stress disorder [PTSD], psychotic, and neurotic) through objective psychological testing. During routine follow-up compensation and pension evaluations, 143 patients were given the Millon Clinical Multiaxial Inventory II (MCMI-II). Additionally, their current disability diagnoses as well as their current percentage of disability were coded. Discriminant function analysis revealed that the pivotal discriminatory variables were alcohol abuse for the PTSD patients, thought disorder for the psychotics, and anxiety for the neurotics. This is remarkably consistent with general clinical expectations. This should allow for more specific use of the MCMI-II in compensation and pension examinations by Department of Veterans' Affairs psychologists.

Adult↗
PubMed1976

On pensioners' circumstances in a large Swedish city. A report from Malmö.

In 1972-1973 the authors carried out a field-work programme in a surburban area covered by the 4th Welfare District of Malmö with the objective of charting the general circumstances among the pensioners living there. Such surveys should be pursued in such a way that immediate needs would be disclosed and met. The findings were intended to form a basis for future improvement projects. As expected, the results show the necessity of tracking down hidden needs, often underestimated by the pensioners themselves, especially those in poor health and of limited means. Within the framework of a permanent field-work programme, those people must be made more aware of their own interests and rights.

Aged↗
PubMed2002

[Intergenerational equity is more than pension financing].

Public old age pensions--often termed the "generational contract"--are part of a broader system of exchange among generations which must be assessed in its entirety when issues of generational equity are at stake. The paper discusses the elements of this exchange system on the basis of the German Aging Survey, a large representative survey of the German population aged 40-85. Its empirical foci are two domains that are usually neglected in the public discourse on generational equity: the productive activities of the elderly and the transfers between generations in the family. The results demonstrate that the elderly contribute substantially more to societal welfare than has become visible so far.

Adult↗
PubMed2006

Predictive factors for long-term sick leave and disability pension among frequent and normal attenders in primary health care over 5 years.

OBJECTIVES: To find predictive factors for long-term sick leave (SL) and disability pension (DP) among frequent attenders (FAs) and normal attenders (NAs) in primary health care. STUDY DESIGN: A cohort study with follow-up over 5 years. METHODS: Groups of FAs and NAs were followed over 5 years. Information about background, situation, sociodemography, life events, social support and sense of coherence were gathered at baseline. Multiple logistic regression analysis was used to determine the influence of each variable on long-term SL and receipt of a DP. RESULTS: During the study period, 18.9% of FAs received long-term SL/DP compared with 6% of NAs. Chronic disease was a predictive factor for long-term SL/DP among FAs [odds ratio (OR) 7.0] and NAs (OR 3.4). Among FAs, a life event was also a predictive factor (OR 2.1). Each additional life event increased the ratio of FAs with long-term SL/DP by 110%. Conflicts and losses had the greatest negative effects on FAs. CONCLUSIONS: FAs are a high-risk group for long-term SL/DP. Besides chronic disease, a life event was the only predictive factor for long-term SL/DP among FAs. These findings indicate that FAs are a vulnerable group for stressful events. Consequently, healthcare personnel should take more notice of life events among FAs.

Adolescent↗
PubMed2001

[Determining the need for medical rehabilitation services of employed members of the legal pension fund. A recommendation from social medicine and social legal viewpoints].

Assessing health care needs in populations has become a major activity of public health medicine worldwide. Its methodology has been developing mainly in the English-speaking world. Concept, methods, and techniques have not yet reached Germany though recently the national expert advisory council for the concerted action in health care (Sachverständigenrat für die Konzertierte Aktion im Gesundheitswesen) provided first "official" definitions of demand, supply, and need to identify over- and undersupply in health care. This article aims at defining, from a combined sociolegal and sociomedical perspective, the need for medical rehabilitation measures among insurees of German pension funds. According to section 15 SGB VI rehabilitation is conceived as a medically coordinated multimodal-multidisciplinary intervention with a cognitive-behavioural orientation. To objectify the need for rehabilitation a series of 9 questions was developed enquiring inter alia about the presence of a disease or disability, the extent or "amplification" of the disorder, its course pattern, the implied risk of permanent work disability and likely success of rehabilitation. Nonspecific back pain served as a paradigmatic condition. One of the main problems encountered is the presently small evidence base to arrive at the necessary prognostic and therapeutic judgements.

Adult↗
PubMed1994

[Diagnosis of an Ullrich-Turner syndrome in pension evaluation].

A 56-year-old woman of short stature (148 cm) was medically examined after applying for a disability pension on account of chronic back-pain. She gave a history of primary amenorrhoea (not examined further), slowly increasing deafness, type IIb diabetes mellitus, hyperlipoproteinaemia, hypothyroidism and osteoporosis. Physical examination showed hypoplasia of both breasts, shield chest and slight webbing of the neck. Ultrasonography of the thyroid revealed late stage of Hashimoto thyroiditis. Vaginal ultrasonography confirmed absence of uterus and adnexae. All these findings were compatible with the diagnosis of Turner's syndrome, which was confirmed by chromosomal examination of 50 analysable metaphases showing chromosomal mosaic 45,X/46,X, i(Xq), as well as two cells with 47 chromosomes, two with isochromosomes for the long arm of the X-chromosome. Treatment consisted of administration of L-thyroxin (75 micrograms/d) and oestrogen. There was no follow-up.

Female↗
PubMed2006

Disability pension for psychiatric disorders: regional differences in Norway 1988-2000.

The aim of this study was to describe regional differences in the incidence of disability pensions (DPs) with psychiatric diagnoses, and to determine whether these differences were related to age and/or gender. We compared the incidence rates of new DPs including all diagnoses, with DP with psychiatric diagnoses in Norwegian regions from 1988 to 2000. The population at risk was all individuals aged 16-67 in each year. Individuals already on DP were excluded. Cases were collected from the Norwegian National Insurance Administration. The results showed that the incidence rate ratio (IRR; Norway reference) for DP with psychiatric diagnoses was most elevated for men 1.41 (95% CI 1.27-1.58) and women 1.48 (95% CI 1.34-1.64) living in the most rural region. Men in the urban area had a higher IRR, 1.33 (95% CI 1.26-1.40), than urban women, 1.02 (95% CI 0.96-1.07). The incidence more than doubled in the youngest age group (16-29 years) and decreased in the oldest age group (60-67 years) between 1988 and 2000. The findings conclude that individuals living in semi-rural regions of Norway are more likely to receive a DP with a psychiatric diagnosis than those living in urban areas. Large gender differences were found in the urban area. Further research is needed to investigate the impact of the psychiatric healthcare system and access to rehabilitation on psychiatric disability.

Adolescent↗
PubMed2004

Predictors of disability pension in long-term sickness absence: results from a population-based and prospective study in Norway 1994-1999.

BACKGROUND: While several socio-demographic predictors of disability pension (DP) have been identified, less is known about the importance of the medical aspects. METHODS: A representative sample of Norwegian long-term sickness absentees, 2043 women and 1585 men, with detailed diagnostic information based on the International Classification of Primary Care (ICPC) was followed up for 5 years. The date of granting DP was obtained from the Norwegian DP-register and used as the dependent variable in Cox multivariate regression analysis. Medical and socio-demographic factors were entered as explanatory variables. RESULTS: Kaplan-Meier estimates of the 5 year risk of DP were 22.9% for the full sample, 22.5% for men and 23.3% for the women. Men on sick leave for mental health disorders had an increased disability risk. Except for pregnancy-related cases, which carried a very low risk for future DP, there was no significant difference between the main diagnostic groups among women. Previous sickness absence increased the disability risk but was significant only for total absence above 20 weeks in the 4 years preceding inclusion. Age was the strongest predictor of future DP. Increasing income decreased the risk, bur not linearly. Unemployment status in the year preceding inclusion increased disability risk for women, but not for men. Among cases with musculoskeletal disorders (54.5% of the sample), subgroups with different disability risks were identified in Cox' regression analysis, with a gender-specific pattern. CONCLUSION: In addition to previously known socio-demographic predictors, medical variables were important in identifying sickness absentees with an increased risk of DP.

Adolescent↗
PubMed1978

Liberalizing the social security retirement test; who would receive the increased pension benefits?

The article examines the distributional impact of liberalizing the social security retirement test. The results of simulations that explore ten liberalization alternatives are presented. The distribution of pension benefit gains from liberalization of the test are determined for the aged who were affected by the test in 1972. The relative costs of various liberalization alternatives are compared with complete abolition of the test.

Age Factors↗
PubMed1989

Comparing the economically advantaged and the pension elite: 1980 census profiles.

The number of economically advantaged retirees has grown rapidly since World War II. About 50% of retired individuals and 40% of retired households in the U.S. in 1980 had family income of more than double the poverty level. Economically advantaged retired households are most often headed by married, noncentral-city homeowners who show residential stability. They tend to have multiple income sources, some with income from at least three sources (the pension elite).

Aged↗
PubMed2002

Social determinants of disability pension: a 10-year follow-up of 62 000 people in a Norwegian county population.

BACKGROUND: Non-medical factors may be important determinants for granting disability pension (DP) even though disability is medically defined, as in Norway. The aim of this analysis was to identify determinants of DP in a total county population in a 10-year follow-up study. METHODS: Participants were people without DP, 20- to 66-years-old in 1984-1986. The baseline data were obtained in the Nord-Trøndelag Health Study (HUNT): 90 000 people were invited to answer questionnaires on health, disease, social, psychological, occupational, and lifestyle factors. Information on those who later received DP was obtained from the National Insurance Administration database in 1995. Data analyses were performed using Cox regression analyses. RESULTS: The incidence of DP showed great variation with regards to age and gender, accounting for an overall increase in the follow-up period. Low level of education, low self-perceived health, occupation-related factors and any long-standing health problem were found to be the strongest independent determinants of DP. Low level of education and socioeconomic factors contributed more to younger people's risk compared to those over 50 years. For people under 50 years of age with a low level of education compared to those with a high level of education, the age-adjusted relative risk for DP was 6.35 for men and 6.95 for women. The multivariate-adjusted relative risk was 2.91 and 4.77, respectively. CONCLUSIONS: Even for a medically based DP, low socioeconomic status, low level of education and occupational factors might be strong determinants when compared to medical factors alone. These non-medical determinants are usually not addressed by individual based health or rehabilitation programmes.

Adolescent↗
PubMed1999

Risk factors for disability pension among unemployed women on long-term sick-leave.

BACKGROUND: In 1996 some 520,000 people (13% of Sweden's working force) were either long-term sick-listed or on disability pensions. To reintroduce sick and injured people to the workforce, vocational rehabilitation has received increasing emphasis. Unemployed women seem particularly difficult to rehabilitate. One explanation could be that unemployed women have more complex problems than others; another could concern the selection of cases for vocational rehabilitation programmes. AIM: The primary aim of this study was to test the hypothesis that unemployed women on sick-leave have more severe problems than others. A second purpose was to investigate whether the manner of selection for vocational rehabilitation programmes is different for unemployed women than for others. MATERIAL AND METHOD: The study analysed 364 registered long-term sick-leave cases (90 days or more) initiated during 1992-1994 in the city of Stockholm, Sweden. RESULT: Our hypothesis was supported by the study. Unemployed women were exposed to more risk factors than unemployed men or employed men and women. Regarding the selection of cases for rehabilitation, no difference was present between unemployed women and others. A finding, however not statistically significant, was that people in vocational rehabilitation, regardless of sex and employment status, were less exposed to risk factors than people not undergoing rehabilitation.

Persons with Disabilities↗
PubMed1994

Isthmic spondylolisthesis among patients receiving disability pension under the diagnosis of chronic low back pain syndromes.

OBJECTIVES: This study evaluated the incidence of lumbar isthmic spondylolisthesis among subjects permanently disabled because of low back pain syndromes. SUMMARY OF BACKGROUND DATA: Previous information pointed to whether spondylolisthesis is associated with more frequent or intensive low back pain than that found in the general population. One may expect severe deformity, neurologic deficits, and hence impairment and disability accompanying such a spinal disorder. However, natural history of spondylolisthesis has also been reported to be benign. METHODS: Files from 952 subjects receiving temporary or permanent disability pension because of musculoskeletal disorders of the vertebral column were investigated; 81% had low back pain syndromes. From the radiologic report of the lumbar spine, which was available in 519 (70%) cases, the radiologic findings were recorded. RESULTS: In 2.5%, isthmic lumbar spondylolisthesis was present. In more than half of the subjects, the location of the defect was on L4. Only minor neurologic findings were present. CONCLUSIONS: The finding that the incidence corresponds well with the incidence in the normal population may suggest that lumbar isthmic spondylolisthesis does not invariably lead to severe impairment or disability, although location of the defect at the level proximal to L5 may be connected to an increased risk for permanent low back disability.

Adult↗
PubMed1995

Post-contact chronic eczema: pension or rehabilitation.

A proportion of patients who suffer from either irritant or allergic contact dermatitis, many of whom have no past or family history of atopy or of any other skin disease, evolve into chronic eczema. Workers' compensation payments are frequently suspended after about 6 to 12 months on the basis of 'endogenous dermatitis'. Patients, often healthy breadwinners in the 30 to 50 age group are deemed unemployable because of persistent active dermatitis. Expensive prolonged litigation frequently follows but the end result is usually a patient who has become a healthy, bored, pensioner/retiree with all the psychological and physical sequelae secondary to inactivity and major lifestyle change. It is now becoming recognized that there are many jobs which a person suffering from various degrees of chronic dermatitis can perform without aggravation of dermatitis. However, widespread acceptance of this tenet requires a change in attitude by all the players in the workers' compensation complex, namely the employer, the insurance company, the medical practitioner, the employee and the union. Fortunately, the emphasis is gradually changing towards multidisciplinary assessment of work potential with appropriate retraining and redeployment of injured workers rather than granting lump sum compensation payouts or pensions.

Adult↗
PubMed1986

Causes of blindness in Australia: analysis of pensions granted by the Department of Social Security on the ground of blindness for the year ending 30 June 1984.

The principal and contributing causes of blindness for all pensions granted by the Department of Social Security on account of blindness in Australia during the year ending 30 June 1984 have been coded according to the International Classification of Diseases, 1975 (ICD9). The results are presented in tables which show the major diagnosis for symmetrical and asymmetrical cases according to frequency and age, and the combination of major and contributing diagnosis according to age, sex and prevalence per 100 persons.

Australia↗