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PubMed1993

The role of pensions in retirement income: trends and questions.

Pensions are an important and increasingly common supplement to Social Security benefits for persons aged 65 or older--particularly for those in the the middle and upper income quintiles. By 1990, pension income was reported by 44 percent of all elderly units--57 percent of the couples and 34 percent of unmarried persons. This article discusses the role of pensions in the income of the elderly; private pension coverage, vesting, and types of plans among active workers; how the shift toward defined contribution plans poses new problems in assessing the role of private pensions in providing retirement income security; and expected pension receipt rates for the future elderly. Pension receipt among the elderly is expected to continue to grow over the next 20-30 years because of past growth in coverage and vesting. Microsimulation models are a relatively new tool for forecasting the future distribution of pension income. The models offer a framework for considering the research questions that, if answered, would help improve our understanding of the impact of the pension system on future income security.

Adult↗
PubMed1982

Survival experience of semi-skilled disability pensioners in Denmark.

The purpose of this study was to estimate the survival prognosis of semi-skilled disability pensioners. The survival experience of 1353 invalid male members of the Danish Semiskilled Workers Union (SID) awarded disability pensions in 1975 was compared with a control group of members of the same union, matched geographically and by age. The two groups were followed until Nov. 30, 1978. For the follow-up period as a whole, the mortality risk among disability pensioners was estimated to be 6.8 times as high as that of controls. The relative risk of mortality was higher at the period's inception than at the end. A very high mortality level was found among disability pensioners awarded the highest level of disability pension, but no differences in mortality were found between disability pensioners awarded the lower levels of disability pension and the corresponding control group. The significance of medical and social factors in reducing the ability to work is discussed, as it relates to grounds for the awarding of disability pensions. The prognosis of one category of disability pensioners is very poor, while the survival prognosis of another is not significantly worsened, despite a considerable deterioration in the ability to work.

Adult↗
PubMed2004

[Relationship between rate of unemployment and incidence of disability pension in Iceland 1992-2003.].

OBJECTIVE: To evaluate the effect of unemployment and the introduction of a new method of disability assessment on the number of recipients of disability pension in Iceland by examining changes in the incidence of disability pension and unemployment year by year from 1992 to 2003. MATERIAL AND METHODS: Information on gender, age and disability grade of new recipients of disability pension in Iceland and corresponding information on the Icelandic population for each year in the period 1992 to 2003 was used to calculate the incidence of disability pension. The results were compared with data on the rate of unemployment in Iceland. RESULTS: The incidence of disability pension was relatively high from 1992 to 1995, was lower from 1996 to 2002 and then increased markedly in 2003. There is a strong correlation between the incidence of disability pension and the rate of unemployment among both genders in Iceland during the period covered by the study. An increase from 1999 to 2000 in the incidence of disability pension among females coincided in time with the introduction of a new method of disability assessment in September 1999, but also with an increase in the rate of unemployment among females. CONCLUSION: It is not warranted to claim that the introduction of a new method of disability evaluation in September 1999 has resulted in a decisive increase in the incidence of disability pension in Iceland. The increase in the number of recipients of disability pension in Iceland recently has a strong statistical correlation with changes in the labour marked, especially with rising unemployment and increased pressure at work.

English Abstract↗
PubMed2004

Disability in society-medical and non-medical determinants for disability pension in a Norwegian total county population study.

The objective of this study was to describe sociomedical determinants and developments for the medically based disability pension in Norway by linking individual based data from a county health survey to data on disability from the National Insurance Administration. Two cross-sectional total population health surveys with an approximate 10-year interval were conducted in Nord-Trøndelag county, HUNT I (1984-86) and HUNT II (1995-97), which allows for analyses of changes over time, supplied with official incidence data on disability pension. The large-scale variations and overall increasing incidence rates of disability pension in Norway during the last 20 years also applied to the county of Nord-Trøndelag. The prevalence of disability pension generally increased in the population from the mid-1980s to the mid-1990s. A striking finding was a consistent pattern of increasing prevalence of disability pension with decreasing socio-economic status and education. A geographic pattern for disability pension prevalence on a municipality level suggested that structural and cultural factors were important in determining the level of disability in society. Medical determinants alone cannot explain either the dramatic variations or the overall increased incidence rates of disability pension in the last two decades in Norway. The results demonstrate the importance of social, non-medical and contextual determinants for disability pension, how these determinants result in important prevalence differences by socio-economic status, and their impact on the level of disability in society.

Adult↗
PubMed2006

Neighborhood social participation, use of anxiolytic-hypnotic drugs, and women's propensity for disability pension: a multilevel analysis.

AIMS: The increasing number of people on disability pension in Sweden is of concern for Swedish policy-makers, and there is a need for a better understanding of the mechanisms behind disability pension. We investigated (i) whether women living in the same neighborhood have a similar propensity for disability pension that relates to neighborhood social participation, and (ii) whether there is an association between anxiolytic-hypnotic drug (AHD) use and disability pension in women that is modified by the neighborhood context. METHODS: We used multilevel logistic regression with 12,156 women aged 45 to 64 (first level) residing in 95 neighborhoods (second level) in the city of Malmö (250,000 inhabitants), Sweden, who participated in the Malmö Diet and Cancer Study (1991-96). RESULTS: Both AHD use (OR = 2.09, 95% CI 1.65, 2.65) and neighborhood rate of low social participation (OR = 11.85, 95% CI 5.09, 27.58) were associated with higher propensity for disability pension. The interval odds ratio indicated that the influence of neighborhood social participation was large compared with the unexplained variance between the neighborhoods. The association between AHD use and disability pension was not modified by the neighborhood context. The median odds ratio was 1.44 after adjusting for individual characteristics and 1.27 after the additional adjusting for neighborhood social participation. CONCLUSIONS: Women living in the same neighborhood appear to have a similar propensity for disability pension, beyond individual characteristics, and this contextual effect seems largely explained by neighborhood social participation. In addition, AHD use might increase the propensity for disability pension in women.

Anti-Anxiety Agents↗
PubMed2003

Cardiorespiratory fitness and risk of disability pension: a prospective population based study in Finnish men.

BACKGROUND: Early retiring is a major social problem in many western countries. AIM: To investigate whether good cardiorespiratory fitness prevents disability pensioning in Finnish middle-aged men. METHODS: Subjects were a random population based sample of 1307 men who were 42-60 years old at baseline, had not retired before baseline or died during follow up, and had undergone a cycle ergometer test at baseline. Cardiorespiratory fitness was assessed at baseline with a maximal but symptom limited exercise test on an electrically braked cycle ergometer. RESULTS: During a follow up of 11 years on average, 790 (60.4%) men were awarded a disability pension, only 254 (19.4%) men reached the old-age pension without previous early pension, and 263 (20.1%) men were still working at the end of follow up. After adjustment for age, body mass index, alcohol consumption, smoking, education, occupation, and baseline chronic diseases, an inverse association was observed between cardiorespiratory fitness and the risk of disability pension. Men with VO2max <25.98 ml/kg/min (lowest fifth) had a 3.28-fold (95% CI 1.70 to 6.32) and men with the duration of exercise test <9.54 minutes (lowest fifth) had a 4.66-fold (95% CI 2.43 to 8.92) risk of disability pension due to cardiovascular diseases compared with men in the highest fifths. Men with lowest fitness level also had an increased risk of disability pension due to musculoskeletal disorders, or all reasons combined. CONCLUSIONS: Physical fitness is inversely associated with the risk of disability pension and especially with the risk of disability due to cardiovascular diseases.

Cardiovascular Diseases↗
PubMed2002

Contracting-out in the United Kingdom: a partnership between social security and private pension plans.

Contracting-out was introduced in the United Kingdom in 1978 as part of the arrangements for the State Earnings-Related Pension Scheme (SERPS) in order to avoid duplication with the existing well-developed defined benefit occupational pension plan sector. Members and sponsors of contracted-out schemes were able to save on their social security contributions in recognition of the fact that they were accruing equivalent benefits through an occupational pension plan. Later on this concept was extended to those with individual money purchase pension plans. This article considers a brief history of contracting-out, the principles of contracting-out, some problems associated with contracting-out, the implications of the introduction of stakeholder pensions and State Second Pension, and the latest rebate review and rebate orders. It examines how U.K. pensions policy since 1978 has been based on a partnership between social security and private pension plans.

Contract Services↗
PubMed2000

Public pension reform in Japan.

The March 2000 pension reform in Japan focused on the long-term financial sustainability of the country's two-tiered public pension system. The government opted for incremental changes in order to maintain pension solvency through 2060. Those changes could reduce future pension funding liability by an estimated one-third. Further, the decision to avoid structural reforms of its pension programs was based on fiscal considerations. Expanding general revenue funding for the first tier from the current share of one-third to cover the entire cost would require increases in the consumption tax that proved to be politically unacceptable. Fully privatizing the second, earnings-related tier would entail transition costs too great to bear at a time of rising budget deficits. In addition, the Japanese public generally supported the sharing of financial burden for public pension programs through a combination of benefit cuts, a raise in the pensionable age, and contribution rate increases. If current cost projections prove to be inaccurate, future pension reviews (scheduled every 5 years) will give the government further opportunity to fine-tune program changes.

Aged↗
PubMed1989

[Employees without pension arrangements].

Old age pensions in modern western industrial countries rest on three pillars: public, collective and individual-private arrangements. The flat-rate public system and the collective systems, domain of industrial relations, prevail in Holland. Since the early seventies the public old age pension (AOW) has been raised to the net minimum wage level. In the meantime the importance of the collective systems has been increasing. The pension levels of these systems are, however, not prescribed by law. In order to measure the present state of the collective systems the Dutch Chamber of Pensions has started a research project to investigate how many workers lack such an arrangement and why they lack it. The results of the project have recently been reported: in 1985 18% (650,000) of the workers (25-65 years) lacked an arrangement. The vast majority of them (87%) was found in the sector of services, especially the commercial services. A second research project has been started to find out the quality of the existing pension arrangements. The results of the two projects together are meant to answer the question whether or not some sort of collective pensions must be enforced by law. The improvement of collective pension schemes, however, should not lead automatically to decreasing public schemes. For most people the public pension system is the most important source of income.

Adult↗
PubMed1983

A prospective longitudinal study of abusers of alcohol granted disability pension.

The present study was carried out to obtain a better conception of the consequences of disability pension for abusers of alcohol. A total of 78 abusers applied for disability pension during 1 1/2 years in one specific region of the Swedish county of Ostergötland. Fifty-six of 61 individuals who could be contacted and who were examined immediately before they were pensioned, could also be re-examined after 2 years. Two minor matched reference groups, newly pensioned non-abusers and abusers undergoing rehabilitation, were also examined in almost an identical way with a 2-year interval. In contrast to common expectations, the pensioned abusers demonstrated positive changes in their reported abuse, psychiatric status, self-rated well-being, nutritional status and mental test performance, as regards perceptual analysis and figurative memory. Their social and structural situation as well as their daily activities were fairly constant. The results are discussed particularly with regard to the selection of examination occasions, the international evaluational research on treatment for alcoholics and the course of alcoholism. It is advocated that the results should be interpreted with caution and not taken as indications for granting pensions to an even greater extent. However, it can be concluded that the examined pensioned abusers showed improvement rather than impairment. This is the fifth report in a series from the research project "Abuse of alcohol - Disability pension - Quality of life".

Activities of Daily Living↗
PubMed2001

Permanent impairments, disabilities and disability pensions related to accidents in Norway.

The purpose of this study was to estimate the burden of accidents in terms of new disability pensioners related to accidental injuries in Norway and to use this information to supplement the picture of the epidemiology of accidents in Norway. The basis of the study was 7,241 new disability pensioners due to accidents in the Disability Register of the National Insurance Administration in Norway for 1992-1997. Included in the analyses are some data from health surveys in USA and Norway. The rate of disability pensioners (16-66 years old) due to accidents increased 4% annually during 1992-1997, and in the age group 16-44 years 8% annually. The increase is found in all types of accidents, except for home and the group other accidents, where the rate is constant. 45% had been injured in traffic accidents, 33% in occupational accidents, 16% in leisure accidents, 4% in home accidents and 2% in other accidents. The rates of disability pensionings due to occupational accidents are three to four times higher among 'blue collar' workers than among 'white collar' workers. While disability pensioning rate in the age group 16-66 years due to accidents has increased 4% annually, the accident mortality for the age group 15-64 years has decreased 3% annually. The relationship between disability pensioning and mortality in the age group 15-64 years is found to be approximately 2:1 for all accidents. For occupational accidents the relationship is 5:1, for traffic accidents 2.5:1, for leisure and other accidents 1:1 and for home accidents 1:2.7. The complete epidemiologic picture due to accidents in Norway per 100,000 of population seems to be: medically treated, 10,000; hospitalised, 1,200; permanently impaired, 800 (of whom probably 50% are treated as out-patients); disabled (restricted activity), 400; fatalities, 40; and disability pensioned in the age group 16-66 years, 50. Medically treated and hospitalised patients due to accidents seem to show a slightly decreasing rate, fatalities a higher decreasing rate. This supplement to the epidemiological picture of rates and trends of impairments, disability and disability pensionings (the more serious consequences of accidents), points to the need to focus on the current trends for accident prevention.

Accident Prevention↗
PubMed2005

[The duration of disability pensions in Iceland].

OBJECTIVE: To analyze the long-term outcome for recipients of disability pension in Iceland. MATERIAL AND METHODS: The study includes all those receiving disability pension for the first time in 1992 in Iceland. Their status in the disability register at the State Social Security Institute of Iceland November 30th 2004 was examined as to whether they were still receiving disability pension, had died, had reached the age of retirement or were not receiving disability pension any more for some other reasons. RESULTS: In 1992 there were 725 new recipients of disability pension in Iceland, 428 females and 297 males. Twelve years later 434 from this group were no longer receiving disability pension, 240 females and 194 males. In most cases this was because they had reached the age of retirement or died (on average 88% of the females and 91% of the males each year). Only 12% of the females and 9% of the males ceased to receive disability pension (and probably went back to work). CONCLUSION: In Iceland few people return to work once they have started receiving disability pension.

Adult↗
PubMed1989

[The significance of childhood conditions with regard to disability pensions. A case-controlled study among unskilled workers].

The significance of the conditions in childhood and adolescence for awarding of disability pension is illustrated by means of a case-control design with persons matched according to age, sex and type of work. The group investigated consisted of 581 general male workers who received middle or highest disability pension and 1,550 control persons. No significant differences were found between the case and control group as regards the occupation of the father, unemployment of the father, illness or disability pension in the parents, economical problems during childhood, growing up in the parental home and growing up in rural or urban surroundings. Disability pensioners had more frequently had schooling for less than seven years. These results cannot confirm the conclusions from previous investigations which are associated with bias in the form of socioeconomical differences between the group investigated and the control group. Unskilled work results in confounding as it is associated not only with poor childhood conditions and also with a high incidence of disability pension. Poor childhood conditions are not found more frequently within the group of general workers among the disability pensioners and can thus not be regarded per se as a risk factor for awarding disability pensioning. However, the childhood condition may influence the choise of occupation and then indirectly act as a risk factor for disability pension.

Adult↗
PubMed2002

Is there an interaction between self-rated health and medication with analgesics and hypnotics in the prediction of disability pension?

AIMS: Several studies have shown that self-rated health (SRH) is associated with drug use. The aim of this study was to investigate the possible interaction between SRH and use of analgesics and hypnotics and its ability to predict disability pension. METHODS: In 1974-78. complete birth-year cohorts of middle-aged male residents in Malmö, Sweden, were invited to a health screening, and the cohort in this study comprised 5,798 men with complete data followed up for 11 years. RESULTS: At inclusion, 27% rated their health as less than perfect, 11% used analgesics, 3% used hypnotics and, during follow-up. 12% received a disability pension. The adjusted hazard ratios of disability pension were 3.1 (CI: 2.6, 3.6) for those who had rated their health as less than perfect and 2.7 (2.3, 3.2) for subjects who used analgesics and/or hypnotics. For subjects with the combined risk of poor SRH and medication, the hazard ratio was 5.5 (4.6, 6.5). The granting of disability pension attributable to the interaction between poor SRH and medication was estimated at 47%, which was statistically significant. CONCLUSIONS: Disability pension among middle-aged men was associated with self-rated health as well as medication and clear evidence of synergism between the two factors was found, while there were no indications of medication acting as a causal link between poor SRH and disability pension. Several mechanisms may contribute to the findings, but the information gained may be used as means to identify those at risk for disability pension.

Adolescent↗
PubMed2006

A population-based cohort study of the effect of common mental disorders on disability pension awards.

OBJECTIVE: Mental illness is consistently underrecognized in general health care, which may lead to underestimation of its effects on awards for social security payments. The authors investigated empirically the contribution of psychiatric morbidity to the award of disability pensions, in particular those awarded for physical diagnoses. METHOD: Using a historical cohort design, the authors utilized a unique link between a large epidemiological cohort study and a comprehensive national database. Baseline information on mental and physical health was gathered from a 1995-1997 population-based health study of those of working age (20-66 years) in Nord-Trøndelag County, Norway, who were not recipients of disability pension (N=45,782). The outcome assessed was the awarding of disability pensions ascribed to specific ICD-10 diagnoses within 6 to 30 months as registered in the National Insurance Administration. RESULTS: Anxiety and depression were robust predictors of disability pension awards in general, even when disability pensions awarded for any mental disorder were excluded. These effects were only partly explained by baseline somatic symptoms and diagnoses and were stronger in individuals aged 20-44 than in those aged 45-66. Somatic symptoms accounted for far more disability pension awards than did somatic diagnoses. CONCLUSIONS: The cost of common mental disorders in terms of disability pensions and lost productivity may have been considerably underestimated by official statistics, particularly for younger claimants. The results suggest this might be due both to overuse of physical diagnoses and underrecognition of common mental disorders in primary care.

Adult↗
PubMed1978

Early retirement pensions in Sweden: trends and regional variations.

The total number of early retirement pensiones has risen sharply since the end of the 1960s. The increase was greatest during the early 1970s following a reform in 1970 which extended the right to early retirement pension to older workers because of labour market considerations. This article discusses various conceivable explanations for the growth in the number of early retirement pensioners and regional variations of this phenomenon. The following explanatory factors are considered: (a) The prospects of getting (keeping) a job. (b) Work capacity. (c) The nature of the pension scheme. (d) Alternative possibilities of support. (e) Preferences concerning early retirement pensions. The discussion focuses on two explanations highlighted in the public debate in Sweden: changes in pension legislation and the role of the solidarity wages policy. An empirical analysis of variations at the provincial level reveals a definite correlation between the proportion of early retirement pensioners and various indices of unemployment and underemployment.

Age Factors↗
PubMed2006

The role country of birth plays in receiving disability pensions in relation to patterns of health care utilisation and socioeconomic differences: a multilevel analysis of Malmo, Sweden.

BACKGROUND: People of low socioeconomic status have worse health and a higher probability of being granted a disability pension than people of high socioeconomic status. It is also known that public and private general physicians and public and private specialists have varying practices for issuing sick leave certificates (which, if longstanding, may become the basis of disability pensions). However, few studies have investigated the influence of a patient's country of birth in this context. METHODS: We used multilevel logistic regression analysis with individuals (first level) nested within countries of birth (second level). We analysed the entire population between the ages of 40 and 64 years (n = 80,212) in the city of Malmo, Sweden, in 2003, and identified 73% of that population who had visited a physician at least once during that year. We studied the associations between individuals and country of birth socioeconomic characteristics, as well as individual utilisation of different kinds of physicians in relation to having been granted a disability pension. RESULTS: Living alone (ORwomen = 1.72, 95% CI: 1.62-1.82; ORmen = 2.64, 95% CI: 2.46-2.83) and having limited educational achievement (ORwomen = 2.14, 95% CI: 2.00-2.29; ORmen = 2.12, 95% CI: 1.98-2.28) were positively associated with having a disability pension. Utilisation of public specialists was associated with a higher probability (ORwomen = 2.11, 95% CI: 1.98-2.25; ORmen = 2.16, 95% CI: 2.01-2.32) and utilisation of private GPs with a lower probability (ORmen = 0.76, 95% CI: 0.69-0.83) of having a disability pension. However, these associations differed by countries of birth. Over and above individual socioeconomic status, men from middle income countries had a higher probability of having a disability pension (ORmen = 1.61, 95% CI: 1.06-2.44). CONCLUSION: The country of one's birth appears to play a significant role in understanding how individual socioeconomic differences bear on the likelihood of receiving a disability pension and on associated patterns of health care utilisation.

Adult↗
PubMed1995

The World Bank, pensions, and income (in)security in the global south.

The authors describe and analyze recent reductions and reorganizations of public pension programs in Latin America, as well as trends in pensions in the global South more broadly. They consider the role of the World Bank in the current pension "reform" process and situate the Bank's policies in the context of privatization, reduction of social budgets, and other aspects of structural adjustment. Chilean pension changes are analyzed in particular, showing that even by the Bank's criteria, the reforms have not been successful. The authors then discuss pension changes in China, where the World Bank is also deeply involved. The article concludes with the consideration of a number of arguments about pensions and support mechanisms in later life--including family support and means-tested welfarism--and argues in favor of global policy approaches, such as globally funded pensions and full access by older persons to productive and remunerated labor.

Aged↗