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PubMed2005

Who foregoes survivor protection in employer-sponsored pension annuities?

PURPOSE: Retirees in traditional pension plans must generally choose between single life annuities, which provide regular payments until death, and joint and survivor annuities, which pay less each month but continue to make payments to the spouse after the death of the retired worker. This article examines the payout decision and measures the share of married retirees with pension annuities who forego survivor protection. DESIGN AND METHODS: The analysis consists of a probit model of the pension payout decision, based on data from the 1992-2000 waves of the Health and Retirement Study. RESULTS: More than one quarter (28%) of married men and two thirds of married women receiving employer-sponsored retirement annuities declined survivor protection. Men with small pensions and limited household wealth, men in better health than their spouses, and men whose spouses have pension coverage from their own employers are more likely than other men to reject survivor protection. IMPLICATIONS: Most workers appear to make payout decisions by rationally balancing the costs and benefits of each type of annuity, suggesting that existing measures to encourage joint and survivor annuities are adequate. However, the growth in 401(k) plans, which are generally not covered by existing laws protecting spousal pension rights, may leave widows vulnerable.

Female↗
PubMed2000

Disability pension for major depression in Finland.

OBJECTIVE: The authors' goal was to investigate the treatment received before receipt of a disability pension for major depression in a representative sample of depressed patients. METHOD: The medical statements for a random sample of 277 subjects drawn from the Disability Pension Register of the Social Insurance Institution were examined. The subjects selected represented individuals in Finland who were granted a disability pension because of DSM-III-R major depression during a 12-month period in 1993-1994. RESULTS: For 254 (92%) of the subjects, the statements regarding pension eligibility were written either by a psychiatrist or a psychiatric resident for patients who were currently being treated in psychiatric settings. There was an additional diagnosis of a comorbid mental disorder or a somatic disease contributing to disability in two-thirds of the statements. Overall, the statements indicated that 242 (87%) of the subjects were prescribed antidepressant medication, but only 24 (9%) received weekly psychotherapy, and only 11 (4%) received ECT. CONCLUSIONS: Most subjects granted a disability pension for major depression in Finland have comorbid mental or physical disorders contributing to their disability. Before receiving their pension, most received antidepressant treatment, but few received the established nonpharmacological treatments.

Adolescent↗
PubMed1998

Disability pensions in severely disturbed in-patient adolescents. Twenty-year prospective study.

BACKGROUND: Knowledge of working capacity from adolescence until adulthood among severely disturbed in-patients is scarce. METHOD: In a follow-up study of 61 adolescent in-patients, we studied associations between being on a disability pension 20 years after hospitalisation, and the patients' psychopathology and treatment-related factors during the hospitalisation and seven-year follow-up. RESULTS: Of the former in-patients, 27% had not been on a disability pension, 20% had short-term pension periods, and 53% were pensioned. Subjects whose overall psychosocial functioning had improved and who had not utilised in-patient services until the seven-year follow-up, had a better prognosis in terms of working capacity. Half of the subjects who had not been on pension during the follow-up had received a diagnosis of conduct disorder at discharge, and half of those pensioned had a psychotic disorder. CONCLUSIONS: The patients' level of psychosocial functioning and capability to work in young adulthood were associated with long-term prognosis in terms of working capacity. Adolescence seems to be the critical time for intensive psychiatric care combined with vocational rehabilitation programmes.

Adolescent↗
PubMed2002

War pensions (1900-1945): changing models of psychological understanding.

BACKGROUND: War pensions are used to examine different models of psychological understanding. The First World War is said to have been the first conflict for which pensions were widely granted for psychological disorders as distinct from functional, somatic syndromes. In 1939 official attitudes hardened and it is commonly stated that few pensions were awarded for post-combat syndromes. AIMS: To re-evaluate the recognition of psychiatric disorders by the war pension authorities. METHOD: Official statistics were compared with samples of war pension files from the Boer War and the First and Second World Wars. RESULTS: Official reports tended to overestimate the number of awards. Although government figures suggested that the proportion of neurological and psychiatric pensions was higher after the Second World War, our analysis suggests that the rates may not have been significantly different. CONCLUSIONS: The acceptance of psychological disorders was a response to cultural shifts, advances in psychiatric knowledge and the exigencies of war. Changing explanations were both a consequence of these forces and themselves agents of change.

Attitude to Health↗
PubMedDate not supplied

Does retirement education teach people to save pension distributions?

As defined contribution pension plans have become increasingly common over the past two decades, so have lump sum distributions from those plans. Employees who elect such a distribution take the balance of their pension account with them when they leave a job. They can then choose to maintain the funds in accounts designated for retirement, invest them in other saving vehicles, or spend them. If spent pension distributions are not replaced by other savings, however, the future elderly are unlikely to be able to maintain a desirable standard of living. With employee-funded pensions expected to play an increasingly important role in financing Americans' retirement, saving these funds in essential. This article is the first to examine the relationship between retirement education--specifically, meetings sponsored by employers or by public and private institutions--and the saving of lump sum distributions. Two definitions of saving are used: one that includes reinvestment only in tax-deferred saving vehicles, and a broader one that includes tax-deferred vehicles, general saving vehicles (stocks, bonds, savings accounts, and so on), and paying off debt. The analysis also evaluates the effects of retirement education on specific groups identified in previous research as being less likely to keep their pension distributions in tax-deferred accounts: namely, women, younger persons, and persons with less than a college education. The same groups tend to be less financially secure in retirement, making the effects of retirement education on them particularly relevant. With an econometric model using ordinary least squares and data from the 1992 Health and Retirement Study, the analysis finds that retirement education does not affect the overall likelihood that employees will save their distributions, whether in tax-deferred or non-tax-deferred vehicles. The picture is more complicated for subgroups of employees. Attending a retirement meeting is associated with an increased likelihood of saving among persons age 40 and under but a decreased probability of saving among college graduates and women. No effect was found for men, individuals over age 40, or persons who did not graduate from college. The finding that retirement education increases the likelihood of younger persons' saving a distribution is reassuring, for these workers are America's future retirees. However, the finding that attending a meeting does not increase saving among some of the most financially vulnerable groups is a matter of concern to policymakers. Further study of the long-term effects of spending pension distributions is needed.

Adult↗
PubMed2005

Sickness absence with low-back, shoulder, or neck diagnoses: an 11-year follow-up regarding gender differences in sickness absence and disability pension.

BACKGROUND: There is very little knowledge on the long-term outcomes of sickness absence. The aim was to investigate sickness absence and disability pensions over 11 years in a cohort of young persons initially long-term sick listed with back, neck, or shoulder diagnoses. METHOD: A prospective population-based cohort study of all 213 individuals in the Municipality of Linköping, Sweden, who in 1985 were aged 25-34 and had at least one new sick-leave spell > 28 days with such diagnoses. MAIN RESULTS: More women (61%) than men fulfilled the inclusion criteria. In 1996, 22% of the cohort (14% of the men, 26% of the women) had been granted disability pension; 76% of these individuals with musculoskeletal and the rest with psychiatric diagnoses. Partial disability pension was granted to 59% of the women, 17% of the men. Women were more often granted temporary disability pension than men. CONCLUSIONS: This proved to be a high-risk group for disability pension. There were large and somewhat unexpected gender differences regarding incidence and type of disability pension. It has been debated how soon physicians should be concerned about the risk of long-term disability regarding these diagnoses; at four or eight weeks of sickness absence - our results support the former, at least for women.

Absenteeism↗
PubMedDate not supplied

[Prevalence of disability pension related to obesity in Iceland 1992-2004].

OBJECTIVES: To investigate changes in the prevalence of disability pension related to obesity in Iceland from 1992 to 2004. MATERIAL AND METHODS: Data were obtained from the disability register of the State Social Security Institute and Statistics Iceland for the years 1992 and 2004. Prevalence of disability pension related to obesity and of disability pension in general was calculated for both years. Statistical significance was assessed by calculating chi square and standardized risk ratios. RESULTS: From 1992 to 2004 the number of recipients of disability pension with obesity as a primary diagnosis increased from 37 to 111, amounting to 183% increase for females and 263% for males. This increase is significantly greater than the increase in disability pension in general during this period. Age standardized risk ratio showed increased disability related to obesity for both genders. Among males it was greater than the general increase in disability, while among females it was less. There was a significantly greater increase in disability related to obesity in areas outside the capital compared with Reykjavík and surrounding areas among females. The increase in disability related to obesity far surpasses the increase in obesity in the population, according to population surveys, suggesting that severe and morbid obesity may be particularly on the rise. CONCLUSION: There has been a significant increase in the prevalence of disability pension related to obesity in Iceland from 1992 to 2004. It is possible that increased social awareness of obesity during the study period has influenced diagnostic habits of physicians and thus increased the use of obesity as a diagnosis in medical certificates and disability assessment. In all likelihood, however, there has been an increase in disabling obesity in Iceland, indicating that obesity is an increasing public health problem demanding appropriate intervention.

Chi-Square Distribution↗
PubMed1987

The relationships between public and private pension schemes: an introductory overview.

Only recently have social insurance and private pensions, collectively, come to be thought of in terms of a total social security benefit package. The economic problems brought on by the 1974 oil crisis initially triggered consideration of a common, integrated role for the two systems. The second oil crisis reinforced the relative expansion in private pension programs, as a supplement to social security. Before these events, private and public pension programs interacted in only a limited number of ways, confined to relatively few countries. These interactions were largely confined to collective bargaining, whereby private pensions were gradually extended to nearly all employees in France and Sweden; mandating, or legally requiring private supplementation of social security, debated in several countries in the early 1970's, but postponed by the 1974 oil crisis; and contracting out, or covering a part of the social security benefit under a private plan, as in the United Kingdom. Overall, the tradition of private pensions was not very strong or broadbased. The current debate centers on which public/private pension mix is desirable from the point of view of an old-age income-maintenance program. A new element is the rising support for a "third pillar"--individual tax-encouraged savings--not only as a supplement, but as an alternative to social insurance.

Aged↗
PubMed1986

Pension status of recently retired workers on their longest job: findings from the New Beneficiary Survey.

Pension coverage among recently retired workers was greater in the early 1980's than it was a decade earlier. Workers whose longest job was with a private employer and women workers were among the groups that experienced the largest increases in coverage by a pension plan other than the social security program. Private pension plan coverage increased from 47 percent to 64 percent for men and from 21 percent to 39 percent for women. The key factors analyzed here include industry, occupation, length of employment, and earnings. Data from the New Beneficiary Survey reveal that a high proportion of covered workers received pension payments at retirement. Pension payments were received by 9 in 10 retirees covered by a government plan and by 3 in 4 retirees covered by a private industry plan on their longest job. In addition, lump-sum payments were received by 12 percent of the men and 21 percent of the women in private pension plans.

Aged↗
PubMed1978

Pension coverage and benefits, 1972: findings from the retirement history sutdy.

This article, based on data from the Retirement History Study, examines coverage by an employee pension plan on the longest job and the extent to which covered workers received an employee pension upon retirement and the size of their benefits. It also examines the joint receipt of employee pension and OASDI benefits and the size of the combined benefits. Each of these pension variables is analyzed for differences by class of worker (private wage and salary or government), sex, and characteristics of the longest job (industry, occupation, tenure, recency of job, extent of employment, and annual earnings rate). The majority of completely retired individuals in their early to middle sixties in 1972 did not receive employee pension benefits in that year. Women employed in private industry on their longest job were the most disadvantaged in this regard. Even when they were fortunate enough to receive retirement benefits from employee pension plans, their benefits were substantially lower than those of men or of women employed in government.

Aged↗
PubMed1996

Pension benefits among the aged: conflicting measures, unequal distributions.

Estimates of total benefits paid by employer sponsored pension plans seem to vary widely between different data sources and measures. Such discrepancies have been used to support differing conclusions about the effectiveness of the pension system. This article examines several measures of aggregate pension benefits in 1990, a year particularly rich in available data. Exploratory analysis suggests that the greatest source of discrepancy lies in differing treatments of lump-sum distributions, although the study also identifies several other types of payments that are variously, and erroneously, counted as pension income. Age of recipients is an important factor in analyzing different measures of aggregate pension benefits; discrepancies are much smaller among the aged than in the population as a whole. The analysis also provides new evidence about the unequal distribution of pension benefits among the aged, confirming from two data sources that benefits are heavily concentrated among higher income groups.

Aged↗
PubMed1999

Sick leave and disability pension before and after treatment for obesity: a report from the Swedish Obese Subjects (SOS) study.

OBJECTIVES: To analyse sick leave and disability pension among surgically and conventionally treated obese patients. DESIGN: A prospective study over five years. Differences in sick leave and disability pension were analysed using multiple and logistic regressions. Possible confounding factors were analysed and controlled for. SETTING: Nine counties in Sweden. SUBJECTS: 369 surgically treated patients and 371 matched obese controls, included in the Swedish Obese Subjects (SOS) study. At baseline, mean body mass index (BMI) was 42 kg/m2 in surgical patients and 41 kg/m2 in controls. After four years of treatment, weight reduction was 20% among surgical patients while the control patients kept their initial weight. INTERVENTION: Gastric bariatric surgery. MEASUREMENTS: Days of sick leave plus disability pension, and days of disability pension. RESULTS: In the year prior to treatment, adjusted average number of days of sickness due to sick leave plus disability pension was similar in surgical patients and controls. Compared with controls, the surgical group had 35% more days of sickness during the first year after initiation of treatment, but 10-14% fewer days during years 2-3. During year four, days of sickness tended to be lower in the surgical group (P = 0.07). In the sub-group, aged above the median, surgical patients had 14-18% fewer days of sickness than controls, during years 2-3 after initiation of treatment This difference did not occur in the group below median age. CONCLUSION: Surgical treatment of obesity results in a reduction of sick leave and disability pension, compared to controls, particularly in subjects aged 47-60 y.

Adult↗
PubMed2002

[Progression of the pension-application process in psychosomatic patients].

Psychosomatic disorders have become increasingly important as a reason for premature retirement. To identify specific characteristics of pension applicants, we broke a random sample consisting of 1,109 patients admitted to Burg Hospital within the framework of psychosomatic rehabilitation programmes into three main groups: a) patients who had not applied for any kind of pension benefits and 'high-risk groups' of pension aspirants who b) had either already submitted an application or c) intended to do so. The comparison of the sociomedical data from the two groups showed that the high-risk group contained a markedly larger percentage of unemployed patients and patients who had been on sick leave for longer periods. The average age of the pension aspirants was higher. Moreover, this group contained a larger percentage of male patients than did the non-applicant group. An assessment of rehabilitation potential uncovered a distinctly depressed potential in the high-risk group. Moreover, the assessment of individual patient performance conducted at the end of each rehabilitation programme yielded significantly lower scores for the high-risk groups in comparison with the non-applicant group. On the basis of the decrease in symptoms, it is evident that only small therapeutic success can be achieved with these patients, who as a group display a significantly lower therapeutic motivation than their non-applicant counterparts. Furthermore, there was a higher incidence of recurrent depressive disorders and somatic pain disorders in the high-risk groups. The development of pension aspirations can be described as a process starting with a disorientation phase, proceeding to an ambivalence phase and culminating in a rigid terminal phase. Patients who have reached this stage are generally resistant to rehabilitation efforts. For this reason, early recognition of pension aspirations is of critical importance.

Adult↗
PubMed1998

Why are older pensioners poorer?

"We show that older [UK] male pensioners have substantially lower incomes than younger pensioners.... We find that cohort differences more than account for the lower incomes of older pensioners in the sense that the mean income of older pensioners is actually higher than the mean income of the same cohort of pensioners when they were younger. We explore a number of possible reasons for this and conclude that it is driven by differential mortality between richer and poorer pensioners. We show how this manifests itself in a long time series of cross-sectional datasets."

Age Factors↗
PubMed1985

Adequacy and effectiveness of a public dental care program for old-age pensioners.

The purpose of the present work was to assess the adequacy and effectiveness of a public dental program for old-age pensioners. The dental care program offered free consultation and treatment at reduced prices to all pensioners (3072) in a municipality near Oslo in 1979. To study treatment need and access to dental care, a random sample of 430 pensioners was drawn from the total population of old-age pensioners; 371 persons were clinically examined. Of the 3072 old-age pensioners 23.7% responded positively and indicated that they were interested in the program, whereas 19.8% accepted, and 14.6% had the treatment carried out. The program adequacy was low and became lower when more restricted criteria for access to dental services were used. The program effectiveness was 18% or 16%, depending on which criteria were used for access. Acceptance of the program was highest among people who were aware of it, had natural teeth, had a dental problem, did not have their own dentist, had limited education, or were among the young pensioners.

Aged↗
PubMed1999

Psychosocial characteristics in young men as predictors of early disability pension with a psychiatric diagnosis.

BACKGROUND: There is little knowledge about disability pensions (DPs) in psychiatric diagnoses. The aim of this study was to analyse risk factors among men for receiving an early disability pension with a psychiatric diagnosis. METHODS: The study is based on data from a nationwide survey of 49 285 young Swedish men who were conscripted into military service in 1969/1970. Potential psychosocial and behavioural risk factors were linked to records from the Swedish Social Insurance Board up until 1993. RESULTS: The majority (63.4%) of the men granted a DP during follow-up had a psychiatric diagnosis as the main and/or secondary diagnosis. Among those conscripts analysed (41 702), 599 had been granted a disability pension with a psychiatric diagnosis. Of these, 35.4% had a diagnosis of psychosis, 23.2% an alcohol- or drug-related diagnosis, and 41.4% 'other' psychiatric diagnosis. Receiving a psychiatric diagnosis at conscription, showing low emotional control, unemployment after graduation, and ranking low on an "IQ" test were strong predictors of all categories of DP with psychiatric diagnoses. In multivariate analysis controlling for the effect of all other risk indicators included in the model, DP with non-alcohol- and non-drug-related psychiatric diagnoses was related to low social support at adolescence but not to signs of extrovert deviant behaviour (risky use of alcohol or contact with police and child authorities). In contrast, DP with an alcohol- or drug-related diagnosis had strong associations with signs of extrovert deviant behaviour. The risk pattern of DP without psychiatric diagnoses was similar to that of DP with a psychosis but also, though to a lesser extent, to that of DP with 'other' psychiatric diagnosis. These similarities could be interpreted as showing that the diagnoses on the records of disability pensions have a low sensitivity and/or specificity or, alternatively, that the risk factors found are risk factors for life careers steering toward a disability pension rather than toward the specific health outcomes per se. CONCLUSIONS: The results illustrate the importance of psychosocial factors established in late adolescence in the complex pathway of a decision of an early DP.

Adult↗
PubMed2006

Disability pension among immigrants in Sweden.

Using large samples, disability pensions among foreign-born and native-born women and men living in Sweden is studied here for the period 1981-1999. The results show foreign-born individuals having higher rates of disability pension. The risk of being on disability pension is very low for newly arrived immigrants, but increases rapidly on a yearly basis after immigration. Higher rates of disability pension are reported for persons born in Greece, Yugoslavia, Turkey and Finland. Results from multivariate analysis indicate that factors such as education, country of residence and marital status cannot fully explain the high rates of disability pension observed among many immigrant groups. Future research needs to address which possible causes are most important for policies to address.

Persons with Disabilities↗
PubMed2003

Factors associated with being granted a pension among psychiatric outpatients with major depression.

BACKGROUND: Little is known about factors associated with early retirement due to major depression in naturalistic settings. We examined to what extent major depression leads to disability pension and whether there are any associated factors with being granted a pension. METHODS: In our retrospective document-based cohort study of 213 adult psychiatric outpatients with first-time documented DSM-III-R major depression, several sociodemographic, clinical and treatment characteristics were detected during the follow-up time of 3 months of medical care in Finland. This information was related to official registers of granted pensions with a follow-up time of 30 months. RESULTS: Forty-six (21.6%) patients were granted a pension during the follow-up period. Greater age, comorbidity and lowered self-esteem were strongly associated with being granted a pension. DISCUSSION: Some risk factors associated with subsequent retirement could be identified at the early phase of the illness.

Adolescent↗