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Open Access Research article

Health problems account for a small part of the association between socioeconomic status and disability pension award. Results from the Hordaland Health Study

Kristian Amundsen Østby1*, Ragnhild E Ørstavik1, Ann Kristin Knudsen2, Ted Reichborn-Kjennerud34 and Arnstein Mykletun5

  • * Corresponding author: Kristian A Østby kroe@fhi.no

Author Affiliations

1 Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway

2 Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway

3 Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway; Institute of psychiatry, University of Oslo, Oslo, Norway

4 Department of Epidemiology, Columbia University, New York, USA

5 Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway; Faculty of Psychology, University of Bergen, Bergen, Norway

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BMC Public Health 2011, 11:12  doi:10.1186/1471-2458-11-12

Published: 6 January 2011

Abstract

Background

Low socioeconomic status is a known risk factor for disability pension, and is also associated with health problems. To what degree health problems can explain the increased risk of disability pension award associated with low socioeconomic status is not known.

Methods

Information on 15,067 participants in the Hordaland Health Study was linked to a comprehensive national registry on disability pension awards. Level of education was used as a proxy for socioeconomic status. Logistic regression analyses were employed to examine the association between socioeconomic status and rates of disability pension award, before and after adjusting for a wide range of somatic and mental health factors. The proportion of the difference in disability pension between socioeconomic groups explained by health was then calculated.

Results

Unadjusted odds ratios for disability pension was 4.60 (95% CI: 3.34-6.33) for the group with elementary school only (9 years of education) and 2.03 (95% CI 1.49-2.77) for the group with high school (12 years of education) when compared to the group with higher education (more than 12 years). When adjusting for somatic and mental health, odds ratios were reduced to 3.87 (2.73-5.47) and 1.81 (1.31-2.52). This corresponds to health explaining only a marginal proportion of the increased level of disability pension in the groups with lower socioeconomic status.

Conclusion

There is a socioeconomic gradient in disability pension similar to the well known socioeconomic gradient in health. However, health accounts for little of the socioeconomic gradient in disability pension. Future studies of socioeconomic gradients in disability pension should focus on explanatory factors beyond health.