Occupational inequality in disability pension among persons with diabetes and comorbidity. (30th September 2020)

• Record Type: Journal Article
• Authors: Bender, A; Andersen, I; Brønnum-Hansen, H; Vrangbæk, K
• Is Part Of: European journal of public health. Volume 30(2020)Supplement 5
• Publication Date: 2020-09-30
• Subjects: Epidemiology -- Europe -- Periodicals; Public health -- Europe -- Periodicals; 362.109405
• DOI: 10.1093/eurpub/ckaa165.698
• Languages: English
• ISSNs: 1101-1262

Abstract

Abstract: Background: Persons with type 2 diabetes (DM2) have higher probability of an early exit from the labour market and to receive permanent disability pension compared with persons without DM2. Objectives: To assess the association between occupational class and disability pension among persons without disease, with DM2 only and DM2 with six comorbid conditions (CVD, musculoskeletal disorders, mental disease, cancer, cerebrovascular disease and ≥2 comorbid diseases). Methods: All employed persons aged 40-64 living in Denmark in the period 2011-2017(n, year 2011=1, 454, 649) were stratified according to DM2 and six major concomitant diseases. We estimated the relative risk of disability pension dependent on DM2 comorbidity status and occupational class by means of a log-binomial regression. Reference group was upper non manual employees with no disease. Results: The highest risks of disability pension were seen for DM2 + mental disease, age 40-59 (RR = 2.45 [2.3-2.5]), DM2 + cerebrovascular disease (RR = 2.45 CI 95% [2.1-2.8]) and DM2 + ≥2 diseases (RR = 2.98 [2.9-3.1]). Unskilled and manual workers were more likely to receive disability pension. The occupational inequality was highest among younger persons and groups of persons with DM2 only and DM2 + CVD and lowest for persons with more than one concomitant disease. Conclusions: The results suggest that among people with DM2, labour market exit depend on both comorbid conditions and occupational class. Overall, our results show that the relative effects of occupational class on disability pension decrease in cases with severe comorbid conditions. In younger persons the mechanisms may be more nuanced, suggesting that persons with DM2 + comorbid conditions in particular have difficulties fulfilling the working requirements of lower occupational jobs. Practitioners may use the results in targeting prevention interventions to persons in high risk of early labour market exit. Key messages: Low occupational class and comorbidity increase the risks of disability pension among persons with DM2. Constrained work-flexibility of low occupational jobs may influence diabetes self-care and explain high inequality in disability pension.