Work-related disability:Causes & consequences

Disability expenditure (including disability pensions, income maintenance and support) accounts for a significant proportion of national income across OECD countries, and varies from less than 1% of Gross Domestic Product in Ireland to nearly 5% in Norway and other Nordic countries. Disability rates have been increasing in almost all OECD countries, despite overall improvements in key objective health indicators. Despite huge and increasing costs, little is known about reasons for awarding disability pens ions. Two explanatory models can be identified in the literature: (1) The "push model" suggests factors beyond individual control to be of relevance, including mental and physical health problems, social inequality in health, health related behaviours (e.g. physical activity, nutrition, alcohol dependence or abuse), and work-place characteristics. (2) The contrary "pull model" challenges the relevance of health, and postulates that disability pension award is more likely the more economic attractive this is for the individual. Despite poor empirical support, this model has strong impact on policy making. Health is an obvious confounder in this hypothesized association, but no study have ever examined this empirically. The aim of this project is to address these issues by employing record-linkages between FD-trygd (the complete Norwegian social security database) and two health surveys: The Health Study of Hordaland County (HUSK) (N=18000) and the Health Study of Nord-Trøndelag County (HUNT) (N=620 00).