Sustainable Working Life Patterns in a Swedish Twin Cohort: Age-Related Sequences of Sickness Absence, Disability Pension, Unemployment, and Premature Death during Working Life
Abstract
:1. Introduction
1.1. Sample and Methods
- From Karolinska Institutet, the Swedish Twin Register (STR) was used to identify the study population and for background information (zygosity, sex and birthyear).
- From Statistics Sweden, the Longitudinal Integrated Database for Health Insurance and Labor Market Studies (LISA) [32] was used for sociodemographic information (educational level, degree of urbanization, marital status), unemployment and old-age pension.
- From the Swedish Social Insurance Agency, the register Micro Data for Analyses of Social Insurance (MiDAS) was used for information on sickness absence (SA) and disability pension (DP).
- From the Swedish Board of Health and Welfare, the Causes of Death Register was used for dates of death.
1.2. Sickness Insurance in Sweden
1.3. Individual Characteristics
1.4. Statistical Methods
- Sustainable working life: SA/DP 0–30 days and UE 0–90 days
- Unemployment >90 days: SA/DP 0–30 days and UE > 90 days
- Moderate SA/DP: SA/DP 30–180 days
- Almost full year of SA/DP: SA/DP 180–365 days
- Full year of SA/DP: SA/DP ≥ 365 days
- Death
- Old-age pension
2. Results
2.1. Sustainable Working Life Patterns of Age Cohort 26–35 Years
2.2. Sustainable Working Life Patterns of the Age Cohort 36–45 Years
2.3. Sustainable Working Life Patterns of Age Cohort 46–55 Years
2.4. Sustainable Working Life Patterns of Age Cohort 56–65 Years
2.5. Familial Effects on Cluster Membership
3. Discussion
3.1. Sustainable Working Life Patterns of Age Cohorts
3.2. Individual Characteristics and Cluster Membership
3.3. Strengths and Limitations
4. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Study Cohorts (Based on Follow-Up Age Periods) | ||||||||
---|---|---|---|---|---|---|---|---|
26–35 Years | 36–45 Years | 46–55 Years | 56–65 Years | |||||
n | % | n | % | n | % | n | % | |
Total (n of individuals in the final sample) | 9892 | 10,620 | 12,964 | 13,974 | ||||
Zygosity | ||||||||
MZ | 5758 | 58 | 4944 | 47 | 5188 | 40 | 5572 | 40 |
DZ | 4134 | 42 | 5676 | 53 | 7776 | 60 | 8402 | 60 |
Sex | ||||||||
Men | 4562 | 46 | 5020 | 47 | 6370 | 49 | 6606 | 47 |
Women | 5330 | 54 | 5600 | 53 | 6594 | 51 | 7368 | 53 |
Education level | ||||||||
Elementary (≤9 years) | 789 | 8 | 1073 | 10 | 2691 | 21 | 4499 | 32 |
High school (10–12 years) | 5381 | 54 | 5940 | 56 | 6349 | 49 | 6157 | 44 |
University/college (>12 years) | 3722 | 38 | 3607 | 34 | 3924 | 30 | 3318 | 24 |
Degree of urbanization | ||||||||
Cities (densely populated areas) | 4471 | 45 | 3943 | 37 | 4183 | 32 | 4298 | 31 |
Towns and suburbs (intermediate density areas) | 3785 | 38 | 4511 | 42 | 5590 | 43 | 6302 | 45 |
Rural areas (thinly populated areas) | 1636 | 17 | 2166 | 20 | 3191 | 25 | 3374 | 24 |
Married | ||||||||
No | 9223 | 93 | 6079 | 57 | 5517 | 43 | 5069 | 36 |
Yes | 669 | 7 | 4541 | 43 | 7447 | 57 | 8905 | 64 |
n | % | Years in State | Most Frequent Sequence Order | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | Order | n | % | |||
26–35 years of age | ||||||||||||
Cluster group 1 | 377 | 4 | 4.65 | 4.71 | 0.47 | 0.13 | 0.05 | 0.00 | 0.00 | 2 --> 1 --> 2 --> 1 | 65 | 17 |
Cluster group 2 | 1971 | 20 | 8.11 | 1.70 | 0.18 | 0.02 | 0.00 | 0.00 | 0.00 | 1 --> 2 --> 1 | 794 | 40 |
Cluster group 3 | 1726 | 17 | 8.08 | 0.20 | 1.47 | 0.21 | 0.03 | 0.01 | 0.00 | 1 --> 3 --> 1 | 766 | 44 |
Cluster group 4 | 5341 | 54 | 10.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1 | 5341 | 100 |
Cluster group 5 | 346 | 3 | 2.89 | 0.77 | 2.08 | 2.03 | 1.92 | 0.31 | 0.00 | 1 --> 4 --> 5 | 11 | 3 |
Cluster group 6 | 131 | 1 | 0.05 | 0.02 | 0.21 | 0.83 | 8.75 | 0.15 | 0.00 | 5 | 70 | 53 |
Total | 9892 | 8.70 | 0.58 | 0.39 | 0.13 | 0.19 | 0.02 | 0.00 | ||||
36–45 years of age | ||||||||||||
Cluster group 1 | 6261 | 59 | 10.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1 | 6261 | 100 |
Cluster group 2 | 836 | 8 | 6.53 | 3.04 | 0.34 | 0.07 | 0.01 | 0.00 | 0.00 | 1 --> 2 --> 1 | 280 | 33 |
Cluster group 3 | 589 | 6 | 5.69 | 0.38 | 2.20 | 1.32 | 0.29 | 0.12 | 0.00 | 1 --> 4 | 28 | 5 |
Cluster group 4 | 2233 | 21 | 8.48 | 0.42 | 1.01 | 0.08 | 0.01 | 0.00 | 0.00 | 1 --> 3 --> 1 | 853 | 38 |
Cluster group 5 | 220 | 2 | 0.04 | 0.01 | 0.08 | 0.28 | 9.60 | 0.00 | 0.00 | 5 | 158 | 72 |
Cluster group 6 | 481 | 5 | 1.66 | 0.55 | 1.27 | 3.39 | 2.72 | 0.41 | 0.00 | 4 | 30 | 6 |
Total | 10,620 | 8.58 | 0.37 | 0.42 | 0.26 | 0.34 | 0.03 | 0.00 | ||||
46–55 years of age | ||||||||||||
Cluster group 1 | 6978 | 54 | 10.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1 | 6978 | 100 |
Cluster group 2 | 3315 | 26 | 8.11 | 0.36 | 1.19 | 0.27 | 0.06 | 0.01 | 0.00 | 1 --> 3 --> 1 | 1107 | 33 |
Cluster group 3 | 768 | 6 | 5.65 | 3.54 | 0.53 | 0.17 | 0.10 | 0.01 | 0.00 | 1 --> 2 --> 1 | 141 | 18 |
Cluster group 4 | 925 | 7 | 0.64 | 0.12 | 0.37 | 0.72 | 8.03 | 0.12 | 0.00 | 5 | 433 | 47 |
Cluster group 5 | 762 | 6 | 2.69 | 0.21 | 2.65 | 2.05 | 0.69 | 1.70 | 0.00 | 1 --> 6 | 58 | 8 |
Cluster group 6 | 216 | 2 | 0.10 | 0.00 | 0.32 | 9.04 | 0.49 | 0.05 | 0.00 | 4 | 123 | 57 |
Total | 12,964 | 8.00 | 0.32 | 0.52 | 0.40 | 0.64 | 0.11 | 0.00 | ||||
56–65 years of age | ||||||||||||
Cluster group 1 | 5076 | 36 | 6.19 | 0.76 | 0.61 | 0.14 | 0.06 | 0.04 | 2.21 | 1 --> 7 | 1392 | 27 |
Cluster group 2 | 4804 | 34 | 9.07 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.92 | 1 --> 7 | 3885 | 81 |
Cluster group 3 | 1740 | 12 | 0.07 | 0.03 | 0.12 | 0.36 | 8.04 | 0.34 | 1.04 | 5 --> 7 | 1127 | 65 |
Cluster group 4 | 1353 | 10 | 3.06 | 0.12 | 2.38 | 1.33 | 1.63 | 0.05 | 1.43 | 1 --> 4 --> 5 --> 7 | 148 | 11 |
Cluster group 5 | 365 | 3 | 1.98 | 0.14 | 0.39 | 0.22 | 0.39 | 6.80 | 0.08 | 1 --> 6 | 105 | 29 |
Cluster group 6 | 636 | 5 | 0.12 | 0.00 | 0.39 | 7.08 | 0.89 | 0.17 | 1.35 | 4 --> 7 | 294 | 46 |
Total | 13,974 | 5.73 | 0.30 | 0.49 | 0.55 | 1.23 | 0.25 | 1.45 |
Age Group 26–35 Years | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Cluster Group 1 (n = 634) | Cluster Group 2 (n = 2698) | Cluster Group 3 (n = 2444) | Cluster Group 4 (n = 3674) | Cluster Group 5 (n = 548) | Cluster Group 6 (n = 190) | |||||||
OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | |
Education level | ||||||||||||
Elementary (≤9 years) | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
High school (10–12 years) | 1.28 | 0.73, 2.22 | 0.66 | 0.46, 0.95 | 1.09 | 0.76, 1.57 | 1.66 | 1.18, 2.33 | 1.32 | 0.73, 2.37 | 0.06 | 0.01, 0.26 |
University/college (>12 years) | 0.81 | 0.37, 1.80 | 0.80 | 0.53, 1.22 | 0.78 | 0.51, 1.19 | 2.34 | 1.60, 3.42 | 0.53 | 0.25, 1.15 | 0.00 | 0.00, 0.00 |
Degree of urbanization | ||||||||||||
Cities (densely populated areas) | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
Towns and suburbs (intermediate density areas) | 0.88 | 0.50, 1.56 | 1.18 | 0.91, 1.52 | 1.15 | 0.87, 1.52 | 0.88 | 0.70, 1.09 | 0.86 | 0.43, 1.72 | 0.26 | 0.07, 1.00 |
Rural areas (thinly populated areas) | 1.80 | 0.83, 3.91 | 0.95 | 0.66, 1.37 | 0.93 | 0.65, 1.34 | 0.93 | 0.70, 1.25 | 1.74 | 0.79, 3.83 | 0.27 | 0.01, 6.17 |
Married | ||||||||||||
No | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
Yes | 0.45 | 0.22, 0.92 | 1.19 | 0.82, 1.71 | 0.82 | 0.59, 1.15 | 1.17 | 0.86, 1.58 | 1.41 | 0.75, 2.64 | 0.04 | 0.00, 0.54 |
Age group 36–45 years | ||||||||||||
Cluster Group 1 (n = 4102) | Cluster Group 2 (n = 1356) | Cluster Group 3 (n = 1058) | Cluster Group 4 (n = 3326) | Cluster Group 5 (n = 332) | Cluster Group 6 (n = 766) | |||||||
Education level | ||||||||||||
Elementary (≤9 years) | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
High school (10–12 years) | 1.07 | 0.82, 1.39 | 0.84 | 0.57, 1.24 | 1.11 | 0.71, 1.73 | 1.35 | 1.02, 1.78 | 0.28 | 0.13, 0.64 | 0.85 | 0.55, 1.32 |
University/college (>12 years) | 1.85 | 1.36, 2.51 | 0.48 | 0.29, 0.81 | 0.99 | 0.58, 1.71 | 1.06 | 0.76, 1.48 | 0.14 | 0.05, 0.43 | 0.34 | 0.18, 0.64 |
Degree of urbanization | ||||||||||||
Cities (densely populated areas) | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
Towns and suburbs (intermediate density areas) | 0.94 | 0.77, 1.14 | 1.16 | 0.80, 1.67 | 1.08 | 0.73, 1.60 | 1.13 | 0.91, 1.41 | 1.21 | 0.58, 2.52 | 0.57 | 0.34, 0.94 |
Rural areas (thinly populated areas) | 0.69 | 0.54, 0.88 | 1.39 | 0.89, 2.16 | 1.11 | 0.69, 1.79 | 1.27 | 0.97, 1.67 | 2.28 | 0.72, 7.17 | 0.83 | 0.48, 1.44 |
Married | ||||||||||||
No | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
Yes | 1.43 | 1.24, 1.66 | 0.66 | 0.51, 0.86 | 0.88 | 0.67, 1.17 | 0.87 | 0.74, 1.02 | 0.33 | 0.18, 0.60 | 0.98 | 0.70, 1.39 |
Age Cohort 46–55 Years | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Cluster Group 1 (n = 5252) | Cluster Group 2 (n = 4730) | Cluster group 3 (n = 1300) | Cluster Group 4 (n = 1402) | Cluster Group 5 (n = 1404) | Cluster Group 6 (n = 420) | |||||||
OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | |
Education level | ||||||||||||
Elementary (≤9 years) | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
High school (10–12 years) | 1.01 | 0.84, 1.20 | 1.17 | 0.98, 1.41 | 0.95 | 0.69, 1.31 | 0.69 | 0.51, 0.94 | 1.26 | 0.90, 1.78 | 0.82 | 0.44, 1.53 |
University/college (>12 years) | 1.44 | 1.16, 1.80 | 1.14 | 0.91, 1.44 | 0.56 | 0.36, 0.87 | 0.34 | 0.22, 0.53 | 1.00 | 0.64, 1.55 | 0.46 | 0.20, 1.07 |
Degree of urbanization | ||||||||||||
Cities (densely populated areas) | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
Towns and suburbs (intermediate density areas) | 1.08 | 0.91, 1.27 | 1.05 | 0.88, 1.26 | 0.75 | 0.52, 1.06 | 0.79 | 0.57, 1.11 | 1.02 | 0.73, 1.43 | 1.04 | 0.48, 2.25 |
Rural areas (thinly populated areas) | 0.97 | 0.78, 1.19 | 1.14 | 0.92, 1.42 | 0.71 | 0.48, 1.06 | 0.75 | 0.51, 1.11 | 1.07 | 0.71, 1.60 | 2.13 | 0.96, 4.75 |
Married | ||||||||||||
No | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
Yes | 1.44 | 1.28, 1.63 | 1.00 | 0.88, 1.13 | 0.71 | 0.55, 0.92 | 0.60 | 0.47, 0.75 | 0.62 | 0.49, 0.78 | 0.91 | 0.57, 1.43 |
Age cohort 56–65 years | ||||||||||||
Cluster Group 1 (n = 6040) | Cluster Group 2 (n = 5320) | Cluster Group 3 (n = 2456) | Cluster Group 4 (n = 2330) | Cluster Group 5 (n = 686) | Cluster Group 6 (n = 1140) | |||||||
Education level | ||||||||||||
Elementary (≤9 years) | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
High school (10–12 years) | 0.97 | 0.85, 1.12 | 1.28 | 1.09, 1.49 | 0.65 | 0.52, 0.79 | 0.99 | 0.78, 1.24 | 0.86 | 0.57, 1.30 | 1.32 | 0.96, 1.81 |
University/college (>12 years) | 0.90 | 0.74, 1.09 | 1.70 | 1.38, 2.09 | 0.40 | 0.28, 0.57 | 1.05 | 0.76, 1.45 | 0.53 | 0.27, 1.07 | 1.18 | 0.76, 1.84 |
Degree of urbanization | ||||||||||||
Cities (densely populated areas) | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
Towns and suburbs (intermediate density areas) | 1.01 | 0.87, 1.17 | 1.01 | 0.85, 1.19 | 1.19 | 0.92, 1.53 | 0.81 | 0.63, 1.04 | 1.18 | 0.73, 1.90 | 0.98 | 0.67, 1.43 |
Rural areas (thinly populated areas) | 0.91 | 0.75, 1.09 | 0.98 | 0.80, 1.20 | 1.30 | 0.97, 1.73 | 0.90 | 0.67, 1.21 | 1.23 | 0.67, 2.25 | 1.17 | 0.76, 1.81 |
Married | ||||||||||||
No | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref | 1.00 | ref |
Yes | 1.16 | 1.03, 1.30 | 1.22 | 1.08, 1.39 | 0.58 | 0.48, 0.70 | 0.94 | 0.77, 1.13 | 0.50 | 0.36, 0.71 | 1.20 | 0.93, 1.56 |
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Ropponen, A.; Josefsson, P.; Böckerman, P.; Silventoinen, K.; Narusyte, J.; Wang, M.; Svedberg, P. Sustainable Working Life Patterns in a Swedish Twin Cohort: Age-Related Sequences of Sickness Absence, Disability Pension, Unemployment, and Premature Death during Working Life. Int. J. Environ. Res. Public Health 2022, 19, 10549. https://doi.org/10.3390/ijerph191710549
Ropponen A, Josefsson P, Böckerman P, Silventoinen K, Narusyte J, Wang M, Svedberg P. Sustainable Working Life Patterns in a Swedish Twin Cohort: Age-Related Sequences of Sickness Absence, Disability Pension, Unemployment, and Premature Death during Working Life. International Journal of Environmental Research and Public Health. 2022; 19(17):10549. https://doi.org/10.3390/ijerph191710549
Chicago/Turabian StyleRopponen, Annina, Pontus Josefsson, Petri Böckerman, Karri Silventoinen, Jurgita Narusyte, Mo Wang, and Pia Svedberg. 2022. "Sustainable Working Life Patterns in a Swedish Twin Cohort: Age-Related Sequences of Sickness Absence, Disability Pension, Unemployment, and Premature Death during Working Life" International Journal of Environmental Research and Public Health 19, no. 17: 10549. https://doi.org/10.3390/ijerph191710549