Predictors of disability pension among young men: The role of alcohol and psychosocial factors

Abstract

The role of alcohol use and behavioural, psychological and social risk factors for a disability pension in young men was analysed in a longitudinal study of 49,321 conscripts. Data collected in 1969–1970 were linked to records from the Swedish Social Insurance Board. A total of 1,276 disability pensions, 155 with an alcohol-related diagnosis, was granted during follow-up until 1992. In univariate Cox regression analysis, risk use of alcohol was a strong predictor of a disability pension with an RR of 2.4 (95% Cl: 2.1–2.8) as were various other variables.The strongest predictor was psychiatric diagnosis at conscription, with an RR of 5.1 (95% Cl: 4.5–5.8). Other predictors were deficient emotional control (RR 3.8; 95% Cl: 3.3–4.4), medication for nervous problems (RR 3.7; 95% Cl: 3.2–4.2), remedial class (RR 3.3; 95% Cl: 2.8–3.9) and unemployment (RR 3.0; 95% Cl: 2.6–3.5). Apprehension for drunkenness and experience of unemployment led to an RR of 7.0 (95% Cl: 5.5–8.8). In multivariate Cox regression analysis the relative risks were generally substantially reduced, indicating confounding and probably complex associations between the different variables. In this analysis the RR was 1.2 (95% Cl: 1.0–1.4) for risk use of alcohol, 2.1 (95% Cl: 1.7–2.4) for psychiatric diagnosis and 1.3 (95% Cl: 1.1–1.5) for contacts with police or a child welfare authority. The corresponding figures for a disability pension with alcohol-related diagnosis were risk use 2.2 (95% Cl: 1.4–3.5), psychiatric diagnosis 1.7 (95% Cl: 1.0–2.7) and contact with police or child welfare authorities 3.5 (95% Cl: 2.0–6.1). Thus a disability pension In young men is predicted by various social, psychosocial and behavioural factors early in life, an argument for increased awareness of such factors in young men with failing working capacity and for vigorous efforts at an early stage.