Self-Rated Health as a Predictor of Disability Retirement – The Contribution of Ill-Health and Working Conditions 英文参考文献.docVIP

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Self-Rated Health as a Predictor of Disability Retirement – The Contribution of Ill-Health and Working Conditions 英文参考文献.doc

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Self-Rated Health as a Predictor of Disability Retirement – The Contribution of Ill-Health and Working Conditions 英文参考文献

Self-RatedHealthasaPredictorofDisabilityRetirement –TheContributionofIll-HealthandWorkingConditions OlliPietila¨inen*,MikkoLaaksonen,OssiRahkonen,EeroLahelma DepartmentofPublicHealth,HjeltInstitute,UniversityofHelsinki,Helsinki,Finland Abstract Objective: Self-rated health is a generic health indicator predicting mortality, many diseases, and need for care. We examined self-rated health as a predictor of subsequent disability retirement, and ill-health and working conditions as potentialexplanationsfortheassociation. Methods:Self-ratedhealthandthecovariateswereobtainedfromtheHelsinkiHealthStudybaselinemailsurveysin2000– 2002conductedamongmunicipalemployeesaged40–60years(n=6525).Datafordisabilityretirementevents(n=625) alongwithdiagnoseswerelinkedfromtheFinnishCentreforPensions,withafollow-upbytheendof2010.Hazardratios (HR)andtheir95%confidenceintervals(CI)werecalculatedusingcompetingrisksmodels. Results:Lessthangoodself-ratedhealthpredicteddisabilityretirementduetoallcausesamongbothwomen(HR=4.60, 95% CI=3.84–5.51) and men (HR=3.83, 95% CI=2.64–5.56), as well as due to musculoskeletal diseases (HR=5.17, 95% CI=4.02–6.66)andmentaldisorders(HR=4.80,95%CI=3.50–6.59)amongwomenandmenpooled.Ill-healthandphysical workingconditionspartlyexplainedthefoundassociations,whichneverthelessremainedaftertheadjustments.Amongthe measures of ill-health limiting long-standing illness explained the association most in all-cause disability retirement and disabilityretirementsduetomusculoskeletaldiseases,whereascommonmentaldisordersexplainedtheassociationmostin disability retirements due to mental health disorders. Among working conditions physical work load and hazardous exposuresatworkexplainedtheassociationmost,althoughmuchlessthanill-health. Conclusions:Self-ratedhealthisastrongpredictorofdisabilityretirement.Thiscanbepartlyexplainedbyill-healthand working conditions. Poor self-rated health provides a useful marker for increased risk of work disability and subsequent disabilityretire