Sigurður Thorlacius

From unemployment to disability? Relationship between unemployment rate and new disability pensions in Iceland 1992–2007

BACKGROUND The study was carried out in order to examine the effect of unemployment on the incidence of disability pension in Iceland by examining changes in this relationship from 1992 to 2007. METHODS The annual incidence of disability pension for the period 1992-2007 was calculated. Correlations and significance tests for the relationship between unemployment rates and disability pension incidence rates were calculated. The relationship was examined for different disease groups. RESULTS Two big fluctuations occurred in the unemployment rate during the study period with an upswing in unemployment from 1993 to 1995 and in 2002 and 2003. In both cases, there were corresponding increases in the incidence of disability pension. The incidence of disability pension declined again when the level of unemployment went down, even though not to the same extent. CONCLUSIONS Health and mental and physical capability determine the overall incidence of disability pension, but marginal fluctuations over time seem to be related to environmental conditions in the labour market, especially the unemployment rate. The observed disability pension incidence pattern in the two unemployment cycles of the study period indicates mainly that people with impaired health are forced out of the labour market in times of increasing unemployment rather than pointing towards a negative effect of unemployment on health. Our findings indicate that there is a need to strengthen the vocational rehabilitation system in Iceland as well as the support system for employment and social participation.

Increased incidence of disability due to mental and behavioural disorders in Iceland 1990-2007.

Aims: To explore longitudinal changes in the importance of mental and behavioural disorders and their subgroups among people receiving disability pension in Iceland in the period 1990 to 2007. Method: Estimation of the incidence of disability pension was based on national demographic data and information from the national disability register which includes the main diagnoses causing disability. Results: The share of mental and behavioural disorders among new recipients of disability pension increased from 14 to 30% for women and 20 to 35% men. There was a marked increase in the incidence of disability due to disorders related to the use of alcohol and other psychoactive substances, mood disorders, disorders of psychological development and behavioural and emotional disorders with onset usually occurring in childhood and adolescence. The proportion of mental and behavioural disorders as the primary diagnosis among new recipients of disability pension increased. Conclusion: The most likely explanation for the changes we observe is alteration in social conditions leading to a lower threshold for seeking disability pension for mental disorders.

Changes in the prevalence of disability pension in Iceland 1976-1996.

Aims: The objectives were to determine changes in the prevalence of disability pension in Iceland and its distribution according to gender, age, and main diagnoses. Methods : The study includes all persons receiving either full or partial disability pension in 1976 and 1996. The age-standardized risk ratio between the years 1976 and 1996 was calculated for all disability pensions and for full disability pension only. Results: The prevalence of all disability pensions decreased significantly among both men and women in 1996 as compared with 1976. When the figures were disaggregated, however, they revealed an increased risk of full disability pension and a decreased risk of partial disability pension. The prevalence of full disability pension had increased in most disease categories. Conclusion: The decreased prevalence of disability pension in 1996 as compared with 1976 is noteworthy, as unemployment was increasing during the years immediately preceding 1996. It seems likely, however, that the decrease of partial disability pension and increase of full disability pension is a reflection of increased competition for work in the labour market as well as increased attractiveness of full disability pension due to new supplementary sickness insurance benefits linked to full disability pension.