EVIDENCE BASED PUBLIC HEALTH POLICY AND PRACTICE

Childhood adversities as a predictor of disability retirement

Karoliina Harkonmäki¹, Katariina Korkeila², Jussi Vahtera³, Mika Kivimäki⁴, Sakari Suominen⁵, Lauri Sillanmäki⁶ and Markku Koskenvuo⁶

¹ Department of Public Health, University of Helsinki, Helsinki, Finland
² Department of Family Medicine, University of Turku, Turku, Finland
³ Finnish Institute of Occupational Health, Helsinki, Finland
⁴ Department of Epidemiology and Public Health, University College London Medical School, London, UK
⁵ Department of Public Health, University of Turku, Turku, Finland
⁶ Department of Public Health, University of Turku, Turku, Finland

Correspondence to:
Correspondence to:
MrsK Harkonmäki
Department of Public Health, PO Box 41, 00014 University of Helsinki, Helsinki, Finland;karoliina.harkonmaki{at}helsinki.fi

Background: There is a large body of research on adulthood risk factors for retirement due to disability, but studies on the effect of adverse childhood experiences are scarce.

Aim: To examine whether adverse childhood experiences predict disability retirement.

Methods: Data were derived from the Health and Social Support Study. The information was gathered from postal surveys in 1998 (baseline) and in 2003 (follow-up questionnaire). The analysed data consisted of 8817 non-retired respondents aged 40–54 years (5149 women, 3668 men). Negative childhood experiences, such as financial difficulties, serious conflicts and alcohol-related problems, were assessed at baseline and disability retirement at follow-up.

Results: The risk of disability retirement increased in a dose–response manner with increasing number of childhood adversities. Respondents who had experienced multiple childhood adversities had a 3.46-fold increased risk (95% CI 2.09 to 5.71) of disability retirement compared with those who reported no such adversities. Low socioeconomic status, depression (Beck Depression Inventory-21), use of drugs for somatic diseases as well as health-related risk behaviour, such as smoking, heavy alcohol consumption and obesity, were also predictors of disability retirement. After simultaneous adjustments for all these risk factors, the association between childhood adversities and the risk of disability retirement attenuated, but remained significant (OR 1.90, 95% CI 1.07 to 3.37).

Conclusions: Information on childhood conditions may increase our understanding of the determinants of early retirement, especially due to mental disorders. Childhood adversities should be taken into account when considering determinants of disability retirement and identifying groups at risk.

Abbreviations: SES, socioeconomic status

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