Sense of coherence and disability pensions. A nationwide, register based prospective population study of 2196 adult Finns

Abstract

Background: Strong sense of coherence (SOC) has been shown to be associated with good, perceived health both in cross sectional and longitudinal studies.

Study objective: To find out if level of SOC was associated to incidence of disability pension.

Study design: A prospective cohort study based on survey data on sense of coherence in 1989 or 1993 and data on disability pensions in 1990–1996 from national registers.

Participants: 2196 identifiable subjects derived from a representative sample (n = 5000) in 1989 of male and female Finns between 15 and 64 years of age. Initial health was categorised on the basis of number of long term illnesses reported on entry into the study (no illnesses; one illness or several illnesses resulting in only mild or moderate functional limitation; one illness or several illnesses resulting in severe or very severe functional limitation).

Main results: In an interindividual comparison a decrease in initial SOC score by one point was significantly (hazard ratio 1.56, 95% confidence intervals 1.15 to 2.12) associated with receipt of a disability pension by subjects who had been 50 years of age or less on entry into the study. Sex was not associated with outcome once initial level of health, level of occupational training, level of engagement in physical exercise, and alcohol consumption were taken into consideration. No similar significant association was seen in relation to people who had been more than 50 years of age on entry into the study.

Conclusions: It seems probable that a weak SOC in people of 50 years or younger increases the likelihood of grant of a disability pension.