Mortality among disability pensioners in Norway and Sweden 1990--96: comparative prospective cohort study

The aim of the study was to assess excess mortality related to disability pension (DP) status and DP diagnoses in Norway and Sweden during 1990-96.

Representative samples of the population aged 30-59 years, without DP at baseline 1 January 1990, 71,293 women and 76,928 men from Norway, and 68,181 women and 71,950 men from Sweden, were followed up during 1990-96. Granting of DP, DP diagnosis, age and gender were explanatory variables in Cox proportional hazards analysis with death from all causes as the outcome variable.

Among women, 10.4% in Sweden and 7.1% in Norway obtained DP, as compared to 7.5% and 5.6% of the men. In Sweden, 66% of female and 49% of male DP recipients had musculoskeletal diagnoses, as compared to 40% and 27% in Norway. In Sweden, 3.0% of the women and 6.1% of the men with DP died, as compared to 4.6% and 8.5% in Norway. Hazard ratios (HRs) for women with DP vs. the non-DP group were 3.2 (95% confidence interval (CI)=2.7-3.8) in Sweden, and 4.9 (95% CI=4.1-5.7) in Norway. Among men with DP, there was no difference in mortality rate between the countries. HRs for men with musculoskeletal diagnoses vs. the non-DP group were 1.5 (95% CI= 1.1-2.0) in Norway and 1.4 (95% CI= 1.1-1.8) in Sweden. In both countries, the mortality rate among female disability pensioners with musculoskeletal diagnoses was not increased.

The study confirmed an increased mortality rate among disability pensioners, except for women with musculoskeletal diagnoses. The mortality pattern related to DP diagnoses was similar in the two countries. A high frequency of musculoskeletal DP diagnoses among women with DP in Sweden explained a lower mortality rate as compared to Norway.