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Background: The aim was to investigate the associations between mental disorders and three different measures of labour-market marginalisation, and differences between native Swedes and immigrants.Methods: The study comprised 1,753,544 individuals, aged 20-35 years, and resident in Sweden 2004. They were followed 2005-2011 with regard to disability pension, sickness absence (≥90 days) and unemployment (≥180 days). Immigrants were born in Western countries (Nordic countries, EU, Europe outside EU or North-America/Oceania), or in non-Western countries (Africa, Asia or South-America). Mental disorders were grouped into seven subgroups based on a record of in- or specialised outpatient health care 2001-2004. Hazard ratios (HRs) with 95% confidence intervals (CIs) were computed by Cox regression models with both fixed and time-dependent covariates and competing risks. We also performed stratified analyses with regard to labour-market attachment.Results: Individuals with mental disorders had a seven times higher risk of disability pension, a two times higher risk of sickness absence, and a 20% higher risk of unemployment than individuals without mental disorders. Individuals with personality disorders and schizophrenia/non-affective psychoses had highest risk estimates for having disability pension and long-term sickness absence, while the risk estimates of long-term unemployment were similar among all subgroups of mental disorders. Among persons with mental disorders, native Swedes had higher risk estimates for disability pension (HR:6.6; 95%CI:6.4-6.8) than Western immigrants (4.8; 4.4-5.2) and non-Western immigrants (4.8; 4.4-5.1), slightly higher risk estimates for sickness absence (2.1;2.1-2.2) than Western (1.9;1.8-2.1), and non-Western (1.9;1.7-2.0) immigrants but lower risk estimates for unemployment (1.4;1.3-1.4) than Western (1.8;1.7-1.9) and non-Western immigrants (2.0;1.9-2.1). There were similar risk estimates among sub-regions within both Western and non-Western countries. Stratification by labour-market attachment showed that the risk estimates for immigrants were lower the more distant individuals were from gainful employment.Conclusions: Mental disorders were associated with all three measures of labour-market marginalisation, strongest with subsequent disability pension. Native Swedes had higher risk estimates for both disability pension and sickness absence, but lower risk estimates for unemployment than immigrants. Previous labour-market attachment explained a great part of the association between immigrant status and subsequent labour-market marginalisation. [ABSTRACT FROM AUTHOR]

Background: This article, based on a study by the Swedish Social Insurance Inspectorate, describes the development of young adults receiving disability benefits due to reduced working capability, and the disability benefit systems in seven European countries; Denmark, Finland, Iceland, Norway, the Netherlands, Sweden, and the UK. This comparative study mainly uses Sweden as a benchmark. Methods: Apart from a documentary and legal data collection and analysis, 26 semi-structured interviews were conducted with representatives of the responsible ministries and authorities in the studied countries. In addition, national and European data was collected. Results: There is an increasing trend of young adults, aged 19–29, on disability benefits in all studied countries. The most common diagnosis group among young adults on disability benefits is mental and behavioural disorders, ranging from 58% in the UK to 80% in Denmark. Conclusions: The comparison of the different disability benefit systems shows that there are relatively large national differences in terms of rules and regulations, the handling of disability benefit cases, and offered rehabilitation activities and other measures to support young adults on disability benefits to strengthen their working capability, and hence enable them to approach the labour market in the future. However, it is clear that these countries face similar challenges, and therefore there could be a lot to learn from European exchange of experiences and expertise in this area. This article identifies a number of measures of special interest to study and discusses further with regard to the further development of the Swedish system for disability benefits for young adults. [ABSTRACT FROM PUBLISHER]

Objectives The aim of this study was to get insight into the role of poor health, unhealthy behaviors, and unfavorable work characteristics on exit from paid employment due to disability pension, unemployment, and early retirement among older workers. Methods Respondents of the longitudinal Survey of Health, Ageing, and Retirement in Europe (SHARE) in 11 European countries were selected when (i) aged between 50 years and the country-specific retirement age, (ii) in paid employment at baseline, and (iii) having information on employment status during the 4-year follow-up period (N=4923). Self-perceived health, health behaviors, and physical and psychosocial work characteristics were measured by interview at baseline. Employment status was derived from follow-up interviews after two and four years. Cox proportional hazards regression analyses were used to identify determinants of unemployment, disability pension, and early retirement. Results Poor health was a risk factor for disability pension [hazard ratio (HR) 3.90, 95% confidence interval (95% CI) 2.51-6.05], and a lack of physical activity was a risk factor for disability pension (HR 3.05, 95% CI 1.68-5.55) and unemployment (HR 1.84,95% CI 1.13-3.01). A lack of job control was a risk factor for disability pension, unemployment, and early retirement (HR 1.30-1.77). Conclusions Poor health, a lack of physical activity, and a lack of job control played a role in exit from paid employment, but their relative importance differed by pathway of labor force exit. Primary preventive inter-ventions focusing on promoting physical activity as well as increasing job control may contribute to reducing premature exit from paid employment. [ABSTRACT FROM AUTHOR]