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Inequity in disability pension: an intersectional analysis of the co-constitution of gender, education and age. The Hordaland Health Study

Journal article
Authors Inger Haukenes
Jesper Löve
Gunnel Hensing
Ann Kristin Knudsen
Simon Øverland
Jussi Vahtera
Børge Sivertsen
Grethe S. Tell
Jens Christoffer Skogen
Published in Critical Public Health
Volume 29
Issue 3
Pages 302-313
ISSN 09581596
Publication year 2019
Published at Institute of Medicine, Department of Public Health and Community Medicine
Pages 302-313
Language en
Keywords Disability pension, epidemiology, gender, inequity, intersectionality
Subject categories Public health medicine research areas, Community medicine, Public health science, Epidemiology

Abstract

© 2018 Informa UK Limited, trading as Taylor & Francis Group Social position, education, gender and increasing age are all identified as important risk factors for disability pension. This study takes an intersectionality approach and examines their co-constitution, in relation to inequity in disability pension. The population included 22,203 middle-aged men and women participating in the community-based Hordaland Health Study, Western Norway (1997–1999). The participants were categorised in four exposure groups: higher educated men, higher educated women, lower educated men and lower educated women. The outcome was disability pension from 1992 to end of 2007, from a national registry. Using recommendations for intersectionality-informed quantitative research, we estimated the main effects of gender and educational attainment on disability pension, and potential statistical multiplicative interactions between gender and education in relation to cause-specific and all-cause disability pension. For all-cause disability pension, men with higher education had the lowest risk for disability pension (rate per 1000 person-years: 2.01) during the course of working life (from age 35 to 57), followed by higher educated women (rate 3.56), and lower educated men (rate 4.59). Finally, women with lower education had a substantially increased risk already in early middle age (rate 8.39). We found a statistical multiplicative effect of lower education and female gender on all-cause disability pension and disability pension with musculoskeletal disorders compared with men with higher education. The discussion highlights that inequity in disability pension is not only about defining vulnerable groups, but also about understanding how privileges and disadvantages are unequally distributed.

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