Factors associated with disability pension in young adults in Switzerland

Background: There has been an overall decreasing trend in the inflow into disability pension (DP) in Switzerland since 2003 with the exception of young adults. Disablement in young adulthood reflects a particularly critical phenomenon given the potentially profound long-term social, economic and health consequences. The aim of this study was therefore to identify the factors for DP in young adults aged 18-39, living in Switzerland. Methods: We used the Social Protection and Labor Market (SESAM); a unique dataset linking data from the Swiss Labor Force Survey, the Swiss Central Compensation Office Register, and the Unemployment Insurance Register. Further advantages of SESAM lie in its sample size, covering almost 1% of Switzerland’s permanent resident population aged 15 and over, and in its panel structure. Multiple logistic regression was employed to explore the association between demographic, socioeconomic, and health characteristics and DP in young adults with long-term activity limitation, living in Switzerland (N=5306). Results: The majority of our sample lived without a working partner (59%) and a child aged 0-14 years (72%), was Swiss-born (74%), had an upper secondary/tertiary degree (84%), received income at least once within the four-year period prior to interview (72%), reported chronic illness (66%) and long-term activity limitation (89%). Mean age was 29 years. Our regression results showed that those living without a working partner (OR 2.11; 95% CI 1.51-2.94) and without a child aged 0-14 (OR 2.15; 95% CI 1.48-3.12), born in Switzerland (OR 2.68; 95% CI 1.87-3.84), of higher age (OR 1.16; 95% CI 1.12-1.19), having completed at most lower secondary school (OR 3.26; 95% CI 2.24-4.76), lacking income throughout the four-year period prior to interview (OR 3.94; 95% CI 2.70-5.75), suffering from chronic illness (OR 4.52; 95% CI 2.83-7.19), and severe long-term activity limitation (OR 4.52; 95% CI 2.83-7.19) had higher odds of DP. Differences were found by learnt occupation; with highest odds for ‘Manufacturing’ (OR 3.59; 95% CI 1.91-6.71) relative to ‘Health, education, culture, and science’. Conclusions: Most importantly, our results showed that educational and employment factors are of high relevance, as well as chronic morbidity and severe long-term activity limitation; implying that early intervention should focus on attaining vocational and academic qualifications beyond the lower secondary level, which should facilitate labor market integration