Disability and Mortality Among Middle-Aged Males in Counties of Finland in 1975-1988

This study compares trends and differentials in disability retirement among counties of Finland using mortality as an approximation of morbidity. The ratio of disability to mortality (the age-standardized prevalence of disability pensions for males aged 35-64 divided by the age-standardized mortality for males aged 45-74), for selected causes and for Ischemic Heart Disease (IHD) in particular, was examined for eleven counties over the period 1975-1988. Multivariate regression analysis was used to assess the effect of selected socio-economic factors on the variation across counties in the disability/mortality ratio for IHD. The association between disability and mortality from IHD was high in all counties but the ratios for northern and central counties were higher than others, in particular those for the southern counties. However, the distinctiveness of this grouping disappeared toward the end of the period, primarily due to a decline in disability in three of the four northern and central counties. Over the entire period, differences in industrial composition of the work force and unemployment account for much of the geographic variation in the IHD disability/mortality index. Higher proportions of the work force in the agriculture sector and higher levels of unemployment were associated with greater IHD disability relative to mortality. On the other hand, higher proportions of the labor force in industry were associated with lower IHD disability/mortality indices