The influence of family structure on the risk of going on disability pension (DP) was investigated among young women by analysing a short-term and long-term effect, controlling for potential confounding and the ‘healthy mother effect’.
Design and participants
This dynamic cohort study comprised all women born in Sweden between 1960 and 1979 (1.2 million), who were 20–43 years of age during follow-up. Their annual data were retrieved from national registers for the years 1993–2003. For this period, data on family structure and potential confounders were related to the incidence of DP the year after the exposure assessment. Using a modified version of the COX proportional hazard regression, we took into account changes in the study variables of individuals over the years. In addition, a 5-year follow-up was used.
Cohabiting working women with children showed a decreased risk of DP in a 1-year perspective compared with cohabiting working women with no children, while the opposite was indicated in the 5-year follow-up. Lone working women with children had an increased risk of DP in both the short-term and long-term perspective. The risk of DP tended to increase with the number of children for both cohabiting and lone working women in the 5-year follow-up.
The study suggests that parenthood contributes to increasing the risk of going on DP among young women, which should be valuable knowledge to employers and other policy makers. It remains to be analysed to what extent the high numbers of young women exiting from working life may be counteracted by (1) extended gender equality, (2) fewer work hours among fathers and mothers of young children and (3) by financial support to lone women with children.
Explanations of the increasing rate of DP in young women in European countries.
High demands linked to family and work situation was expected to be a contributing factor.
Parenthood contributed to an increased risk of going on DP among young women. Lone working women with children had an increased risk of DP in both a 1- and 5-year perspective.
Cohabiting working women with children had a lower risk of DP than other cohabiting women in a 1-year perspective, while the opposite was shown in a 5-year follow-up.
The number of children among working women tended to increase the risk of DP 5 years later.
Strengths and limitations of this study
High representativity and statistical precision due to complete coverage of the study group.
The possibility to utilise different time spans of follow-up, a 1-year follow-up focusing the family situation just before going on DP and a longer follow-up showing the association between family structure and risk of DP 5 years later.
The possibility to take into account the changes of family and work situation over time and to adjust for the time-dependent changes of the confounding factors considered.
Lack of information on the diagnoses of DP.
Lack of information on full time or part time work.
The generalisability is restricted to countries with a welfare system similar to that of Sweden, although the knowledge could also be a pointer for other countries developing or changing their welfare system. A similar study based on men is warranted.