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Earnings among people with multiple sclerosis compared to references, in total and by educational level and type of occupation: a population-based cohort study at different points in time
Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Stockholm, Sweden;Swedish Social Insurance Agcy, Dept Anal & Forecast, Stockholm, Sweden.
Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Stockholm, Sweden.ORCID iD: 0000-0003-4150-4275
Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Stockholm, Sweden;Swedish Red Cross Univ Coll, Dept Hlth Sci, Huddinge, Sweden.
Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Stockholm, Sweden.
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 7, article id e024836Article in journal (Refereed) Published
Abstract [en]

Objectives To investigate earnings among people with multiple sclerosis (PwMS) before and after MS diagnosis compared with people without MS, and if identified differences were associated with educational levels and types of occupations. Furthermore, to assess the proportions on sickness absence (SA) and disability pension (DP) in both groups. Design Population-based longitudinal cohort study, 10 years before until 5 years after MS diagnosis. Setting Working-age population using microdata linked from nationwide Swedish registers. Participants Residents in Sweden in 2004 aged 30-54 years with MS diagnosed in 2003-2006 (n= 2553), and references without MS (n= 7584) randomly selected by stratified matching. Outcome measures Quartiles of earnings were calculated for each study year prior to and following the MS diagnosis. Mean earnings, by educational level and type of occupation, before and after diagnosis were compared using t-tests. Tobit regressions investigated the associations of earnings with individual characteristics. The proportions on SA and/or DP, by educational level and type of occupation, for the diagnosis year and 5 years later were compared. Results Differences in earnings between PwMS and references were observed beginning 1 year before diagnosis, and increased thereafter. PwMS had lower mean earnings for the diagnosis year (difference= SEK 28 000, p< 0.05), and 5 years after diagnosis, this difference had more than doubled (p< 0.05). These differences remained after including educational level and type of occupation. Overall, the earnings of PwMS with university education and/or more qualified occupations were most like their reference peers. The proportions on SA and DP were higher among PwMS than the references. Conclusions The results suggest that the PwMS' earnings are lower than the references' beginning shortly before MS diagnosis, with this gap increasing thereafter. Besides SA and DP, the results indicate that educational level and type of occupation are influential determinants of the large heterogeneity of PwMS' earnings.

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BMJ PUBLISHING GROUP , 2019. Vol. 9, no 7, article id e024836
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Occupational Health and Environmental Health
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URN: urn:nbn:se:uu:diva-395555DOI: 10.1136/bmjopen-2018-024836ISI: 000485269700245PubMedID: 31300492OAI: oai:DiVA.org:uu-395555DiVA, id: diva2:1363011
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Forte, Swedish Research Council for Health, Working Life and WelfareAvailable from: 2019-10-22 Created: 2019-10-22 Last updated: 2019-10-22Bibliographically approved

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