Skip to main content

Advertisement

SpringerLink
Log in

Disparities in mortality by disability: an 11-year follow-up study of 1 million individuals

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

This longitudinal study examines to what extent the risk of mortality—all-cause, natural death, suicide, and unintentional injury mortality—differs by types and severity of disabilities as well as disability status.

Methods

Data were the National Sample Cohort of 1,025,340 individuals in South Korea followed from 2002 to 2013. Cox regression with time-variant variables was used to estimate the hazard ratio of mortality by disability.

Results

Individuals with disabilities had a higher risk of mortality compared to those without (HR 1.84, 95% CI 1.80–1.88 for natural death; HR 1.83, 95% CI 1.64–2.03 for suicide; HR 1.54, 95% CI 1.38–1.71 for unintentional injury). All types of disability were associated with an increased risk of natural death. Individuals with mental disability were the highest risk group for suicide (HR 7.14, 95% CI 5.31–9.60). People defined as having severe disability had an elevated risk for all categories of mortality.

Conclusions

Disabilities are important markers of high risk of mortality. Findings call for actions to reduce mortality risk of people with disabilities, including preventing suicidal behaviors of those with mental disability.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Amosun SL, Mutimura E, Frantz JM (2005) Health promotion needs of physically disabled individuals with lower limb amputation in Rwanda. Disabil Rehabil 27:837–847

    Article  PubMed  Google Scholar 

  • Australian Institute of Health and Welfare (2010) Health of Australians with disability: health status and risk factors. Australian Government, Canberra

    Google Scholar 

  • Björkenstam C, Alexanderson K, Björkenstam E, Lindholm C, Mittendorfer-Rutz E (2014) Diagnosis-specific disability pension and risk of all-cause and cause-specific mortality: a cohort study of 4.9 million inhabitants in Sweden. BMC Public Health 14:1–11

    Article  Google Scholar 

  • Dale C, Prieto-Merino D, Kuper H, Adamson J, Bowling A, Ebrahim S, Casas JP (2012) Modelling the association of disability according to the WHO International Classification of Functioning, Disability and Health (ICF) with mortality in the British Women’s Heart and Health Study. J Epidemiol Community Health 66:170–175

    Article  PubMed  Google Scholar 

  • Dieckmann F, Giovis C, Offergeld J (2015) The life expectancy of people with intellectual disabilities in Germany. J Appl Res Intellect Disabil 28:373–382

    Article  PubMed  Google Scholar 

  • Feng Q, Hoenig H-M, Gu D, Yi Z, Purser J-L (2010) Effect of new disability subtype on 3-year mortality in Chinese older adults. J Am Geriatr Soc 58:1952–1958

    Article  PubMed  PubMed Central  Google Scholar 

  • Florio T, Trollor J (2015) Mortality among a cohort of persons with an intellectual disability in New South Wales, Australia. J Appl Res Intellect Disabil 28:383–393

    Article  PubMed  Google Scholar 

  • Forman-Hoffman VL, Ault KL, Anderson WL, Weiner JM, Stevens A, Campbell VA, Armour BS (2015) Disability status, mortality, and leading causes of death in the US community population. Med Care 53:346–354

    PubMed  PubMed Central  Google Scholar 

  • Giannini MJ, Bergmark B, Kreshover S, Elias E, Plummer C, O’Keefe E (2010) Understanding suicide and disability through three major disabling conditions: intellectual disability, spinal cord injury, and multiple sclerosis. Disabil Health J 3:74–78

    Article  PubMed  Google Scholar 

  • Gjesdal S, Mæland JG, Svedberg P, Hagberg J, Alexanderson K (2008) Role of diagnoses and socioeconomic status in mortality among disability pensioners in Norway: a population-based cohort study. Scand J Work Environ Health 34:479–482

    Article  PubMed  Google Scholar 

  • Gómez-Olivé FX, Thorogood M, Bocquier P, Mee P, Kahn K, Berkman L, Tollman S (2014) Social conditions and disability related to the mortality of older people in rural South Africa. Int J Epidemiol 43:1531–1541

    Article  PubMed  PubMed Central  Google Scholar 

  • Gustafson DR, Mazzuco S, Ongaro F, Antuono P, Forloni G, Albani D, Gajo GB, Durante E, Caberlotto L, Zanardo A, Siculi M, Gallucci M (2012) Body mass index, cognition, disability, APOE genotype, and mortality: the “Treviso Longeva” study. Am J Geriatr Psychiatry 20:594–602

    Article  PubMed  Google Scholar 

  • Heslop P, Glover G (2015) Mortality of people with intellectual disabilities in England: a comparison of data from existing sources. J Appl Res Intellect Disabil 28:414–422

    Article  PubMed  Google Scholar 

  • Husemoen LLN, Osler M, Godtfredsen NS, Prescott E (2004) Smoking and subsequent risk of early retirement due to permanent disability. Eur J Public Health 14:86–92

    Article  PubMed  Google Scholar 

  • Kahng S-K (2010) Does depression predict suicide?: gender and age difference in the relationship between depression and suicidal attitudes. Korean J Soc Welf Stud 41:67–99

    Article  Google Scholar 

  • Karlsson NE, Carstensen JM, Gjesdal S, Alexanderson KAE (2007) Mortality in relation to disability pension: findings from a 12-year prospective population-based cohort study in Sweden. Scand J Public Health 35:341–347

    Article  PubMed  Google Scholar 

  • Kavanagh AM, Krnjacki L, Aitken Z, LaMontagne AD, Beer A, Baker E, Bentley R (2015) Intersections between disability, type of impairment, gender and socio-economic disadvantage in a nationally representative sample of 33,101 working-aged Australians. Disabil Health J 8:191–199

    Article  PubMed  Google Scholar 

  • Kim S-H, Lee Y-H, Hwang J-H, Oh M-A, Lee M-K, Lee N-H, Kang D-U, Kwon S-J, Oh H-K, Yoon S-Y, Lee S-W (2014) 2014 Survey on persons with disabilities. Korea Institute for Health and Social Affairs, Seoul

    Google Scholar 

  • Landi F, Liperoti R, Russo A, Capoluongo E, Barillaro C, Pahor M, Bernabei R, Onder G (2010) Disability, more than multimorbidity, was predictive of mortality among older persons aged 80 years and older. J Clin Epidemiol 63:752–759

    Article  PubMed  Google Scholar 

  • Lauer E, McCallion P (2015) Mortality of people with intellectual and developmental disabilities from select US state disability service systems and medical claims data. J Appl Res Intellect Disabil 28:394–405

    Article  PubMed  Google Scholar 

  • Lee J, Lee J-S, Park S-H, Shin S-A, Kim K-W (2016) Cohort Profile: the National Health Insurance Service–National Sample Cohort (NHIS-NSC), South Korea. Int J Epidemiol. doi:10.1093/ije/dyv319

    Google Scholar 

  • Leenaars AA, Lester D (1998) Social factors and mortality from NASH in Canada. Crisis 19:73–77.

    Article  CAS  PubMed  Google Scholar 

  • Leinonen T, Martikainen P, Laaksonen M, Lahelma E (2014) Excess mortality after disability retirement due to mental disorders: variations by socio-demographic factors and causes of death. Soc Psychiatry Psychiatr Epidemiol 49:639–649

    Article  PubMed  Google Scholar 

  • Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Aryee M (2013) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859):2224–2260

    Article  Google Scholar 

  • Mabbett D (2003) Definitions of disability in Europe: a comparative analysis. European Commission, Brussels

    Google Scholar 

  • Majer IM, Nusselder WJ, Mackenbach JP, Klijs B, van Baal PHM (2011) Mortality risk associated with disability: a population-based record linkage study. Am J Public Health 101:e9–e15

    Article  PubMed  PubMed Central  Google Scholar 

  • McCarron M, Carroll R, Kelly C, McCallion P (2015) Mortality rates in the general Irish population compared to those with an intellectual disability from 2003 to 2012. J Appl Res Intellect Disabil 28:406–413

    Article  PubMed  Google Scholar 

  • OECD (2010) Sickness, disability and work: breaking the barriers: a synthesis of findings across OECD countries. OECD Publishing, Paris

    Google Scholar 

  • Ouellette-Kuntz H, Shooshtari S, Balogh R, Martens P (2015) Understanding information about mortality among people with intellectual and developmental disabilities in Canada. J Appl Res Intellect Disabil 28:423–435

    Article  PubMed  Google Scholar 

  • Pearlin LI, Schieman S, Fazio EM, Meersman SC (2005) Stress, health, and the life course: some conceptual perspectives. J Health Soc Behav 46:205–219

    Article  PubMed  Google Scholar 

  • Polvinen A, Laaksonen M, Gould R, Lahelma E, Leinonen T, Martikainen P (2015) Socioeconomic inequalities in cause-specific mortality after disability retirement due to different diseases. Scand J Public Health 43:159–168.

    Article  CAS  PubMed  Google Scholar 

  • Republic of Korea Ministry of Health and Welfare (2015) Current status of individuals on the National Disability Registry. http://www.mohw.go.kr/front_new/jb/sjb030301ls.jsp?PAR_MENU_ID=03&MENU_ID=0321#. Accessed 5 Oct 2016

  • Rimmer JH (1999) Health promotion for people with disabilities: the emerging paradigm shift from disability prevention to prevention of secondary conditions. Phys Ther 79:495–502

    CAS  PubMed  Google Scholar 

  • Shneidman ES (1981) The psychological autopsy. Suicide Life Threat Behav 11(4), 325–340.

    Article  Google Scholar 

  • Turner RJ, Noh S (1988) Physical disability and depression: a longitudinal analysis. J Health Soc Behav 29:23–37

    Article  CAS  PubMed  Google Scholar 

  • Van Orden KA, Witte TK, Cukrowicz KC, Braithwaite SR, Selby EA, Joiner TE (2010) The interpersonal theory of suicide. Psychol Rev 117:575–600

    Article  PubMed  PubMed Central  Google Scholar 

  • Wallman T, Wedel H, Johansson S, Rosengren A, Eriksson H, Welin L, Svärdsudd K (2006) The prognosis for individuals on disability retirement: an 18-year mortality follow-up study of 6887 men and women sampled from the general population. BMC Public Health 6:1–9

    Article  Google Scholar 

  • Westerling R, Gullberg A, Rosen M (1996) Socioeconomic differences in ‘avoidable’ mortality in Sweden 1986–1990. Int J Epidemiol 25:560–567

    Article  CAS  PubMed  Google Scholar 

  • WHO (2011) World report on disability. World Health Organization, Geneva

    Google Scholar 

  • Wright P, De Boer W (2002) Introduction. In: Assessing disability in Europe: similarities and differences. Council of Europe Publishing, Strasbourg, pp 7-23.

Download references

Acknowledgements

This study was supported by a research Grant of Seoul National University (No. 200-20160025). The authors would like to thank the anonymous reviewers for their helpful comments that greatly contributed to enhancing the quality of this manuscript.

Author information

Authors and Affiliations

  1. Department of Social Welfare, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea

    Jung Min Park, Beop-Rae Roh & Yeongmin Moon

  2. National Pension Research Institute, Jeonju, Republic of Korea

    Ukchan Oh

Authors
  1. Jung Min Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ukchan Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Beop-Rae Roh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yeongmin Moon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jung Min Park.

Ethics declarations

Conflict of interest

None.

Institutional approval

This study was approved by the Institutional Review Board of Seoul National University (IRB No. E1604/001-007).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, J.M., Oh, U., Roh, BR. et al. Disparities in mortality by disability: an 11-year follow-up study of 1 million individuals. Int J Public Health 62, 989–996 (2017). https://doi.org/10.1007/s00038-017-0966-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00038-017-0966-5

Keywords

Search

Navigation