{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T12:19:19Z","timestamp":1744287559037,"version":"3.37.3"},"reference-count":58,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007360","name":"Stiftelsen f\u00f6r \u00c5bo Akademi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007360","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In working ages, sickness absence is strongly related to persons\u2019 health condition. We studied how birth order was associated with receipt of sickness allowance, distinguishing between mental disorders, musculoskeletal disorders and injuries.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A follow-up study based on the entire Finnish population was conducted for sibling groups born 1969\u20131982, in which each sibling was observed from age 35 years in the period 2004\u20132018. Focus was on within-family variation in first-time sickness allowance receipt.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Results of stratified Cox regressions revealed that each increase in birth order was associated with a slightly higher risk of sickness absence from any cause. For mental disorders, associations were stronger; the hazard ratio as compared to first borns was 1.03 (95% CI: 0.98\u20131.08) of second borns, 1.10 (0.99\u20131.22) of third borns, and 1.52 (1.25\u20131.85) of fourth or higher borns. Corresponding numbers for musculoskeletal disorders were 1.12 (1.07\u20131.17), 1.19 (1.09\u20131.30) and 1.15 (0.96\u20131.38), and for injuries 1.06 (1.01\u20131.12), 1.09 (1.21\u20131.14) and 0.96 (0.77\u20131.20), respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Birth order effects were generally stronger for women than men, and to some extent influenced by educational level, occupation, income, and family composition. Possible latent mechanisms behind the associations may relate to within-family dynamics at childhood.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0280532","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T04:02:50Z","timestamp":1674014570000},"page":"e0280532","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Birth order and sickness absence: Register-based evidence from Finland"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1039-8289","authenticated-orcid":true,"given":"Kaarina","family":"Reini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Saarela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,1,17]]},"reference":[{"key":"pone.0280532.ref001","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1016\/S0140-6736(04)17099-2","article-title":"Restricted fetal growth and adverse maternal psychosocial and socioeconomic conditions as risk factors for suicidal behaviour of offspring: a cohort study","volume":"364","author":"E Mittendorfer-Rutz","year":"2004","journal-title":"Lancet"},{"issue":"6","key":"pone.0280532.ref002","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1007\/s00127-011-0405-5","article-title":"Family size and perinatal circumstances, as mental health risk factors in a Scottish birth cohort","volume":"47","author":"DV Riordan","year":"2012","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"pone.0280532.ref003","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.socscimed.2014.11.007","article-title":"Birth order and physical fitness in early adulthood: evidence from Swedish military conscription data","volume":"123","author":"K Barclay","year":"2014","journal-title":"Soc Sci Med"},{"key":"pone.0280532.ref004","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.drugalcdep.2016.06.029","article-title":"Birth order and hospitalization for alcohol and narcotics use in Sweden","volume":"167","author":"K Barclay","year":"2016","journal-title":"Drug Alcohol Depend"},{"issue":"7","key":"pone.0280532.ref005","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1093\/aje\/kwt014","article-title":"Maternal age at child birth, birth order, and suicide at a young age: a sibling comparison","volume":"177","author":"JH Bj\u00f8rngaard","year":"2013","journal-title":"Am J Epidemiol"},{"issue":"12","key":"pone.0280532.ref006","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1093\/aje\/kwu090","article-title":"Birth Order and Suicide in Adulthood: Evidence From Swedish Population Data","volume":"179","author":"M Rostila","year":"2014","journal-title":"Am J Epidemiol"},{"issue":"2","key":"pone.0280532.ref007","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1007\/s13524-015-0377-2","article-title":"Birth order and mortality: a population-based cohort study","volume":"52","author":"K Barclay","year":"2015","journal-title":"Demography"},{"key":"pone.0280532.ref008","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.socscimed.2016.04.008","article-title":"Birth order and mortality in two ethno-linguistic groups: Register-based evidence from Finland","volume":"158","author":"J Saarela","year":"2016","journal-title":"Soc Sci Med"},{"key":"pone.0280532.ref009","doi-asserted-by":"crossref","first-page":"108859","DOI":"10.1016\/j.drugalcdep.2021.108859","article-title":"Birth order and alcohol-related mortality by ethnic origin and national context: Within-family comparisons for Finland and Sweden","volume":"226","author":"J Saarela","year":"2021","journal-title":"Drug Alcohol Depend"},{"key":"pone.0280532.ref010","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1126\/science.2740913","article-title":"Number of siblings and educational attainment","volume":"245","author":"PE Blake","year":"1989","journal-title":"Science"},{"key":"pone.0280532.ref011","first-page":"669","article-title":"The more the merrier? 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