Causes of disability

Times change, as do the causes of disability

	According to a recent study by the Régie des rentes du Québec, the illnesses behind the cases of disability recognized under the Québec Pension Plan have changed significantly since the first year it was implemented. The differences are attributable to changes in the illnesses themselves, but also to recent developments in medicine and to administrative modifications made to the Plan over the years.

Illnesses on the rise: diseases of the musculoskeletal system, mental disorders and cancer

The number of beneficiaries with diseases of the musculoskeletal system (example: rheumatoid arthritis) has been increasing since 1970. The proportion of beneficiaries with these illnesses has grown from 6% at the beginning of the Plan to approximately 20% in 1984, and has remained stable since that time. The relaxing of eligibility requirements is partly responsible for this increase, since in 2003, the beneficiaries deemed to be disabled using the less strict definition of disability represented 70% of the beneficiaries with these types of illnesses, compared to 40% in 1984.

The proportion of new beneficiaries of a disability pension with a mental disorder has doubled in Québec since payment of the first pension. The proportion of women has always been higher than men (20% compared to 14% for men in 2003). Most new beneficiaries under age 40 fall into this category.

Beneficiaries with cancer represent 20% of those who receive a disability pension under the Québec Pension Plan, that is, approximately 5% more than in 1970. In 90% of the cases, these persons are deemed to be disabled according to the new definition of disability based on age.

Together, these 3 categories of illnesses are responsible for close to 60% of the new cases of disability recognized under the Plan in 2003.

Reduced incidence: diseases of the cardiovascular and respiratory systems

Medical breakthroughs are without a doubt behind the reduction in the number of persons disabled following an illness of the cardiovascular system (example: heart attack) or respiratory system (example: chronic bronchitis) since the mid-1980s. Diseases of the cardiovascular system, which were previously the principal cause of disability (44% of new cases in 1970), represented only 13% of new beneficiaries in 2003: 17% for men and 7% for women.

The proportion of men with respiratory illness has gradually decreased over the years. In 2003, they represented 4% of new beneficiaries of a disability pension, that is, a percentage similar to that of women since 1970.

The numbers are stable: disorders of the nervous system

Since the beginning of the Plan, disorders of the nervous systems have affected approximately 10% of new beneficiaries. This group of illnesses includes notably multiple sclerosis and Alzheimer's disease.

Advances in medicine have contributed to a reduction in the number of beneficiaries with certain illnesses, but have also reduced the number of pensions that end because of a beneficiary's death; this applies to all causes of disability since 1970. The next article of this issue goes into more detail about the reasons that a disability pension might end.