Social security status and mortality in Belgian and Spanish male workers.

OBJECTIVE To assess differences in mortality rates between social security statuses in two independent samples of Belgian and Spanish male workers. METHODS Study of two retrospective cohorts (Belgium, n=23,607; Spain, n=44,385) of 50-60 year old male employees with 4 years of follow-up. Mortality rate ratios (MRR) were estimated using Poisson regression models. RESULTS Mortality for subjects with permanent disability was higher than for the employed, for both Belgium [MRR=4.56 (95% CI: 2.88-7.21)] and Spain [MRR=7.15 (95% CI: 5.37-9.51)]. For the unemployed/early retirees, mortality was higher in Spain [MRR=1.64 (95% CI: 1.24-2.17)] than in Belgium [MRR=0.88 (95% CI: 0.46-1.71)]. CONCLUSION MRR differences between Belgium and Spain for unemployed workers could be partly explained because of differences between the two social security systems. Future studies should further explore mortality differences between countries with different social security systems.