Incidence and Length of Sickness Absence among Hierarchical Occupational Classes and Non-Wage-Earners: A Register Study of 1.6 Million Finns.

Jenni Blomgren,Sauli Jäppinen

doi:10.3390/ijerph18020501

Abstract

Socioeconomic differences in sickness absence are well known, but previous studies have tended to focus on wage earners only. This study examined incidence and length of sickness absence comparing the employee groups of upper and lower non-manual employees and manual workers, but also entrepreneurs, the unemployed and other non-wage-earners. The study utilized register data on a nationally representative 70% sample of Finns aged 25–62 at the end of year 2012 (N = 1,615,352). Sickness absence spells compensated by sickness allowance and initiated during 2013 were retrieved from the register of the Social Insurance Institution of Finland (SIIF) and followed until the end of each episode and linked to socio-demographic covariates collected from the registers of the SIIF and of Statistics Finland. Zero-inflated negative binomial regression was used in multivariate models. After adjusting for age, marital status, region and income, there were clear differences in the occurrence and length of sickness absence across socioeconomic groups. Compared to upper non-manual employees, lower non-manual employees and especially manual workers had higher cumulative annual incidence of sickness absence among both men and women, but the entrepreneurs, the unemployed and other non-wage-earners had a clearly higher expected number of sickness absence days. Results varied by diagnostic group. The results highlight the importance of different types of preventive measures for reducing the occurrence of sickness absence and for preventing prolongations of sickness absence spells in different socioeconomic groups.

Highlights

Sickness absence incurs significant costs for the employers, for the individuals and their families and for the society as a whole in terms of lost productivity, lost income, and payments of sickness benefits [1,2]
The outcomes of the study were (1) the incidence of at least one new sickness absence episode in the study population during 2013, corresponding to the cumulative incidence measure suggested by Hensing [31] and (2) length of sickness absence, measured as the total number of sickness absence days in absence episodes that started during year 2013 among those who had new episodes in 2013 [31]
The associations of the socio-demographic covariates with all-cause sickness absence are presented in Table 1. 7% of men and 10% of women in the study cohort had at least one sickness absence episode compensated by sickness allowance that started during year

Summary

Introduction

Sickness absence incurs significant costs for the employers, for the individuals and their families and for the society as a whole in terms of lost productivity, lost income, and payments of sickness benefits [1,2]. In Finland, around two thirds of employees have at least some sickness absence during one year’s time [3], and about 4% of theoretical yearly working time (i.e., regular working time in accordance with an agreed system of working hours and including annual leave) are estimated to be lost due to sickness absence [4]. Around 10% of non-retired Finns have long sickness absence spells that exceed working days, entitling to sickness allowance paid by the Social Insurance Institution of Finland [5]. Long sickness absence in particular, is strongly associated with poor health, disability retirement and even mortality [6,7,8,9,10,11]. Knowledge of the determinants of sickness absence and of the accumulation of sickness absence days is important to be able to target effective measures that aim to prevent both incidence and prolongation of sickness absence and to curb its harmful consequences.

Objectives

Methods

Results

Discussion

Conclusion