Occupational prestige and sickness absence inequality in Sweden: a registry-based study

Abstract

Abstract Background Socioeconomic position has been linked to sickness absence (SA). However, less is known about the role of occupational prestige, a measure of social status afforded by one's occupation, in SA. To expand knowledge on socioeconomic determinants of SA and on gender differences in SA, this study aimed to investigate the association between occupational prestige and SA and the distribution of the association in women and men. The study also aimed to analyze the effects of intersections of gender and occupational prestige on SA. Methods The study was based on data of 97 397 employed individuals aged 25-59 years selected from the 2004, 2007 and 2010 waves of the Swedish Labour Force Survey. Baseline occupational prestige was measured with the Standard International Occupational Prestige Scale. Information on SA was retrieved from the national register. Two measures of SA were defined: the number of SA days in any particular year during a 3-year follow-up and long-term (>120 days) SA based on data of participants with at least one sick leave spell during the follow-up. Results Working in lower prestige occupations was associated with increased SA among women and men. The association was independent of other socioeconomic indicators, such as income, education, and occupational class. In the intersectional analysis, women regardless of prestige level and men in lower prestige occupations had higher probability of SA compared with men in high prestige occupations. Women in high prestige occupations had the highest absenteeism rates (IRR, 2.25, 95%CI, 2.20-2.31), while men in medium prestige occupations had the lowest rates (IRR, 1.17, 95%CI, 1.13-1.20). Compared with the rest of the groups, men in low and medium prestige occupations had higher odds for long-term absence. Conclusions Women, regardless of occupational prestige level, and men in lower occupational prestige had an increased risk of sickness absence. Key messages Occupational prestige was associated with sickness absence in women and men. There is need to pay close attention to occupational prestige as a factor that may influence health and labor market participation.