Abstract
BackgroundPrevious studies have focused on the relationship between employment pathways and health-related outcomes based on cross-sectional or longitudinal approaches. However, little is known about the cumulative effects of employment status mobility on sickness absence (SA) over time. The aim of the present study was to examine the association between prior labour market participation (LMP) patterns and SA trajectories from a life-course perspective.MethodsThis cohort study was based on a sample of 11,968 salaried workers living in Catalonia and affiliated with the Spanish Social Security system, who accumulated more than 15 days on SA in at least one quarter during 2012–2014. Individuals were grouped into three different working life stages: early (18–25 years), middle (26–35 years), and late (36–45 years). To identify LMP patterns, we applied sequence analysis and cluster analysis (2002–2011), and we used latent class growth modelling to identify SA trajectories (2012–2014). Finally, we applied multinomial logistic regression models to assess the relationship between LMP patterns and SA trajectories.ResultsThe analyses yielded six LMP patterns: stable employment (value range: 63–81%), increasing employment (5–22%), without long-term coverage (7–8%), decreasing employment (4–10%), fluctuant employment (13–14%), and steeply decreasing employment (7–9%). We also identified four SA trajectories: low stable (83–88%), decreasing (5–9%), increasing (5–11%), and high stable (7–16%). However, the only significant association we identified for LMP patterns and SA trajectories was among young men, for whom an increasing employment pattern was significantly associated with a lower risk for increased days on SA (adjusted odds ratio: 0.21; 95% confidence interval: 0.05–0.96).ConclusionsSA trajectories are generally not related to prior 10-year LMP patterns at any stage of working life. To disentangle this relationship, future research might benefit from considering working life transitions with a quality-of-work approach framed with contextual factors closer to the SA course.
Highlights
Previous studies have focused on the relationship between employment pathways and health-related outcomes based on cross-sectional or longitudinal approaches
We examined the association between labour market participation (LMP) patterns and sickness absence (SA) trajectories, using multinomial logistic regression models adjusted for potential confounders
The stable employment LMP pattern showed a higher proportion of women in the early working life cohort (WLC) compared to proportions in the late WLC (76.9% vs 70.7%), whereas the opposite pattern was observed for men (63.3% vs 81.3%)
Summary
Previous studies have focused on the relationship between employment pathways and health-related outcomes based on cross-sectional or longitudinal approaches. Experiences during working life are usually characterised as changes in employment and working conditions, the transitions in employment status that may influence an individual’s future health course. Such events and transitions may occur independently or be part of a cluster or causal chain, as each working experience increases the risk for other events or transitions. Previous research has mainly focused on risk and prognostic factors (individual, socio-demographic, occupational) for sickness absence (SA) [5,6,7], but a less considered aspect is the extent to which transitions in and out of the labour market may affect an individual’s work-related health outcomes. In the labour market context, a Norwegian study showed an inverse correlation between unemployment rate and the probability of having SA lasting longer than 14 days [8]
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