Work stress, migration background and risk of long-term sickness absence in Denmark

Abstract

Abstract Background Work stress may increase risk of long-term sickness absence, but little is known if this association differs by migration background. In this study, we examined the prospective association between effort-reward imbalance at work and risk of long-term sickness absence in individuals with and without migration background in the Danish workforce. Methods We included 59,468 respondents from a nationwide survey on work and health, 3,226 with a migration background (immigrants or first generation descendants of immigrants) and 56,242 without a migration background. Effort-reward imbalance was assessed by self-report. Migration background and long-term sickness absence (spells ≥6 weeks) were assessed by national register data. Using Cox regression, we estimated the association between effort-reward imbalance and onset of long-term sickness absence during 12 months follow-up separately for participants with and without a migration background, adjusted for age, sex, education and previous long-term sickness absence. Results The effort-reward imbalance score at baseline was similar for respondents with and without a migration background. The hazard ratio for long-term sickness absence during follow-up per 1 standard deviation increment in effort-reward imbalance at baseline was 1.26 (95% CI: 1.16-1.37) and 1.16 (95% CI: 1.13-1.20) for respondents with and without a migration background, respectively. Conclusions Work stress, measured by effort-reward imbalance, is associated with an increased risk of long-term sickness absence in workers with and without a migration background in Denmark. Although the estimate was higher in workers with a migration background, confidence intervals overlapped indicating that associations were similar in both groups. The results suggest that prevention activities on effort-reward imbalance and long-term sickness absence should not be prioritized by migration background but should be offered to the whole workforce. Key messages Work stress, measured by effort-reward imbalance, is associated with an increased risk of long-term sickness absence in workers with and without a migration background in Denmark. The results suggest that prevention activities on effort-reward imbalance and long-term sickness absence activities should be offered to the whole workforce.