Original article

Scand J Work Environ Health 2015;41(4):338-346    pdf full text


Explaining educational differences in sickness absence: a population-based follow-up study

by Kaikkonen R, Härkänen T, Rahkonen O, Gould R, Koskinen S

Objects There is a marked socioeconomic gradient in sickness absences, but the causes of this gradient are poorly understood. This study examined the role of health and work-related factors as determinants of educational differences in long-term sickness absence in an 8-year follow-up.

Methods The study comprised a population-based sample of 5835 Finns aged 30–64 years (participation 89%, N=3946) in a register-based 8-year follow-up. This is a novel method to predict the population average of sickness absence days per working year (DWY) based on the expected outcome values using Poisson and gamma regression models.

Results The difference in the DWY between the lowest and highest educational level was clear among both men (3.2 days/year versus 8.0 days/year) and women (women 4.4 days/year versus 10.1 days/year). Adjusting for physical working conditions, health status and health behavior, and obesity attenuated the differences. Psychosocial working conditions had only a minor effect on the association. After adjusting for health and work-related factors, the difference attenuated by 1.8 days and 2.6 days among men and women, respectively.

Conclusions Our results suggest that improvements in physical working conditions and reducing smoking, particularly among employees with a low level of education, may markedly reduce educational differences in sickness absence.

This article refers to the following texts of the Journal: 2003;29(2):159-165  2009;35(1):1-5  2010;36(5):404-412
The following articles refer to this text: 2015;41(4):325-327; 2015;41(6):542-553
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