Sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income in native Swedes and immigrants

Abstract

Background: Sickness absence with cash benefits from the sickness insurance gives an opportunity to be relieved from work without losing financial security. There are, however, downsides to taking sickness absence. Periods of sickness absence, even short ones, can increase the risk for future spells of sickness absence and unemployment. The sickness period may in itself have a detrimental effect on health. The aim of the study was to investigate if there is an association between exposure to sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income from work. Methods: Our cohort consisted of all immigrants aged 21–25 years in Sweden in 1993 (N = 38 207) and a control group of native Swedes in the same age group (N = 225 977). We measured exposure to sickness absence in 1993 with a follow-up period of 15 years. We conducted separate analyses for men and women, and for immigrants and native Swedes. Results: Exposure to ≥60 days of sickness absence in 1993 increased the risk of sickness absence [hazard ratio (HR) 1.6–11.4], unemployment (HR 1.1–1.2), disability pension (HR 1.2–5.3) and death (HR 1.2–3.5). The income from work, during the follow-up period, among individuals with spells of sick leave for ≥60 days in 1993 was around two-thirds of that of the working population who did not take sick leave. Conclusions: Individuals on sickness absence had an increased risk for work absence, death and lower future income.

Length of sickness absence and sustained return-to-work in mental disorders and musculoskeletal diseases: a cohort study of public sector employees

“…It is known from previous studies that long-term sickness absence is a prognostic marker of future absence from work, early retirement due to ill health, and mortality (3)(4)(5)(6)(7)(8)(9). Long-term sickness absence is also associated with future unemployment, financial difficulties, psychological and social problems, and social exclusion (10)(11)(12).…”

Adverse outcomes of sick leave due to mental disorders: A prospective study of discordant twin pairs

“…Sick leave is more common among groups with lower socioeconomic status (66), however, sick-leave rates are now increasing in professions requiring higher education (67). Negative outcomes of being on sick leave that have previously been studied include premature death (68), suicide (69), reoccurring sick-leave (70), disability pension (71), unemployment (11,12), low income (72), and poor physical and mental health (73). The effect of sick leave can vary depending on gender, education and immigration status (11,74), as well as age and diagnosis (10).…”

“…Negative outcomes of being on sick leave that have previously been studied include premature death (68), suicide (69), reoccurring sick-leave (70), disability pension (71), unemployment (11,12), low income (72), and poor physical and mental health (73). The effect of sick leave can vary depending on gender, education and immigration status (11,74), as well as age and diagnosis (10). In order to facilitate comparison between sick-leave studies, they can be categorized in the structure shown in Table 2, and perspectives taken in this thesis are marked in bold (75).…”

“…Moreover, aspects other than mental disorders such as workrelated factors, health status, socio-economic situation and family background, are of importance when studying sick leave (2,(6)(7)(8)(9). How sick leave affects an individual varies depending on life situation (10), but on population level, sick leave due to mental disorders has been found to increase the risk of future absence from the labor market in forms of further sick leave, disability pension, and unemployment (11), causing high costs and lower productivity for society (12,13). In order to address this major public health problem, more knowledge is needed on how these common stress-related and other mental disorders develop, how they lead to sick leave and what consequences this may have.…”

Sick leave due to mental disorders, morbidity and mortality: a prospective study of discordant twin pairs

“…Sick leave due to mental disorders has been found to have a negative effect on future work life, such as a higher risk of unemployment and a lower income [7][8][9]. Sick leave has also been associated with a number of adverse health outcomes, such as poor self-rated health [10,11] and early death [12].…”