Long-term sickness absence trajectories among ageing municipal employees - the contribution of social and health-related factors

BMC Public Health. 2023 Jul 26;23(1):1429. doi: 10.1186/s12889-023-16345-9.

Abstract

Background: The ageing work force is heterogeneous, following distinct development in work ability. This study aims to identify trajectories of long-term sickness absence (SA) in later careers and to examine potentially modifiable factors associated with the development of SA.

Methods: Data comprised of municipal employees of the city of Helsinki aged 50-60 years during 2004-2018 (N = 4729, 80% women). The developmental trajectories of long-term (> 10 working days) SA were examined with Group-based trajectory modelling (GBTM) using SA records of the Social Insurance Institution of Finland during 2004-2018. All-cause and diagnosis-specific (mental disorder- and musculoskeletal disease-related) SA days were analysed. The association of social and health-related factors with trajectory membership was examined using multinomial logistic regression (odds ratios and 95% confidence intervals).

Results: A model with three trajectories was selected for both all-cause and diagnosis-specific SA. Regarding all-cause long-term SA trajectories, 42% had no long-term SA, 46% had low levels of SA, and 12% had a high rate of SA during follow-up. Lower occupational class, reporting smoking, overweight or obesity, moderate or low leisure-time physical activity, and sleep problems were associated with a higher likelihood of belonging to the trajectory with a high rate of SA in both all-cause and diagnosis-specific models.

Conclusions: Most ageing employees have no or little long-term SA. Modifiable factors associated with trajectories with more SA could be targeted when designing and timing interventions in occupational healthcare.

Keywords: Ageing; Cohort study; Health behaviour; Sick leave; Sickness absence; Trajectories; Work arrangements.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aging*
  • Female
  • Finland / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Diseases* / epidemiology
  • Obesity
  • Occupations
  • Overweight
  • Sick Leave