Associations between health and combinations of sickness presence and absence.

BACKGROUND The association between sickness presence (SP), sickness absence (SA) and health is not well known although research on these phenomena has grown in recent years. AIMS To identify the health outcomes of different combinations of self-reported SP and SA while controlling for background and work-related factors. METHODS The study group was a representative three-wave sample of 1886 employed individuals from the Swedish Working Life Cohort, gathered in 2004-2006. Block-wise multiple logistic regression analyses were conducted for combinations of self-reported SP and SA, using controls for background, work-related and previous health factors. RESULTS The crude odds ratios showed that health and mental well-being were most negatively affected in the group with high SP and SA in the preceding year. When differences in individual background, health and work-related factors were controlled for, distinct significant odds ratios remained. The odds ratios for negative health outcomes were between 1.49 (95% CI: 1.02-2.18) and 2.64 (95% CI: 1.81-3.85) higher among those with both high SP and high SA than those with both low SP and low SA. However, the study also indicated that individuals with high SP and low SA showed the highest odds ratios for poor mental well-being. CONCLUSIONS The results showed that combinations of frequent self-rated SP and SA are related to negative values in the four measured aspects of self-reported health 1 year later. Occupational medicine practitioners should therefore be concerned particularly with employees who report frequently occurring SP and SA.