Analyses of Sickness Absence

Abstract

Sickness absence is an empirical phenomenon of all time. Generally, it has a medical cause. However, other factors also appear to have an impact on the actual rate of sickness absence, such as the institutional setting, the business cycle and the economic structure. Many questions on the different dimensions of sickness absence are still not fully answered, since there are great differences between countries, firms and individuals. Since patterns of sickness absence vary from one employer or employee to another, it is essential to investigate the specific transitions or shocks that employees undergo. Examining sickness absence behaviour in relation to job transitions and health shocks should shed more light on the relation between sickness absence and incentives, selection and health. The first part of this dissertation (Chapters 2 and 3) focuses on changes in sickness absence in periods of transitions in the labour market. Chapter 2 examines absenteeism for employees who make a job transition and considers the procyclical nature of absenteeism in the period around transitions between jobs, since both are procyclical. We use economy-wide employer-employee matched data focusing on the period 2004-05. The decrease in absences during the probationary period is smaller than the increase in absence after the notification of termination of the employment contract. The net increase of sickness absence in the period around job transition intensifies the procyclical nature of sickness absence. Chapter 3 takes the period 2004-05 and investigates its rates of absenteeism among newly hired Dutch employees after a period of unemployment in 2002-05. Our results, contrary to the ones in the business cycle literature, show that employees do not react strongly to the incentive of being long-term unemployed, since sickness absence is 1.3 percentage points higher for employees who have been unemployed for more than a year, which suggests that a sorting mechanism dominates the incentive effect. Therefore, in a new job after unemployment, the disciplining effect of this spell on sickness absence is not dominant. The second part of this dissertation (Chapters 4 and 5) focuses on health shocks and their effect on sickness absence behaviour. This part of the dissertation concentrates on two specific health shocks, pregnancies and fractures, which influence sickness absence behaviour. Chapter 4 studies absenteeism in relation to the intensity of the condition. We consider the consequences of including the intensity of the condition in the absence equation by focusing on the development of absence for a homogeneous group of female workers during forty weeks of pregnancy. The results suggest that the intensity of the pregnancy is strengthening the explanatory factors of sickness absence consistent with the relationships suggested in the literature. As the social gradient, health and sickness absence are interrelated, Chapter 5 investigates whether, after controlling for health, there still is a social gradient in sickness absence. In order to address this question, we make use of an unexpected health shock that may lead to sickness absenteeism for one specific medical reason: fractures. We find strong evidence of a social gradient in sickness absence, since the increase is in sickness absence is higher for low-salaried workers than for high-salaried employees