Sickness absence trajectories and its relationship with prior Labour Market Participation patterns : a life course approach

Background: Previous studies have focused on analysing specific labour market situations and their relationship with sickness absence (SA). However, little is known about the relationship between mobility between different employment status and the course of future SA with a life course perspective. Methods: A cohort study of Spanish affiliated workers, residents of Catalonia, who accumulated SA days during 2012-2014 (objective 1) or more than 15 SA days in the same period (objectives 2 and 3). We applied sequence and cluster analysis to identify patterns of labour market participation (LMP) and latent class growth models to identify SA trajectories. Finally, we applied multinomial logistic regression models to assess the relationship between LMP patterns and SA trajectories. Results: SA trajectories were not related to prior ten-year LMP patterns, except in men from the early working life stage, where an increasing employment pattern was associated with a lower risk for increased days on SA over time. Nevertheless, considering two-year LMP patterns, we found associations with SA trajectories in women of the early and middle stage of working life. The former had U-shaped employment patterns that were negatively associated with increasing SA trajectories, while the latter had increasing employment patterns and patterns without coverage that were positively associated with increasing SA trajectories. Conclusion: Knowing the evolution of transitions between employment status close to SA could provide useful information to prevent specific SA courses in the future.Antecedentes: Estudios previos se han enfocado en analizar situaciones del mercado laboral específicas y su relación con la incapacidad temporal (IT). Sin embargo, se sabe poco sobre la relación entre la movilidad entre diferentes situaciones de empleo y el curso futuro de la IT con una perspectiva de curso de vida. Métodos: Un estudio de cohorte de personas afiliadas españolas, residentes en Cataluña, que acumularon días en IT durante 2012-2014 (objetivo 1) o más de 15 días en IT en el mismo período (objetivos 2 y 3). Aplicamos análisis de secuencia y de agrupamiento para identificar patrones de participación en el mercado laboral (PML) y modelos de crecimiento de clases latentes para identificar trayectorias de IT. Finalmente, aplicamos modelos de regresión logística multinomial para evaluar la relación entre los patrones de PML y las trayectorias de IT. Resultados: Las trayectorias de IT no estaban relacionadas con diez años de PML previa, excepto en hombres de la etapa de vida laboral temprana, donde un patrón de empleo creciente se asocia con un menor riesgo de acumular más días en IT en el tiempo. Sin embargo, considerando dos años previos de PML se encontraron asociaciones con el curso futuro de la IT en mujeres de la etapa temprana y media de la vida laboral. Las primeras tenían patrones de empleo en forma de U que se asociaban negativamente con trayectorias de IT crecientes, mientras que las últimas tenían patrones de empleo creciente y sin cobertura que se asociaban positivamente con trayectorias de IT crecientes. Conclusión: Conocer la evolución de las transiciones entre situaciones de empleo cercanas a la IT podría proveer información útil para prevenir cursos específicos de IT en el futur

Unequal access? Use of sickness absence benefits by precariously employed workers with common mental disorders: a register-based cohort study in Sweden

Objective: This study compares the use of sickness absence benefits (SABs) due to a common mental disorder (CMD) between precariously employed and non-precariously employed workers with CMDs. Design: Register-based cohort study. Participants: The study included 78 215 Swedish workers aged 27-61 who experienced CMDs in 2017, indicated by a new treatment with selective serotonin reuptake inhibitors (SSRIs). Excluded were those who emigrated or immigrated, were self-employed, had an annual employment-based income 90 days of unemployment per year, had student status, had SABs due to CMDs during the exposure measurement (2016) and the two previous years, had an SSRI prescription 1 year or less before the start of the SSRI prescription in 2017, had packs of >100 pills of SSRI medication, had a disability pension before 2017, were not entitled to SABs due to CMDs in 2016, and had no information about the exposure. Outcome: The first incidence of SABs due to CMDs in 2017. Results: The use of SABs due to a CMD was slightly lower among precariously employed workers compared with those in standard employment (adjusted OR [aOR] 0.92, 95% CI 0.81 to 1.05). Particularly, women with three consecutive years in precarious employment had reduced SABs use (aOR 0.48, 95% CI 0.26 to 0.89), while men in precarious employment showed weaker evidence of association. Those in standard employment with high income also showed a lower use of SABs (aOR 0.74, 95% CI 0.67 to 0.81). Low unionisation and both low and high-income levels were associated with lower use of SABs, particularly among women. Conclusions: The study indicates that workers with CMDs in precarious employment may use SABs to a lower extent. Accordingly, there is a need for (1) guaranteeing access to SABs for people in precarious employment and/or (2) reducing involuntary forms of presenteeism