Dual trajectories of short-term and long-term sickness absence and their social- and health-related determinants among women in the public sector.

backgroundShort- and long-term sickness absence (SA) vary in their determinants. We examined short- and long-term SA contemporaneously as two interconnected phenomena to characterize their temporal development, and to identify employees with increasing SA at an early stage.

methodsWe extracted 46- to 55-year-old employed women from the Helsinki Health Study occupational cohort during 2000-17 (N = 3206) and examined the development of short- (1-14 days) and long-term (>14 days) SA using group-based dual trajectory modelling. In addition, we investigated the associations of social-, work- and health-related factors with trajectory group membership.

resultsFor short-term SA, we selected a three-group solution: 'no short-term SA' (50%), 'low frequency short-term SA' (40%), and 'high frequency short-term SA' (10%) (7 spells/year). For long-term SA, we also selected three trajectory groups: 'no long-term SA' (65%), 'low long-term SA' (27%), and 'high long-term SA' (8%). No SA in the short-term SA model, indicated a high probability of no SA in the long-term model and vice versa. The developmental pattern was far less certain if participant was assigned to a trajectory of high SA in either one of the models (short- or long-term SA model). Low occupational class and poor health behaviours were associated with the trajectory groups with more SA.

conclusionSA does not increase with age among most employees. If either SA rate was high, the developmental patterns were heterogenous. Employers' attention to health behaviours might aid in reducing both short- and long-term SA.