ArticleEuropean journal of public health2026
Joint contribution of body mass index and psychological distress to short and long sickness absence among young and early midlife public sector employees: a register-linked follow-up study.
Article in European journal of public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Overweight/obesity and psychological distress often co-exist and are associated with sickness absence (SA). The objective of this study was to examine joint contribution of overweight/obesity and psychological distress on short and long SA periods, and to explore potential synergistic interactions between these factors. The Helsinki Health Study survey collected in 2017 among 19-39-year-old Finnish municipal employees was linked to employer's SA registers (1-7 days for short and 8+ days for long SA periods), including participants consenting to linkage (n = 3966, 80% women). The mean follow-up time was 2.1 years. We calculated body mass index (BMI) from weight and height and evaluated psychological distress using the emotional wellbeing subscale of RAND-36 health-related quality of life survey. Rate ratios (RRs) and their 95% confidence intervals (CIs) were calculated for SA periods using negative binomial regression models. Interaction between overweight/obesity and psychological distress was examined using the Synergy Index (S). Most participants (85%) had at least one short and over one-fourth (29%) one long SA period. Overweight/obesity (42%) and psychological distress (23%) jointly contributed to short (RR, 1.62; 95% CI, 1.44-1.82) and long (RR, 2.48; 95% CI, 2.09-2.95) SA periods, compared to those with healthy weight and no psychological distress. The interaction between overweight/obesity and psychological distress was additive for short (S = 1.11), and synergistic for long SA periods (S = 1.40). Sociodemographic factors, working conditions, and health behaviors only slightly attenuated these associations. It is important to consider co-occurrence of overweight/obesity and psychological distress in prevention of SA.
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