Occupational class differences in diagnostic-specific sickness absence: a register-based study in the Finnish population, 2005–2014

Abstract

BackgroundMusculoskeletal diseases and mental disorders are major causes of long-term sickness absence in Western countries. Although sickness absence is generally more common in lower occupational classes, little is known about class differences in diagnostic-specific absence over time. Focusing on Finland during 2005–2014, we therefore set out to examine the magnitude of and changes in absolute and relative occupational class differences in long-term sickness absence due to major diagnostic causes.MethodsA 70-per-cent random sample of Finns aged 25–64 linked to register data on medically certified sickness absence (of over 10 working days) in 2005–2014 was retrieved from the Social Insurance Institution of Finland. Information on occupational class was obtained from Statistics Finland and linked to the data. The study focused on female (n = 658,148–694,142) and male (n = 604,715–642,922) upper and lower non-manual employees and manual workers. The age-standardised prevalence, the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were calculated for each study year to facilitate examination of the class differences.ResultsThe prevalence of each diagnostic cause of sickness absence declined during the study period, the most common causes being musculoskeletal diseases, mental disorders and injuries. The prevalence of other causes under scrutiny was less than 1 % annually. By far the largest absolute and relative differences were in musculoskeletal diseases among both women and men. Moreover, the absolute differences in both genders (p < 0.0001) and the relative differences in men (p < 0.0001) narrowed over time as the prevalence declined most among manual workers. Both genders showed modest and stable occupational class differences in mental disorders. In the case of injuries, no major changes occurred in absolute differences but relative differences narrowed over time in men (p < 0.0001) due to a strong decline in prevalence among manual workers. Class differences in the other studied diagnostic causes under scrutiny appeared negligible.ConclusionsBy far the largest occupational class differences in long-term sickness absence concerned musculoskeletal diseases, followed by injuries. The results highlight potential targets for preventive measures aimed at reducing sickness absence and narrowing class differences in the future.

Association between socioeconomic position and occupational health service utilisation trajectories among young municipal employees in Finland

“…In the present context, primary care visits can be interpreted as an indicator of incidence of acute illnesses, as the Finnish OHS system distinguish visits related to occupational health hazards. The present results concerning primary care visits are in line with previous findings from our own and other studies showing the socioeconomic differences in SA among employees and the gender differences in SA, that is, women having more absence than men 7 10 14 18 21. It can be assumed that large number of OHS visits precede SA 27…”

“…Service utilisation information is important for planning preventive actions via targeted interventions or improving case management protocols8 9 arranged by the OHS. According to extensive Finnish and international evidence, socioeconomic differences in SA are large,10–21 thus it would be important to monitor the differences in OHS utilisation from the socioeconomic viewpoint and to be able to identify groups for interventions.…”

Frequent attenders in occupational health primary care: A cross-sectional study

“…Musculoskeletal disorders are also the leading cause of sickness absence and disability pensions in Finland, again linking FA to potential disability. 25 In our study especially illnesses of the back and spine and illnesses of neck, cervical spine and tension headache were closely associated with FA10. Back pain has been associated with frequent attendance in primary care, and our study confirms this association.…”

Sickness absence due to different musculoskeletal diagnoses by occupational class: a register-based study among 1.2 million Finnish employees

“…The socioeconomic gradient in sickness absence is particularly steep in musculoskeletal diseases,9–12 and this has remained over time 12. However, studies examining occupational class differences in sickness absence simultaneously across different musculoskeletal diagnoses are lacking.…”