Sickness presence, sickness absence, and self‐reported health and symptoms

The purpose of this paper is to compare sickness presence (SP) and sickness absence (SA) regarding the strength of their relationship to health/ill‐health. In a previous Canadian study a stronger association between SP and health/ill‐health than between SA and health/ill‐health was shown.

Five Swedish data sets from the years 1992 to 2005 provided the study populations, including both representative samples and specific occupational groups (n=425‐3,622). Univariate correlations and multiple logistic regression analyses were performed. The data sets contained questions on SP and SA as well as on various health complaints and, in some cases, self‐rated health (SRH).

The general trend was that correlations and odds ratios increased regularly for both SP and SA, with SP showing the highest values. In one data set, SRH was predicted by a combination of the two measures, with an explained variance of 25 percent. Stratified analyses showed that the more irreplaceable an individual is at work, the larger is the difference in correlation size between SP and SA with regard to SRH. SP also showed an accentuated and stronger association with SRH than SA among individuals reporting poor economic circumstances.

The results support the notion that SA is an insufficient, and even misleading, measure of health status for certain groups in the labor market, which seem to have poorer health than the measure of SA would indicate.

A combined measure of sickness presence and absence may be worth considering as an indicator of both individual and organizational health status.