Sick leave before and after the age of 65 years among those in paid work in Sweden in 2000 or 2005: a register-based cohort study

Trends in Associations Between Sickness Absence Before the Age of 65 and Being in Paid Work After the Age of 65: Prospective Study of Three Total Population Cohorts

The increasing workforce participation at higher ages may impact social insurance systems, however, this has hardly been studied at all. We studied associations between sociodemographic factors and prior sickness absence and disability pension, with having paid work and sickness absence after age 65, and if such associations changed over time. We used longitudinal register data regarding three cohorts of all residents in Sweden who turned 65 in 2000, 2005, or 2010 (N = 50,000, 68,000, and 99,000, respectively). Although employment rates when aged 66-71 increased between the cohorts, associations of sociodemographic factors with paid work and sickness absence, when aged 66-71 did not. Both sickness absence and disability pension when aged 60-64 were negatively associated with working past 65. Sickness absence when aged 60-64 was positively associated and disability pension was negatively associated with sickness absence after 65. Possibilities to remain in paid work with different health conditions need to be strengthened to avoid inequalities when raising the retirement age.

Sociodemographic and morbidity characteristics of people on long-term sick leave

BACKGROUND

Certifying long-term sick leave and coordinating complex rehabilitation programs are essential activities of social insurance doctors. These doctors have a role in preventing the decreased work capacity of employees that may lead to leaving the labour market and the transition of these employees to other social insurance benefits, such as a work disability pension.

OBJECTIVES

Analysis of long-term sick leaves (over 183 days) to identify risk factors and population groups with low potential for work capacity rehabilitation.

METHOD

We conducted a cross-sectional study between September 2019 and September 2020. The information was collected from the National Institute of Medical Assessment and Work Capacity Rehabilitation Bucharest registers and the EXPMED application. The data were statistically analysed using PSPP software.

RESULTS

The highest rehabilitation percentage was achieved in cases of traumatic injuries (73.17%), followed by musculoskeletal diseases (70.06%). We noticed lower recovery in cases of nervous system diseases (50.56%) and cardiovascular diseases (44.23%). In the group that summed up the other pathologies, the recovery percentage was 58.37%. People who regained their work capacity were significantly younger (mean age 47.87 y ± 8.93) than those who turned to other forms of social benefits, such as a disability pension or an old-age pension (mean age 53.16 y ± 8.43).

CONCLUSION

Most of the subjects (72%) regained their work capacity and did not need a disability pension. We identified the sociodemographic and morbidity characteristics of people on long-term sick leave along with target groups requiring intensive intervention measures.

Sickness Absence and Disability Pension in the Trade and Retail Industry: A Prospective Cohort Study of 192,000 White-Collar Workers in Sweden

OBJECTIVE

This study aimed to investigate future sickness absence (SA) and disability pension (DP) among privately employed white-collar employees in the trade and retail industry.

METHODS

A prospective population-based cohort study of all 192,077 such workers in Sweden in 2012, using linked microdata from nationwide registers, was conducted. Descriptive statistics of annual SA/DP during 2010 to 2016 and logistic regression for SA/DP in 2016 were used.

RESULTS

Women had more mean SA/DP net days/person; however, there were no sex differences in the mean number of net days/person with SA/DP. The mean number of net days/person increased, especially with mental diagnoses. Sickness absence in 2012 was the strongest factor associated with SA/DP in 2016 (women: odds ratio, 3.28; 95% confidence interval, 3.09-3.47; men: odds ratio, 4.10; 95% confidence interval, 3.76-4.48). Work-related factors were weakly associated with future SA/DP.

CONCLUSIONS

The number of SA/DP net days per person increased, especially SA/DP days due to mental diagnoses.

Trajectories of sickness absence and disability pension days among 189,321 white-collar workers in the trade and retail industry; a 7-year longitudinal Swedish cohort study

Objective

1) identify different trajectories of annual mean number of sickness absence (SA) and disability pension (DP) days among privately employed white-collar workers in the trade and retail industries and 2) investigate if sociodemographic and work-related characteristics were associated with trajectory membership.

Methods

A longitudinal population-based cohort register study of all white-collar workers in the trade and retail industry in 2012 in Sweden (N = 189,321), with SA and DP data for 2010–2016. Group-based trajectory analysis was used to identify groups of individuals who followed similar trajectories of SA/DP days. Multinomial logistic regression was used to determine associations between sociodemographic and work-related factors and trajectory membership.

Results

We identified four trajectories of SA/DP days. Most individuals (73%) belonged to the trajectory with 0 days during all seven years, followed by a trajectory of few days each year (24%). Very small minorities belonged to a trajectory with increasing SA/DP days (1%) or to constantly high SA/DP (2%). Men had a lower risk of belonging to any of the three trajectories with SA/DP than women (OR Low SA/DP 0.42, 95% CI 0.41–0.44; Increasing SA/DP 0.34, 0.30–0.38; High SA/DP 0.33, 0.29–0.37). Individuals in occupations with low job control had a higher risk of belonging to the trajectory High SA/DP (OR low demands/low control 1.51; 95% CI 1.25–1.83; medium demands/low control 1.47, 1.21–1.78; high demands/low control 1.35, 1.13–1.61).

Conclusion

Most white-collar belonged to trajectories with no or low SA/DP. Level of job control was more strongly associated with trajectory memberships than level of job demands.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14005-y.

Associations of sickness absence and disability pension due to mental and somatic diagnoses when aged 60-64 with paid work after the standard retirement age; a prospective population-based cohort study in Sweden

Background

The proportion of people working beyond age 65 is increasing. We aimed to explore whether sickness absence (SA) and disability pension (DP) due to mental, somatic, or both diagnoses when aged 60–64 were associated with being in paid work when aged 66–71.

Methods

This prospective population-based cohort study included all 98,551 individuals who in 2010 turned 65 years, lived in Sweden, and were in paid work at some point when aged 60–64. Data from three nationwide registers were used with 2010 as baseline, with SA or/and DP as the exposure variables (2005–2009) and paid work as the outcome variable (2011–2016). Logistic regression was conducted to calculate odds ratios (OR) with 95% confidence intervals (CI) for the association between exposures and outcome, controlling for sociodemographic factors. The analyses were also stratified by sex.

Results

Nearly half were in paid work during follow-up. Those with SA due to mental diagnoses had lower likelihood of being in paid work among both sexes (women OR: 0.76; 95% CI: 0.69–0.84; men 0.74; 0.65–0.84), while this association was smaller for SA due to somatic diagnoses (women 0.87; 0.84–0.91; men 0.92; 0.89–0.96). SA due to both mental and somatic diagnoses was associated with a lower likelihood of paid work for men (0.77; 0.65–0.91), but not women (0.98; 0.88–1.09). Regardless of diagnosis group and sex, DP had the strongest association with not being in paid work (women mental DP 0.39; 0.34–0.45; women somatic DP 0.38; 0.35–0.41; women mental and somatic DP 0.28; 0.15–0.56; men mental DP 0.36; 0.29–0.43; men somatic DP 0.35; 0.32–0.38; men mental and somatic DP 0.22; 0.10–0.51). Combined SA and/or DP demonstrated ORs in-between the diagnosis groups of SA and DP alone (e.g., mental SA and/or DP women and men combined 0.61; 0.57–0.65).

Conclusions

SA and DP were negatively associated with being in paid work after the standard retirement age of 65. The association was especially strong for DP, irrespective of diagnosis group. Moreover, compared to somatic diagnoses, SA due to mental diagnoses had a stronger association with not being in paid work. More knowledge is needed on how mental SA impedes extending working life.

Sickness absence among privately employed white-collar workers: A total population study in Sweden

Background: Knowledge about sickness absence (SA) and disability pension (DP) among privately employed white-collar workers is very limited. Aims: This study aimed to explore SA and DP among privately employed white-collar women and men using different measures of SA to investigate differences by branch of industry, and to analyse the association between sociodemographic factors and SA. Methods: This was a population-based study of all 1,283,516 (47% women) privately employed white-collar workers in Sweden in 2012, using register data linked at the individual level. Several different measures of SA and DP were used. Logistic regression was used to investigate associations of sociodemographic factors with SA. Results: More women than men had SA (10.9% women vs. 4.5% men) and DP (1.8% women vs. 0.6% men). While women had a higher risk of SA than men and had more SA days per employed person, they did not have more SA days per person with SA than men. The risk of SA was higher for women (odds ratio (OR)=2.54 (95% confidence interval (CI) 2.51–2.58)), older individuals (OR age 18–24 years=0.58 (95% CI 0.56–0.60); age 55–64 years OR=1.43 (95% CI 1.40–1.46) compared to age 45–54 years), living in medium-sized towns (OR=1.05 (95% CI 1.03–1.06)) or small towns/rural areas (OR=1.13 (95% CI 1.11–1.15)), with shorter education than college/university (OR compulsory only=1.64 (95% CI 1.59–1.69); OR high school=1.38 (95% CI 1.36–1.40)), born outside the EU25 (OR=1.23 (95% CI 1.20–1.27)) and singles with children at home (OR=1.33 (95% CI 1.30–1.36)). Conclusions: SA and DP among privately employed white-collar workers were lower than in the general population. SA prevalence, length and risk varied by branch of industry, sex and other sociodemographic factors, however, depending on the SA measure used.

The longitudinal integrated database for health insurance and labour market studies (LISA) and its use in medical research

Education, income, and occupation are factors known to affect health and disease. In this review we describe the Swedish Longitudinal Integrated Database for Health Insurance and Labour Market Studies (LISA, Longitudinell Integrationsdatabas för Sjukförsäkrings- och Arbetsmarknadsstudier). LISA covers the adult Swedish population aged ≥ 16 years registered on December 31 each year since 1990 (since 2010 individuals aged ≥ 15 years). The database was launched in response to rising levels of sick leave in the country. Participation in Swedish government-administered registers such as LISA is compulsory, and hence selection bias is minimized. The LISA database allows researchers to identify individuals who do not work because of injury, disease, or rehabilitation. It contains data on sick leave and disability pension based on calendar year. LISA also includes information on unemployment benefits, disposable income, social welfare payments, civil status, and migration. During 2000–2017, an average of 97,000 individuals immigrated to Sweden each year. This corresponds to about 1% of the Swedish population (10 million people in 2017). Data on occupation have a completeness of 95%. Income data consist primarily of income from employment, capital, and allowances, including parental allowance. In Sweden, work force participation is around 80% (2017: overall: 79.1%; men 80.3% and women 77.9%). Education data are available in > 98% of all individuals aged 25–64 years, with an estimated accuracy for highest attained level of education of 85%. Some information on civil status, income, education, and employment before 1990 can be obtained through the Population and Housing Census data (FoB, Folk- och bostadsräkningen).