Sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income in native Swedes and immigrants

Eur J Public Health. 2015 Aug;25(4):688-92. doi: 10.1093/eurpub/cku250. Epub 2015 Jan 28.


Background: Sickness absence with cash benefits from the sickness insurance gives an opportunity to be relieved from work without losing financial security. There are, however, downsides to taking sickness absence. Periods of sickness absence, even short ones, can increase the risk for future spells of sickness absence and unemployment. The sickness period may in itself have a detrimental effect on health. The aim of the study was to investigate if there is an association between exposure to sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income from work.

Methods: Our cohort consisted of all immigrants aged 21-25 years in Sweden in 1993 (N = 38 207) and a control group of native Swedes in the same age group (N = 225 977). We measured exposure to sickness absence in 1993 with a follow-up period of 15 years. We conducted separate analyses for men and women, and for immigrants and native Swedes.

Results: Exposure to ≥60 days of sickness absence in 1993 increased the risk of sickness absence [hazard ratio (HR) 1.6-11.4], unemployment (HR 1.1-1.2), disability pension (HR 1.2-5.3) and death (HR 1.2-3.5). The income from work, during the follow-up period, among individuals with spells of sick leave for ≥60 days in 1993 was around two-thirds of that of the working population who did not take sick leave.

Conclusions: Individuals on sickness absence had an increased risk for work absence, death and lower future income.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Disabled Persons / statistics & numerical data*
  • Emigrants and Immigrants / statistics & numerical data*
  • Female
  • Health Status
  • Humans
  • Income / statistics & numerical data*
  • Male
  • Mortality
  • Pensions / statistics & numerical data*
  • Proportional Hazards Models
  • Risk Factors
  • Sick Leave / statistics & numerical data*
  • Sweden / epidemiology
  • Unemployment / statistics & numerical data*