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Psychosocial determinants of sickness absence

A longitudinal study of Finnish men and women

Ari Väänänen

Finnish Institute of Occupational Health 2005. 117 s. ISBN 951-802-610-6
Bogomtale fra forlaget.

It has often been proposed that work and family life offer many psychosocial health resources. These important spheres of life may also entail many psychosocial health risks that may differ according to gender, for instance, due to distinctive social obligations, work environments, and values. Sickness absence is an important indicator of employees’ health problems. The aim of this multisample study is to examine the longitudinal associations between psychosocial factors and medically certified sickness absence (> 3 days episodes) in men and women. It does not attempt to give an exhaustive account of all determinants of sickness absence, but rather aims to enlarging knowledge on specific determinants (job characteristics, sources of social support, social psychological organizational characteristics, work-family characteristics and reciprocity in intimate relationships) of sickness absence in employed men and women by using multifaceted theoretical approaches and hypotheses.
The study consists of two prospective private sector studies (N=3 850), one prospective public sector study (N=753) and one cross-sectional public sector study (N=6 442). The private sector population was composed of domestic personnel working for a multinational forest industry enterprise, while the public sector population was composed of municipal workers of eight Finnish towns. The participants’ responses to the questionnaires on psychosocial factors were combined with medical sickness absence data from the employers’ records. The sickness absence follow-ups varied from the 21 months to 9 years.
Women had somewhat weaker task-related and social characteristics at work, such as job autonomy and coworkers’ support, and men more often enjoyed a privileged position at work compared to women as regards role clarity and organizational climate in particular. Women had also more domestic responsibilities, and they experienced more work-family conflict. As an exception, women and men reported a similar level of intimate reciprocity in their close relationships, and women reported higher network support. The private sector study showed that, of the job characteristics, job autonomy strongly protected against subsequent sickness absence particularly among male employees. Of the sources of social support, strong supervisor’s support tended to lower women’s sickness absence rate, while coworkers’ support had a parallel effect among men in the private sector. In the public sector, supportiveness of the social network decreased the rate of sickness absence only among male employees. Of the organizational characteristics of the private sector, good role clarity strongly decreased the rate of sickness absence among white-collar male employees, while organizational climate was a predictor of blue-collar women’s sickness absence. In the public sector, negative spillover from work to family („work-family spillover“) was associated with an increased rate of sickness absence in both men and women, whereas negative spillover from family to work („family-work spillover“) was associated with an elevated risk of sickness absence only in women. Extensive total working hours (work + domestic hours) were associated with a higher sickness absence rate only among men. Giving more support than receiving in intimate relationships tended to decrease sickness absence among public sector female employees during a 9-year follow-up, but this effect was not observed among their male counterparts. Finally, the psychosocial factors did not mediate the gender difference in sickness absence. After all adjustments, women had about 25-30% more sickness absences than men.
Women’s greater exposure to potentially adverse psychosocial factors is rather consistent. However, the higher exposure level cannot explain the difference in sickness absence between men and women. Most importantly, this longitudinal study on the psychosocial determinants of sickness absence reveals that employed Finnish women and men are vulnerable to party different psychosocial characteristics in their work and domestic environment. The results point out the need to develop gender-sensitive psychosocial theories on employees’ health. The measures to reduce psychosocial risk factors should match the specific needs and realities of gendered groups of employees.