Contribution of compositional changes in the workforce to sickness absence trends in Finland

Abstract Background Information on factors driving work disability trends helps to evaluate the potential of interventions to improve the health and work ability of the workforce. We assessed whether the long-term decrease in sickness absences in Finland is explained by observed and unobserved compositional changes in the workforce. Methods Utilising register-based panel data on Finnish private and public sector employees aged 30-62, we examined the annual onset of compensated full sickness absence (granted after 10 working days) in the period 2005-2016. We applied random effects models adjusting for changes in observed sociodemographic factors of the study population. We also applied fixed effects models, with corrections of the estimates for cohort ageing, to additionally account for unobserved time-invariant characteristics of the study population over the years. Results Of the observed factors, increases in educational level partly explained the decreasing trend in sickness absences, and more so among women than men and among private than public sector employees. Changes in occupational class and industrial sector played little role in the public sector and only slightly further explained the sickness absence trend in the private sector. The decreasing trend in sickness absences appeared to be largely explained by unobserved time-invariant individual characteristics. Conclusions The decrease in sickness absences appeared to be more strongly influenced by compositional changes in factors that are established before fully entering the labour market - such as educational level as well as unmeasured individual characteristics that remain unchanged after childhood and early adulthood - than in the work environment or other factors contributing at working age. Attempts to improve the health and work ability of the workforce should not only rely on interventions directed at the working age population, but also on those carried out early during the life course. Key messages • Compositional changes in the workforce should be taken into account when assessing sickness absence trends. • Interventions aiming to improve the health and work ability of the workforce should be implemented already early in the life course and not only in working age.


Background:
The association between family-related life events (e.g., getting married or having children) and unsustainable working life in terms of unemployment, sickness absence and disability pension (SA/DP) are rarely studied from a life-course perspective although having public health importance.We investigated trajectories of unsustainable working life, and the associations between change in family-related life events and unsustainable working life trajectories by controlling for familial factors.Methods: This is a prospective cohort study of 37,867 Swedish twins aged between 20-40 years on 31st December 1994.Data on trajectories of annual unemployment, SA/DP, and a combined measure of unsustainable working life months was collected from the Swedish national registers.The trajectories over a 23-year period were analysed by groupbased trajectory modelling.Associations of change in familyrelated life events with trajectory groups in the whole sample were estimated by multinomial logistic regression and in discordant twin pairs (n = 4,647 pairs) with conditional models.

Results:
Most participants had no or low levels of unemployment, SA/ DP or combined unsustainable working life during 1994-2016.Individuals who were stably married or changed from being single living without children to married living with children had a decreased risk of unsustainable working life compared to individuals with stable family-related life events.The risk of unsustainable working life months over time was higher among individuals who changed from married to single status regardless of having children (range of HRs:1.31-4.44).

Conclusions:
Family-related life events such as maintaining the relationship or getting married and having children decreases the risk of unsustainable working life while divorce is a risk factor for unsustainable working life.From a public health perspective, actions to support family formation or life would consequently promote a sustainable working life.

Key messages:
Unsustainable working life was less likely among married and among those who changed from single living without children to married with children compared to those with stable family life events.Individuals who changed from being married to divorced status had an increased risk of unsustainable working life over time and therefore being potentially an important group for public health.
Abstract citation ID: ckac129.094Contribution of compositional changes in the workforce to sickness absence trends in Finland

Background:
Information on factors driving work disability trends helps to evaluate the potential of interventions to improve the health and work ability of the workforce.We assessed whether the long-term decrease in sickness absences in Finland is explained by observed and unobserved compositional changes in the workforce.

Methods:
Utilising register-based panel data on Finnish private and public sector employees aged 30-62, we examined the annual onset of compensated full sickness absence (granted after 10 working days) in the period 2005-2016.We applied random effects models adjusting for changes in observed sociodemographic factors of the study population.We also applied fixed effects models, with corrections of the estimates for cohort ageing, to additionally account for unobserved time-invariant characteristics of the study population over the years.

Results:
Of the observed factors, increases in educational level partly explained the decreasing trend in sickness absences, and more so among women than men and among private than public sector employees.

Results:
The 23 eligible studies from across the world evaluated diverse strategies addressing PE including tax and trade reforms, industrial disputes legislation, business registration, and use of incentives to stimulate permanent contracts.Also included were union strategies to reach precarious workers, the provision of social benefits, and youth apprenticeships.
15th European Public Health Conference 2022 Changes in occupational class and industrial sector played little role in the public sector and only slightly further explained the sickness absence trend in the private sector.The decreasing trend in sickness absences appeared to be largely explained by unobserved time-invariant individual characteristics.Conclusions:The decrease in sickness absences appeared to be more strongly influenced by compositional changes in factors that are established before fully entering the labour market -such as educational level as well as unmeasured individual characteristics that remain unchanged after childhood and early adulthood -than in the work environment or other factors contributing at working age.Attempts to improve the health and work ability of the workforce should not only rely on interventions directed at the working age population, but also on those carried out early during the life course.Our systematic review followed the 2020 PRISMA framework and covered PubMed, Scopus, Web of Science, and sources of grey literature.We included qualitative, quantitative, or mixed-methods studies evaluating initiatives to reduce workers' PE published from 2000 to 2021 and focused on adult workers.
(N = 47,425).ESENER is a representative company survey, conducted on behalf of the European Agency for Safety and Health at Work (EU-OSHA).The outcome of interest is information on the existence of a procedure to support employees' RTW after a long sickness absence.The analysis is carried out using logistic models, comparing countries and welfare state regimes.