Sickness absence and disability pension in white-collar workers in the trade and retail industry

Abstract Background Very little is known about sickness absence among white-collars workers in the trade and retail industry, despite being a large and important group on the labour market. The aim was to investigate future sickness absence (SA) and disability pension (DP) in a cohort of privately employed white-collar employees in the trade and retail industry. Methods A prospective population-based cohort study of all 192,077 such white-collar workers (44% women) in Sweden in 2012, using linked microdata from three nationwide registers covering 2012-2016. Prevalence and mean number of SA and/or DP net days/year in general and by diagnoses categories were calculated for all and also stratified by sex. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) between sociodemographic and work-related factors and future SA/DP. Results The proportion who had SA and/or DP was higher in women (10-13%, depending on year) than men (4-6%) each year. Each studied year, women had more mean SA/DP net days than men in the entire cohort, however, among those who had SA and/or DP, there were no gender differences regarding the mean number of net days. The mean number of SA/DP net days increased for both women and men each year, especially SA due to mental diagnoses. SA in 2012 was the strongest factor associated with SA/DP in 2016 (OR women 3.28, 95% CI 3.09-3.47; men 4.10, 95% CI 3.76-4.48). Work-related factors were only weakly or insignificantly associated with future SA/DP. The ORs for most factors were stronger for men than for women. Conclusions More knowledge about the mechanisms behind these results are needed. Some SA/DP measures showed large sex-differences, others not - it is important to use different measures to show the complexity of these phenomena. Several factors were more strongly associated with SA/DP among men than among women, indicating that there are other factors of importance for women. Key messages Most white-collar workers in the trade and retail industry had no SA/DP in any of the six studied years. SA due to mental diagnoses was the largest and fastest-growing SA/DP diagnostic group. Sickness absence in 2012, female sex, and low education were associated with future SA/DP. Most other sociodemographic and job-related factors were not, or only weakly, associated with future SA/DP.


Background:
Very little is known about sickness absence among whitecollars workers in the trade and retail industry, despite being a large and important group on the labour market. The aim was to investigate future sickness absence (SA) and disability pension (DP) in a cohort of privately employed white-collar employees in the trade and retail industry.

Methods:
A prospective population-based cohort study of all 192,077 such white-collar workers (44% women) in Sweden in 2012, using linked microdata from three nationwide registers covering 2012-2016. Prevalence and mean number of SA and/or DP net days/year in general and by diagnoses categories were calculated for all and also stratified by sex. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) between sociodemographic and work-related factors and future SA/DP.

Results:
The proportion who had SA and/or DP was higher in women (10-13%, depending on year) than men (4-6%) each year. Each studied year, women had more mean SA/DP net days than men in the entire cohort, however, among those who had SA and/or DP, there were no gender differences regarding the mean number of net days. The mean number of SA/DP net days increased for both women and men each year, especially SA due to mental diagnoses. SA in 2012 was the strongest factor associated with SA/DP in 2016 (OR women 3.28, 95% CI 3.09-3.47; men 4.10, 95% CI 3.76-4.48). Work-related factors were only weakly or insignificantly associated with future SA/DP. The ORs for most factors were stronger for men than for women.

Conclusions:
More knowledge about the mechanisms behind these results are needed. Some SA/DP measures showed large sexdifferences, others not -it is important to use different measures to show the complexity of these phenomena. Several factors were more strongly associated with SA/DP among men than among women, indicating that there are other factors of importance for women. Key messages: Most white-collar workers in the trade and retail industry had no SA/DP in any of the six studied years. SA due to mental diagnoses was the largest and fastest-growing SA/DP diagnostic group. Sickness absence in 2012, female sex, and low education were associated with future SA/DP. Most other sociodemographic and job-related factors were not, or only weakly, associated with future SA/DP.

Background:
Precarious and non-standard employment (NSE) has negative implications for workers' health. As part of a six-country comparative mixed methods case study, this research explores US-based workers' experiences in NSE and its influences on their health and well-being in a context of weak labor regulations and social welfare programs.

Methods:
To understand US policy context, we analyzed country-level labor regulatory and social protection frameworks using 2019 Organization for Economic Cooperation and Development data. To understand workers' experiences, we conducted indepth interviews with NSE workers in various occupations in New York City (N = 40) between January and May 2021. We recruited and screened eligibility via Facebook advertisements and an online questionnaire, respectively. We used deductive and inductive thematic analysis for interview data.

Results:
With heavy reliance on market competition in the US, minimal state regulation and flexible labor markets create less secure employment along with limited government-funded social supports. Workers' experiences center on the Hustle, i.e., figuring out how to make NSE work for them and their families. They lack healthcare coverage and have low expectations of other supportive employment and social protections (e.g., paid leave). While NSE payoffs (e.g., perceived flexibility) were common for most, almost all experience NSE tradeoffs (e.g., job insecurity and instability) that create stress and overwork, negatively implicating overall health and well-being. These impacts differ by access to resources associated with social location (e.g., immigration status). COVID-19 exacerbated these experiences.

Discussion:
Low expectations of supportive policies of US workers in NSE are linked to the individualized hustle, as they attempt to counter NSE tradeoffs often relying on family to fill those gaps. Over-reliance on privatization for social supports such as healthcare coverage can be detrimental to workers' health. Key messages: US workers in NSE experience stress and overwork with low expectations of support from the state. We caution against increasingly market-based policies in Europe, which may jeopardize public health.