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Local economy and sickness absence: prospective cohort study
  1. Marianna Virtanen1,
  2. Mika Kivimäki1,2,
  3. Marko Elovainio3,
  4. Pekka Virtanen4,
  5. Jussi Vahtera1
  1. 1Finnish Institute of Occupational Health, Helsinki, Finland
  2. 2University of Helsinki, Department of Psychology, Helsinki, Finland
  3. 3National Research and Development Centre for Welfare and Health, Helsinki, Finland
  4. 4School of Public Health, University of Tampere, and Pirkanmaa Hospital District, Tampere, Finland
  1. Correspondence to:
 Dr M Virtanen
 Finnish Institute of Occupational Health, Department of Psychology, Topeliuksenkatu 41 aA, FIN-00250 Helsinki, Finland;


Study objective: To investigate the effect of the local economy, as measured by municipal revenue and local unemployment rate, on sickness absence among the employed.

Design: A prospective cohort study of 60 160 public sector employees (46 081 women, 14 079 men) with ecological measures of municipal revenue and local unemployment rate 1999–2000 and individual measures of sickness absence at baseline 1999 and at follow up 2000–2001.

Results: Among men and women, constantly poor local economy, as shown by low municipal revenue and high unemployment rate, was related to decreased self certified sickness absence rates. Local unemployment rate was a stronger predictor of self certified sickness absence than municipal revenue and the effect was stronger among men than among women. High unemployment rate predicted increased medically certified sickness absence among women.

Conclusions: Working in areas of poor local economy is associated with increased long term sickness absence but decreased probability to take a short term sick leave. Unemployment rate may have an effect on the threshold to take a sick leave in relation to minor illnesses even when area deprivation poses health risk to its residents. To prevent adverse health effects of presenteeism, working while ill, and to reduce medically certified sickness absence, potential benefits may be attained by improving economic conditions and re-employment in deprived areas.

  • community
  • health
  • job insecurity
  • sickness absence
  • unemployment
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  • Funding: MK, MV, and JV were supported by the Academy of Finland (projects 104891, 105195 and 77560) and the Finnish Environment Fund.

  • Conflict of interest: none declared.

  • Ethics approval: approval of the ethics committee of the Finnish Institute of Occupational Health was obtained for this study.

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