Background: Previous studies show that sickness absence predicts health, but it is unclear whether this association is persistent over time and whether specific diseases underlie long-term associations. The aim of this study was to investigate overall and diagnosis-specific sickness absences as predictors of sustained sub-optimal health.
Methods: Prospective occupational cohort study of 15,320 employees (73% men) aged 37 to 51. Sickness absence records in 1990-1992, including 13 diagnostic categories, were examined in relation to self-rated health measured annually for the years 1993-2006.
Results: 3,385 employees (22%) had >30 days of sickness absence and 5,564 (36%) 1-30 days during the 3-year exposure window. Repeated-measures logistic regression analysis adjusted for age, sex, occupational status and chronic diseases show employees with >30 absence days, compared to those with no absences, had 2.14 (95% CI 2.00-2.29) times higher odds for suboptimal health over the 14 years of follow-up. Retirement did not dilute this association. 9 sickness absence diagnostic categories, such as diseases of the nervous, circulatory, metabolic, musculoskeletal, sensory and gastro-intestinal systems, cancer, mental disorders and external causes, independently predicted increased risk of sustained sub-optimal health.
Conclusions: There is a remarkably persistent association between sickness absence and future long-term self-rated health status for the majority of diagnostic categories for sickness absence. This suggests that the association between sickness absence and health is ubiquitous and not driven by a limited number of rare and severe diseases.
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