Changes in Economic Difficulties and Subsequent Sickness Absence: A Prospective Register-Linkage Study
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OBJECTIVES: People's economic difficulties are associated with their health, but consequences of changes in economic difficulties are less understood. We aimed to examine the associations between changes in economic difficulties and subsequent sickness absence while considering socioeconomic circumstances and other covariates. DESIGN: A prospective cohort study. SETTING: Helsinki, Finland. PARTICIPANTS: Municipal employees of the City of Helsinki, Finland (n=3859), who were respondents to the baseline (2000-2002) and follow-up (2007) questionnaire surveys and had register-based follow-up data on sickness absence until the end of 2010. PRIMARY AND SECONDARY OUTCOME MEASURES: Self-certified short (1-3 days) and medically certified intermediate (4-14 days) and long (15+ days) sickness absence spells were examined using employer's personnel register data. RESULTS: Persistent frequent economic difficulties predicted short (rate ratios (RR) 1.66 95% CI 1.49 to 1.86), intermediate (RR 2.13 95% CI 1.85 to 2.45) and long (RR 2.18 95% CI 1.75 to 2.70) sickness absence spells. Increasing economic difficulties similarly predicted sickness absence spells. The risks were somewhat stronger the longer the absence, and remained although attenuated somewhat after full adjustment. Weak risks were found also for persistent occasional economic difficulties and decreasing economic difficulties, and they attenuated further after full adjustments. CONCLUSIONS: Changes in economic difficulties predict subsequent sickness absence even after considering income, baseline health and other covariates. Thus economic difficulties should be considered when addressing causes of sickness absence.
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From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [117]
Persistent economic difficulties predict increased sickness absence.
“Persistent economic difficulties predict increased sickness absence, highlighting the broad impact of financial stress on health [117,118].”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [117]
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Cites
SF-36 health survey: Manual and interpretation guide
Ware, J. (2003) · Medical Entomology and Zoology · Cited by 11,424 · see citing works
Pearlin, L. I., & Schooler, C. (1978) · Journal of Health and Social Behavior · doi:10.2307/2136319 · Cited by 7,791 · cited 1× · see citing works
“Economic difficulties and their changes over time Economic difficulties were measured using two identical questions repeated at baseline and follow-up.(7) The questions asked, first about the frequency of difficulties in”
MethodPearlin, L. I., & Schooler, C. (1978) · PubMed · Cited by 6,764 · see citing works
Ware, J. E. (2000) · Spine · doi:10.1097/00007632-200012150-00008 · Cited by 4,455 · see citing works
Poverty Statistics in the Late 1980s: Research Based on Micro-data
Hagenaars, A., de Vos, K., & Zaidi, M. A. (1994) · Medical Entomology and Zoology · Cited by 664 · see citing works
Financial Strain over the Life Course and Health among Older Adults
Kahn, J. R., & Pearlin, L. I. (2006) · Journal of Health and Social Behavior · doi:10.1177/002214650604700102 · Cited by 630 · see citing works
Ferrie, J. E., Shipley, M. J., Stansfeld, S. A., & Marmot, M. G. (2002) · Journal of Epidemiology & Community Health · doi:10.1136/jech.56.6.450 · Cited by 531 · see citing works
Over the limit: the association among health, race and debt
Drentea, P., & Lavrakas, P. J. (2000) · Social Science & Medicine · doi:10.1016/s0277-9536(99)00298-1 · Cited by 392 · see citing works
Finnish health and social welfare registers in epidemiological research
Haukka, J. K. (2009) · Norsk Epidemiologi · doi:10.5324/nje.v14i1.284 · Cited by 318 · see citing works
Sickness Absence: An International Comparison
Barmby, T., Ercolani, M. G., & Treble, J. G. (2002) · The Economic Journal · doi:10.1111/1468-0297.00046 · Cited by 248 · see citing works
Laaksonen, M., Rahkonen, O., Martikainen, P., & Lahelma, E. T. (2005) · American Journal of Public Health · doi:10.2105/ajph.2004.047969 · Cited by 206 · see citing works
Self-citationCohort Profile: The Helsinki Health Study
Lahelma, E. T., Aittomäki, A., Laaksonen, M., Lallukka, T. M., Martikainen, P., Piha, K., Rahkonen, O., & Saastamoinen, P. (2012) · International Journal of Epidemiology · doi:10.1093/ije/dys039 · Cited by 172 · see citing works
Self-citationAlcohol Intake and Sickness Absence: A Curvilinear Relation
Vahtera, J. (2002) · American Journal of Epidemiology · doi:10.1093/aje/kwf138 · Cited by 161 · see citing works
Laaksonen, E., Martikainen, P., Lahelma, E., Lallukka, T., Rahkonen, O., Head, J., & Marmot, M. (2007) · International Journal of Epidemiology · doi:10.1093/ije/dym074 · Cited by 161 · see citing works
Self-citationBioactive foods in promoting health: fruits and vegetables.
WATSON, R. R., & Preedy, V. R. (2009) · Elsevier eBooks · doi:10.1016/c2009-0-01836-4 · Cited by 144 · see citing works
Financial strain is a significant correlate of sleep continuity disturbances in late-life
Hall, M. H., Buysse, D. J., Nofzinger, E. A., Reynolds, C. F., Thompson, W. K., Mazumdar, S., & Monk, T. H. (2007) · Biological Psychology · doi:10.1016/j.biopsycho.2007.10.012 · Cited by 141 · see citing works
Interrelationships between education, occupational class, income and sickness absence
Piha, K., Laaksonen, M., Martikainen, P., et al. (2009) · European Journal of Public Health · doi:10.1093/eurpub/ckp162 · Cited by 114 · see citing works
Christensen, K. B., Labriola, M., Lund, T., et al. (2008) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2006.056135 · Cited by 100 · see citing works
Health-related behaviours and sickness absence from work
Laaksonen, M., Piha, K., Martikainen, P., Rahkonen, O., & Lahelma, E. T. (2009) · Occupational and Environmental Medicine · doi:10.1136/oem.2008.039248 · Cited by 99 · see citing works
Self-citationSacker, A., Bartley, M., Firth, D., & Fitzpatrick, R. M. (2001) · Social Science & Medicine · doi:10.1016/s0277-9536(00)00176-3 · Cited by 99 · see citing works
Diagnosis-specific sickness absence and all-cause mortality in the GAZEL study
Ferrie, J. E., Vahtera, J., Kivimäki, M., et al. (2008) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2008.074369 · Cited by 99 · see citing works
Mika Kivimaki, B., Vahtera, J., Elovainio, M. J., Lillrank, B., & Kevin, M. V. (2002) · Psychosomatic Medicine · doi:10.1097/01.psy.0000031576.42041.b1 · Cited by 97 · see citing works
Self-reported economic difficulties and coronary events in men: evidence from the Whitehall II study
Ferrie, J. E., Martikainen, P., Shipley, M. J., & Marmot, M. G. (2005) · International Journal of Epidemiology · doi:10.1093/ije/dyi063 · Cited by 91 · see citing works
Kristensen, T. R., Jensen, S. M., Kreiner, S., & Mikkelsen, S. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-643 · Cited by 79 · see citing works
The healthy worker effect. Selection of workers and work forces.
Wilcosky, T. C., & Wing, S. (1987) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.2078 · Cited by 76 · see citing works
Drinking habits and sickness absence: The contribution of working conditions
Salonsalmi, A., Laaksonen, M., Lahelma, E. T., & Rahkonen, O. (2009) · Scandinavian Journal of Public Health · doi:10.1177/1403494809350519 · Cited by 69 · see citing works
Self-citationMultiple Dimensions of Socioeconomic Position and Obesity among Employees: The Helsinki Health Study
Laaksonen, M., Sarlio‐Lähteenkorva, S., & Lahelma, E. T. (2004) · Obesity Research · doi:10.1038/oby.2004.230 · Cited by 64 · see citing works
Self-citationVahtera, J., Westerlund, H., Ferrie, J. E., Head, J. A., Melchior, M., Singh‐Manoux, A., Zins, M., Goldberg, M., Alexanderson, K. A. E., & Mika Kivimaki, B. (2009) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2008.083923 · Cited by 59 · see citing works
Laaksonen, E., Martikainen, P., Lallukka, T., Lahelma, E., Ferrie, J., Rahkonen, O., Marmot, M., & Head, J. (2009) · Journal of Epidemiology and Community Health · doi:10.1136/jech.2008.077198 · Cited by 56 · see citing works
Self-citationVäänänen, A., Kouvonen, A. M., Mika Kivimaki, B., Oksanen, T., Elovainio, M. J., Virtanen, M., Pentti, J., & Vahtera, J. (2009) · Occupational and Environmental Medicine · doi:10.1136/oem.2008.042044 · Cited by 51 · see citing works
The contribution of lone parenthood and economic difficulties to smoking
Rahkonen, O., Laaksonen, M., & Karvonen, S. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2004.11.044 · Cited by 51 · see citing works
Self-citationAittomäki, A., Martikainen, P., Laaksonen, M., Lahelma, E. T., & Rahkonen, O. (2012) · Social Science & Medicine · doi:10.1016/j.socscimed.2012.05.015 · Cited by 49 · see citing works
Self-citationLallukka, T. M., Ferrie, J. E., Mika Kivimaki, B., Shipley, M. J., Rahkonen, O., & Lahelma, E. T. (2012) · Sleep Medicine · doi:10.1016/j.sleep.2011.10.036 · Cited by 49 · see citing works
Self-citationLahelma, E. T., Laaksonen, M., & Aittomäki, A. (2008) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-008-0320-6 · Cited by 46 · see citing works
Self-citationLaaksonen, M., Kääriä, S.-M., Leino‐Arjas, P., et al. (2010) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.3131 · Cited by 41 · see citing works
Trends in socioeconomic differences in sickness absence among Finnish municipal employees 1990—99
Piha, K., Martikainen, P., Rahkonen, O., et al. (2007) · Scandinavian Journal of Public Health · doi:10.1080/14034940601160706 · Cited by 40 · see citing works
Self-citationLaaksonen, E., Lallukka, T., Lahelma, E., Ferrie, J., Rahkonen, O., Head, J., Marmot, M., & Martikainen, P. (2011) · European Journal of Public Health · doi:10.1093/eurpub/ckq089 · Cited by 37 · see citing works
Self-citationLallukka, T. M., Arber, S., Rahkonen, O., & Lahelma, E. T. (2010) · Sleep Medicine · doi:10.1016/j.sleep.2010.04.011 · Cited by 37 · see citing works
Self-citationRelative Weight and Sickness Absence
Laaksonen, M., Piha, K., & Sarlio‐Lähteenkorva, S. (2007) · Obesity · doi:10.1038/oby.2007.570 · Cited by 31 · see citing works
The Effect of Occupational and Workplace Gender Composition on Sickness Absence
Laaksonen, M., Martikainen, P., Rahkonen, O., et al. (2012) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e318241ed42 · Cited by 30 · see citing works
Self-citationЛааксонен, Э., Martikainen, P., Head, J. A., et al. (2008) · European Journal of Public Health · doi:10.1093/eurpub/ckn123 · Cited by 28 · see citing works
Past and present socioeconomic circumstances and psychotropic medication: a register-linkage study
Mauramo, E., Lallukka, T. M., Laaksonen, M., Martikainen, P., Rahkonen, O., & Lahelma, E. T. (2012) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2011-200036 · Cited by 20 · see citing works
Self-citationLallukka, T. M., Laaksonen, M., & Rahkonen, O. (2009) · Elsevier eBooks · doi:10.1016/b978-0-12-374628-3.00007-4 · Cited by 7 · see citing works
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Cohen, S., Gianaros, P. J., & Manuck, S. B. (2016) · Perspectives on Psychological Science · doi:10.1177/1745691616646305 · Cited by 549 · see citing works
Shchaslyvyi, A. Y., Antonenko, S. V., & Telegeev, G. D. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21081077 · Cited by 73 · see citing works
- Authors
- Lallukka, T., Lahelma, E., & Rahkonen, O.
- Affiliations
- University of Helsinki (FI)
- Corresponding author
- Lallukka, Tea
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2013
- Volume
- 3
- Issue
- 1
- Pages
- e002212
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC3549204
- OpenAlex
- W1988785702
- Cited by
- 11
- References
- 43
- Citations by year
- 2024: 1 · 2020: 1 · 2019: 1 · 2017: 1 · 2016: 1 · 2015: 3 · 2014: 1 · 2013: 2
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Työväentutkimus Vuosikirja (submittedVersion)
- Funders
- Academy of Finland (1129225, 1257362, 1135630)
- Topics
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- economic problems, sick leave, socioeconomic conditions, municipal employees, income, health disparities, short-term sickness absence, long-term sickness absence
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