Staffan Marklund

Predicting Perceived Employability: Human Capital or Labour Market Opportunities?

Employability is believed to be a crucial concept concerning employees’ job security. This study investigates whether factors associated with human capital and the dual labour market predict perceived employability. Two national representative Swedish samples are used, representing economic recession (1993, N ¼ 4952) and prosperity (1999, N ¼ 6696). Employability was perceived as higher during prosperity, but human capital factors as well as dual labour market factors predicted perceived employability, irrespective of the time period. These findings indicate that the understanding of employability is enhanced by considering both structural and individual dimensions.

The relationship between perceived employability and subsequent health

Abstract Being capable of getting new employment may enable an employee to cope with turbulent situations or deteriorating job conditions. Individuals who have higher perceived employability are likely to appraise a situation at work more favourably, and consequently experience better health and well-being. The aim of the present study was to investigate the relationship between perceived employability and subsequent health, while controlling for baseline health, background factors, and work environment exposures. The study is based on 53 items in the National Working Life Cohort in Sweden from two data collections (2004 and 2005), comprising 1918 individuals. Forced entry hierarchical regression analysis showed that, after controlling for demographics, psychological demands, control, and ergonomic exposures, perceived employability was positively associated with global health and mental well-being, but unrelated to physical complaints. When baseline health status was added, perceived employability was still a significant predictor of two out of three outcome variables. Individuals with higher perceived employability had a tendency to report better health and well-being a year later. It is concluded that how an employee perceives his or her possibilities in regard to acquiring new employment is relevant for well-being at a later stage. Perceived employability, which has been little studied before, is therefore a useful concept in health promotion, both at the individual and at the organizational level.

Illness, disease, and sickness absence: an empirical test of differences between concepts of ill health

Objectives: In studies of public health and morbidity different concepts of ill health are often seen as interchangeable alternatives. With the help of extensive population information this research intends to show how different concepts and measurements produce very different pictures of health and ill health. The concept trilogy of “illness,” “disease,” and “sickness” is used to capture different aspects of ill health. Design: Cross sectional data were obtained through comprehensive interview surveys 1988–2001 and registers of sickness absence. Because of lack of data some years had to be excluded. Settings: Swedish population. Participants: Annual data for around 3500 employed and self employed persons. Main results: Most people have some sort of illness or complaint. Fewer could be registered with a disease. Even fewer had been on sick leave. The overlap was fairly low. There also was an obvious discrepancy between reporting having a disease and a subject’s rating of general health. It was shown that the different concepts showed different trends over time. Conclusions: The discrepancies between the concepts imply that you have to be very careful when using public health data to illustrate different aspects of morbidity. The comparatively low degree of overlap between them shows that they represent different realities. There is a need to do further empirical research about how different aspects of morbidity are interrelated. Their lack of interrelation seems to be an important research area worth developing further.

Consequences of sickness presence and sickness absence on health and work ability: A Swedish prospective cohort study

ObjectiveTo determine whether self-reported sickness presence (SP) and self-reported sickness absence (SA) are specific risk factors for future health problems or reduced work ability in the active workforce.Materials and MethodsThe study population consisted of a cohort based on a random sample (n = 2181) with data for 2004, 2005, and 2006. The subjects were employees aged from 25 to 50 years in 2004. Cross-tabulations were calculated to identify significant background factors (sex, age, education, socioeconomic position), work factors (work demands, control, adjustment latitude), and outcome factors. Block-wise multiple logistic regression analyses were performed for outcome factors (SP, SA, self-rated health, physical complaints, work ability, mental well-being).ResultsSA and SP were found to have negative health consequences; this was particularly pronounced for those with frequent SP or SA. There was a dose-response relationship between the degree of SA, SP and the different health outcomes. The health risks remained, after control for background factors, prior working conditions and initial health. SP also appeared to lead to SA, whereas SA did not have a significant impact on future SP.ConclusionsThe results suggest that both SP and SA are strong predictors of future poor health, physical complaints, low mental well-being and low work ability. The detrimental influence of frequent SP was most pronounced in relation to work ability and physical complaints, although all of the measured health factors were affected. The negative effects of SA on the different health outcomes were similar.

Work-family interference and long-term sickness absence: a longitudinal cohort study.

BACKGROUND Alongside work environment factors, interference between work and domestic life has been proposed as an important explanation for long-term sickness absence, particularly for women. The aim was to investigate the association between work-to-family interference, family-to-work interference and long-term sickness absence among women and men in different family- and work-related settings. METHODS The study population was a random sample of 2867 gainfully employed adults in Sweden aged 25-50. In 2004, telephone interview data were collected that included questions about family, work and health. The outcome measure was having at least one spell of long-term sickness absence (>14 days) in 2005 based on social insurance register data. Associations were analysed by logistic regression. RESULTS Work-to-family interference was more common than family-to-work interference and more often reported by women. The overall associations with long-term sickness absence were weak. However, after adjustment for age and self-reported health, work-to-family interference was associated with long-term sick leave among men with higher socioeconomic status (odds ratio 2.87; 95% CI 1.36-6.07), and there was also a tendency to association among women bearing the main responsibility for housework and family (1.59; 0.99-2.54). CONCLUSIONS These findings suggest that work-to-family interference is associated with long-term sickness absence in the working population, but in a gender- and situation-specific manner. Hence, extensive work responsibilities for men, and probably extensive family responsibilities for women, could hamper the balance between work and family and increase the risk of long-term sick leave. Further studies are warranted within this area.

Work status, work hours and health in women with and without children

Objectives: The authors studied self-reported health in women with and without children in relation to their work status (employed, student, job seeker or homemaker), work hours and having an employed partner. Methods: The study group comprised of 6515 women born in 1960–1979 who were interviewed in one of the Swedish Surveys of Living Conditions in 1994–2003. Self-rated health, fatigue and symptoms of anxiety were analysed. Results: Having children increased the odds of poor self-rated health and fatigue in employed women, female students and job seekers. The presence of a working partner marginally buffered the effects. In dual-earner couples, mothers reported anxiety symptoms less often than women without children. Few women were homemakers (5.8%). The odds of poor self-rated health and fatigue increased with increasing number of children in employed women, and in women working 40 h or more. Poor self-rated health was also associated with the number of children in students. Many mothers wished to reduce their working hours, suggesting time stress was a factor in their impaired health. The associations between having children and health symptoms were not exclusively attributed to having young children. Conclusions: Having children may contribute to fatigue and poor self-rated health particularly in women working 40 h or more per week. Student mothers and job seeking mothers were also at increased risk of poor self-rated health. The results should be noted by Swedish policy-makers. Also countries aiming for economic and gender equality should consider factors that may facilitate successful merging of work and family life.

Self-Reported Health in Mothers: The Impact of Age, and Socioeconomic Conditions

ABSTRACT The aim of the present analysis was to study health and well-being in mothers compared to women without children, and to analyze potential interactions with age and socioeconomic conditions. The study comprised 5,368 Swedish women born in 1960–1979 who were interviewed in any of the population-based Surveys of Living Conditions during the period 1996–2003. Having children at home was related to self-reported health symptoms and long-standing illness in multiple logistic regression models. The impact of age, cohabitation status, full-time or part-time work, and income level were analyzed. While mothers were less burdened by long-standing illness, partly due to selection mechanisms (a “healthy mother effect”), they experienced worse self-rated health and more fatigue than women without children, and the odds of poor self-rated health and fatigue increased by number of children. Conditions that strengthened the association between motherhood and impaired health were young maternal age, fulltime employment, high income, and being alone. The study indicates a need for improved negotiations between parents regarding a fair share of work and family duties and extended support for lone mothers to prevent adverse health effects in women combining children and work. The results may be useful to policy-makers and employers in developing new policies.

Long-term sickness absence: changes in risk factors and the population at risk

OBJECTIVES To investigate changes over time in factors associated with long-term sickness absence (LTSA) and in the fraction of LTSA attributable to these risk factors in 1986-1989 and 2002, respectively. MATERIALS AND METHODS Data from two earlier Swedish studies respectively comprising 1622 and 2009 employees with a history of LTSA (> or = 60 days), and 1019 and 1903 employed members of the general labour force as controls (ages 20-64 years) was used. The studies were conducted before and after extensive changes in the Swedish labour market during the 1990s, and they used sickness absence data from national social insurance records and self-reported information on sociodemographic, lifestyle, and work characteristics. Associations between these factors and LTSA were estimated by logistic regression, and population attributable fractions were calculated. RESULTS The results indicate that, after the 1990s, LTSA was associated with female sex (odds ratio = 1.84, 95% CI: 1.57-2.15) and was also more strongly associated with various aspects of the psychosocial work environment and job situations. A larger population at risk, primarily an ageing workforce, account for a large proportion of LTSA. CONCLUSIONS The results confirm consistent associations between LTSA and several established risk factors, and they also reveal a change in the risk panorama. The current findings demonstrate that, to understand the magnitude of LTSA, both risk factors and the population at risk must be monitored over time. Prevention should aim to create healthy workplaces in general and also focus on female-dominated public sector occupations.

Positive and negative reasons for sickness presenteeism in Norway and Sweden: a cross-sectional survey

Objectives This article investigates various reasons for sickness presenteeism (SP), that is, going to work despite illness. The research questions asked is: What are the main reported reasons for SP in Norway and Sweden? Design Cross-sectional survey in Norway and Sweden. Use of binomial logistic regression analysis. Participants A random sample of people aged between 20 and 60 years was obtained from complete and updated databases of the Norwegian and Swedish populations. A postal questionnaire was sent to the selected individuals, with response rate 33% (n=2843). 2533 workers responded to questions about SP during the last 12 months. Primary and secondary outcome measures The article informs about the distribution of reasons for SP in Norway and Sweden, selected by the respondents from a closed list. The article also examines which factors influence the most often reported reasons for SP. Results 56% of the Norwegian and Swedish respondents experienced SP in the previous year. The most frequently reported reasons for SP include not burden colleagues (43%), enjoy work (37%) and feeling indispensable (35%). A lower proportion of Norwegians state that they cannot afford taking sick leave adjusted OR (aOR 0.16 (95% CI 0.10 to 0.22)), while a higher proportion of Norwegians refer to that they enjoy their work (aOR=1.64 (95% CI 1.28 to 2.09)). Women and young workers more often report that they do not want to burden their colleagues. Managers (aOR=2.19 (95% CI 1.67 to 2.86)), highly educated persons and the self-employed more often report that they are indispensable. Conclusions Positive and negative reasons for SP are reported, and there are significant differences between respondents from the two countries. The response rate is low and results must be interpreted with caution. Study design Cross-sectional study.

Medically certified sickness absence with insurance benefits in women with and without children

Background: Sickness absence in Sweden is high, particularly in young women and the reasons are unclear. Many Swedish women combine parenthood and work and are facing demands that may contribute to impaired health and well-being. We compared mothers and women without children under different conditions, assuming increased sickness absence in mothers, due to time-based stress and psychological strain. Methods: All women born in 1960–79 (1.2 million) were followed from 1993 to 2003. Information on children in the home for each year was related to medically certified sickness absence with insurance benefits the year after. We used age and time-stratified proportional hazard regression models accounting for the individuals changes on study variables over time. Data were retrieved from national administrative registers. Results: Sickness absence was higher in mothers than in women without children, the relative risks decreased by age, with no effect after the age of 35 years. An effect appeared in lonely women irrespective of age, while in cohabiting women only for the ages 20–25 years. Mothers showed increased sickness absence in all subgroups of country of birth, education, income, sector of employment and place of residence. The relation between number of children and sickness absence was nonlinear, with the highest relative risks for mothers of one child. The upward trend of sickness absence at the end of 1990s was steeper for mothers compared to women without children. Conclusion: Despite the well-developed social security system and child care services in Sweden, parenthood predicts increased sickness absence, particularly in young and in lone women.