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


METHODS
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.


METHODS
Swedish population.


METHODS
Annual data for around 3500 employed and self employed persons.


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.
Wikman
Anders
A
Department for Work and Health, Swedish National Institute for Working Life, 113 91 Stockholm, Sweden. anders.wikman@ali.se
Marklund
Staffan
S
Alexanderson
Kristina
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011634:Public Health; D018582:Sick Leave / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology; D009626:Terminology as Topic