title: Sickness absence and subsequent disposable income: A population-based cohort study.
abstract: OBJECTIVE
  Studies show a negative association between an absence from work due to disease of injury (sickness absence (SA)) and subsequent earnings; however, little is known about the association between SA and an individuals' subsequent overall economic welfare. Our primary objective was to evaluate individuals' disposable income (DI) following a spell of SA. Our secondary objective was to examine if the potential association between SA and DI differs, depending on the diagnosis given to that sickness or the duration of the SA spell.
  
  
  METHODS
  We used a cohort based on a linked individual register database that includes all individuals living in Sweden from 2001 to 2005, aged 30-54. DI was measured 2-6 years after a spell of SA and compared with a propensity score-matched reference group (individuals without SA in 2005). Each year of follow-up during 2007-2011 was estimated by linear regression for three different forms of exposure: SA (yes/no), diagnosis specific (cancer, circulatory, injuries, musculoskeletal or mental illnesses), and by duration of the SA spell (15-29, 30-89, 90-179 or > 179 days).
  
  
  RESULTS
  Individuals with SA during 2005 had 4% lower disposable income in subsequent years than the reference group. Our results were similar across diagnoses, except for mental diagnoses, where disposable income was 7-10% lower than the reference group; and for cancer, where we found only a marginal difference among those with SA and the reference group. Furthermore, DI was negatively associated with the SA spell duration.
  
  
  CONCLUSIONS
  SA was associated with lower subsequent DI, 2–6 years after a SA spell, especially after a mental illness diagnosis and if the SA was for longer spells.
authors: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden Department of Analysis and Prognosis, Swedish Social Insurance Agency, Stockholm, Sweden Michael.Wiberg@ki.se.
authors: Michael
authors: M
authors: Wiberg
authors: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
authors: Emilie
authors: E
authors: Friberg
authors: Department of Analysis and Prognosis, Swedish Social Insurance Agency, Stockholm, Sweden Uppsala Department of Economics and Center for Labor Studies, Uppsala, Sweden.
authors: Edward
authors: E
authors: Palmer
authors: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
authors: Magnus
authors: M
authors: Stenbeck
mesh_terms: D000041:Absenteeism; D000328:Adult; D015331:Cohort Studies; D003933:Diagnosis; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D008875:Middle Aged; D012042:Registries; D018582:Sick Leave / Q000706:statistics & numerical data*; D013548:Sweden; D013997:Time Factors
keywords: Cohort study; diagnosis; disposable income; healthy subjects; household income; illness; insurance; mental health; sick leave; sickness absences