title: Educational differences in sickness absence trends among young employees from 2002 to 2013 in Helsinki, Finland.
abstract: Socioeconomic differences in sickness absence (SA) are well established among older employees but poorly understood among the young. Our aim was to examine 12-year trends in educational differences in SA among young female and male employees, and to assess the magnitude of the differences.
  
  
  
  We examined annual SA spells. The data were obtained from the employer's registers and linked to Statistics Finland's register data on completed education and qualifications. Education was classified into four hierarchical groups. Joinpoint regression models were used to identify turning points in SA trends. The magnitude of the relative educational differences was estimated in accordance with the relative index of inequality for 2002, 2008 and 2013.
  
  
  
  Employees of the City of Helsinki, Finland, in 2002-2013.
  
  
  
  The analyses covered female and male employees aged 25-34 years: employees aged 35-54 years were used as a reference group.
  
  
  
  SA spells.
  
  
  
  An educational gradient emerged among younger and older women and men. SA spells increased in the early 2000s, and downward turning points were located in 2007-2010 in all educational groups among women and in most groups among men. The magnitude of the differences remained broadly stable among younger women from 2002 to 2013, and decreased slightly among older women and more strongly among younger and older men. The educational differences were greater among men than women in the early 2000s, but similar among both at the end of the study period.
  
  
  
  The changes in SA spells may reflect the economic downturn started in 2008 and resulting job insecurity. Early preventive measures aimed at reducing educational differences in SA should be focused at an early stage on those with low levels of education in particular.
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland.
authors.forename: Hilla
authors.initials: H
authors.lastname: Sumanen
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Lahelma
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland.
authors.forename: Jouni
authors.initials: J
authors.lastname: Lahti
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland.
authors.forename: Olli
authors.initials: O
authors.lastname: Pietiläinen
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland.
authors.forename: Ossi
authors.initials: O
authors.lastname: Rahkonen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D003430:Cross-Sectional Studies; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D017678:Sex Distribution; D018582:Sick Leave / Q000639:trends*; D012959:Socioeconomic Factors
keywords: Education; Sick Leave; Work disability; Young adults