Socioeconomic and sex differentials in reason for sickness absence from the Whitehall II study
Socioeconomic and sex differentials in reason for sickness absence from the Whitehall II study
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DOI：
10.1136/oem.55.2.91
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发表时间：
1998-02-01
影响因子：
4.9
通讯作者：
Marmot, M
中科院分区：
文献类型：
--
作者：
Feeney, A;North, F;Marmot, M
目的：在疾病和死亡率方面存在很大的社会经济差异。本文描述了白厅II研究中按就业级别划分的特定病假原因的分布，并通过与全科医生记录的比较来验证医疗原因。方法-分析5620名年龄在35-55岁的男性和女性公务员的病假数据。数据来自参与白厅II研究的20个伦敦公务员部门中的12个，这些部门有缺勤的医疗原因。结果：呼吸系统疾病和胃肠炎占所有缺勤时间的一半以上，头痛偏头痛、肌肉骨骼疾病、损伤和神经症占缺勤原因的20%-30%。与就业级别呈负相关，级别越低，短期(小于或等于7天)和长期(7天)的缺勤率越高。总的来说，女性的缺勤率高于男性。对长期缺勤原因(21天)的比较表明，公务员和全科医生之间的一致性不高。结论--缺乏关于病假和缺勤医疗原因的国家综合数据，特别是妇女缺勤和缺勤时间不同的数据。来自白厅II研究的数据显示，缺勤医疗原因的分布存在很大的就业级别和性别差异，这与其他研究中记录的发病率的社会经济差异类似。可能的解释包括疾病和疾病的主观性质；工作/家庭接口；以及缺勤文化的影响。较长期的后续行动将提供有关病假是否与严重发病率和死亡率有关的信息。
Objectives-Large socioeconomic differences exist in disease and mortality. This paper describes the distribution of specific medical reasons for sickness absence by grade of employment in the Whitehall II study and validates the medical reason by comparison with general practitioners' records.Methods-Analysis of sickness absence data on 5620 male and female civil servants aged 35-55 years. Data have been collected from 12 of the 20 London based civil service departments participating in the Whitehall II study, where medical reason for absence was available. Rates and distributions of reasons for absence for short spells (less than or equal to 7 days) and long spells (>7 days) were analysed.Results-Respiratory disorders and gastroenteritis accounted for over half of all spells of absence, with headache and migraine, musculoskeletal disorders, injury, and neurosis accounting for a further 20%-30% of absences. There was an inverse association with employment grade, the lower the grade the higher the rate of absence for both short spells (less than or equal to 7 days) and long spells (>7 days). In general, women had higher rates of absence than men. Comparison of reason for very long spells of absence (>21 days) showed moderate agreement between civil service and general practitioner.Conclusion-There is a lack of national comprehensive data on sickness absence and medical reason for absence, in particular for women and for spells of different duration. Data from the Whitehall II study show large employment grade and sex differences in the distribution of medical reasons for absence that are similar to socioeconomic differences in morbidity documented in other studies. Possible explanations include the subjective nature of illness and disease; the work/family interface; and the influence of the absence culture. Longer term follow up will provide information on whether sickness absence relates to serious morbidity and mortality.