Sickness Absence and Precarious Employment: A Comparative Cross-National Study of Denmark, Finland, Sweden, and Norway

Background: Precarious employment is a major social determinant of health and health inequalities with effects beyond the health of workers. Objective: To investigate the association between precarious employment and sickness absence in 4 Nordic countries, Denmark, Finland, Norway, and Sweden. Methods: Logistic regression analyses were conducted separately for each country on data from 4186 respondents aged 15–65 years in Denmark, Finland, Norway, and Sweden derived from the 2010 European Working Conditions Survey. Sickness absence was based on self-reports and defined as absence of seven or more day per year. Precarious employment was operationalized as a multidimensional construct of indicators. Analyses were also conducted separately for men and women. Results: The prevalence of sickness absence was lowest in Sweden (18%), and highest in Finland (28%). 3 precarious employment indicators were positively associated with sickness absence; the pattern being largely similar in the total sample. In the sex-disaggregated sample, 5 precarious employment indicators increased the likelihood of sickness absence; the pattern was heterogeneous, with women generally having significantly higher odds of sickness absence than men. “Low household income” and “sickness presenteeism” were strong predictors of sickness absence among both sexes in most of the 4 studied countries. Sickness absence varied between the Nordic countries in the sex-disaggregated analyses. Conclusion: Precarious employment indicators predicted sickness absence in the Nordic countries. Findings emphasize the need to prioritize informed and monitored collective bargaining for all workers, increase working time flexibility, and improving work conditions.