Associations of psychological distress and body weight with sickness presenteeism in Finland, 2017

Abstract Background Psychological distress and body mass index (BMI) are jointly associated with sickness absence, but it is not known if they are similarly linked to sickness presenteeism. We examined whether psychological distress and BMI are jointly associated with the number of sickness presenteeism days among young and early midlife municipal employees. Methods The Helsinki Health Study survey (participants 19-39-year-old in 2017) on self-reported psychological distress, Work Ability Score (WAS), and BMI was prospectively linked to employer's register data on sickness absence and employee tenure (n = 3,515, 80% women). The follow-up was 12 months or until the end of the work contract, which ever occurred first. Annual sickness presenteeism days lost due to reduced workability were estimated based on WAS (current workability 0-10 compared to lifetime best) and discount factors from a prior study. Rate ratios (RRs) and their 95% confidence intervals (CIs) were calculated for presenteeism days using negative binomial regression. Sociodemographic factors, working conditions, and health behaviors were included as covariates. Results Among participants, 18% had psychological distress and 42% overweight (BMI≥25 kg/m2). For all participants, sickness presenteeism accounted for 4.4% of total working days, and the majority (58.9%) had at least one sickness presenteeism day. Participants with one or both exposures had higher RRs for sickness presenteeism days over the follow-up (psychological distress and overweight: RR: 2.91, CI 2.36-3.60; psychological distress and healthy BMI [BMI<25 kg/m2]: RR: 2.56, CI 2.10-3.13; no psychological distress and overweight: RR: 1.14, CI 1.00-1.30) compared to no psychological distress and healthy BMI. Conclusions Overweight and psychological distress are major public health concerns which are linked to sickness presenteeism days. Employees with psychological distress and overweight may benefit from early support to help prevent sickness presenteeism. Key messages • Among Finnish young and early midlife municipal employees, psychological distress and overweight were associated with lower perceived workability and higher number of sickness presenteeism days. • Supporting young and early midlife municipal employees with psychological distress and overweight might be beneficial when considering preventive actions against sickness presenteeism.