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Determinants in adolescence for adult sickness absence in women and men: a 26-year follow-up of a prospective population based cohort (Northern Swedish cohort)

Ellenor Mittendorfer-Rutz1*, Gunnel Hensing2, Hugo Westerlund13, Magnus Backheden4 and Anne Hammarström5

Author Affiliations

1 Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden

2 Department of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Social Medicine, The Sahlgrenska Academy, Gothenburg, Sweden

3 Stress Research Institute, Stockholm University, Stockholm, Sweden

4 Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden

5 Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

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BMC Public Health 2013, 13:75  doi:10.1186/1471-2458-13-75

Published: 26 January 2013



To date little is known regarding how factors measured in adolescence predict sickness absence in adulthood, and whether different patterns of factors exist for women and men that could contribute to an explanation of adult gender differences in sickness absence.


All pupils in the last year of compulsory school in the municipality of Luleå with complete information from surveys (questionnaires) in 1981 and 1983 (compulsory and upper-secondary schooling; 16 and 18 years of age, N=719) were followed with register data on medically certified sickness absence (1993–2007). Generalised linear models were applied to calculate Risk Ratios with 95% Confidence Intervals (CI) comparing annual mean numbers of sickness absence spells in exposed versus unexposed groups.


In the multivariate model, the following factors were found to be predictive of future sickness absence in women: participating in an upper secondary school program in 1983 dominated by women (> 60%): 1.41 (95% CI 1.00 – 1.97); sometimes sickness absence from school in 1981: 1.60 (95% CI 1.18 – 2.17) and low parental socioeconomic status in 1981: 2.20 (95% CI 1.44 – 3.38). In men, low school grades in 1981: 4.36 (95% CI 2.06 – 9.22) and fathers not in gainful employment in 1981: 2.36 (95% CI 1.53 – 3.66) were predictive.


The findings suggest that sickness absence in adulthood is predicted by factors measured in adolescence. These predictors may differ for women and men. For women, early life absence and social environmental factors, for men low achievements at school and lack of employment of their father seem to be predictive.

Sickness absence; Gender; Socio-economic; Parental