Health isn’t the only consideration for a sick day

Socioeconomic factors play a significant role in decisions around sick leave, increasingly so during the current cost-of-living crisis, a dynamic labour market, and winter-borne illnesses, new research has confirmed.

A new study published in the University of Technology’s Applied Economics has identified that financial and employment circumstances are increasingly impacting the number of sick days taken.

According to Dr Nancy Kong, a Senior Research Fellow at the UTS Centre for Health Economics Research and Evaluation, a distinct divide exists between casual or contract workers and permanent employees, whereby workers are less likely to take time off when jobs feel harder to replace.

The research, co-authored by Dr David Rowell from the University of Queensland and Professor Peter Zweifel of the University of Zurich, drew on a survey by the Household, Income and Labour Dynamics in Australia (HILDA), which analysed data from over 15,000 Australians between 2005 and 2016.

Even accounting for variability in occupation, job satisfaction, household circumstances, living arrangements, marital status, education, and residence, these findings do not indicate “that casual and fixed-term workers are healthier”, Dr Kong identified.

She said: “A more likely explanation is that taking time off is riskier when work is insecure. Non-permanent workers may have less access to paid sick leave. They may also worry that saying no to work, even when ill, could affect future hours or their chances of keeping their job.”

“For a permanent employee, staying home with influenza may be inconvenient, but for a casual worker, it may trigger financial stress.”

As would be unfortunately expected, trends also show that economic insecurity translates to less sick leave taken. The study found that when local unemployment rates rise by 5 percentage points, sick leave drops.

In the same vein, Dr Kong identified that job security plays a significant factor, whereby many in such circumstances “worry that being absent could make them seem less reliable or increase the risk of losing work”.

Compensation also proved a factor, albeit a more nuanced one. While higher wages alone didn’t directly correlate to leave behaviour, within workers with poorer health, higher wages were associated with more sick leave taken, confirming that certain workplaces and entitlements “mean they are supported to take time off when they are unwell without fear of a potential financial penalty”.

However, gender proved to be the most prominent factor. According to the findings, men average about half a day less of taken sick leave than women with similar health and employment circumstances per year, translating to a 23 per cent difference.

This, Dr Kong said, “may reflect differences in health needs, caring responsibilities or how likely people are to see medical care … but it also points to workplace cultures and gender expectations about ‘toughness’, reliability and working through illness”.

The findings reveal the importance of recognising that sick leave rates are not, on their own, a reflection of physical health, and that employers should not consider low sick leave rates as a workplace success without considering relevant factors, such as culture.

“Employers and policymakers often focus on reducing absence, but workers who attend while unwell may recover more slowly, spread infection to colleagues, and be less productive,” Dr Kong said.

In this vein, employers need to consider the importance of reducing stigma around sick leave.

Dr Kong said: “Employers can help by creating a culture where taking legitimate sick leave is clearly supported: managers should model this behaviour, policies should be simple and non-punitive, and performance measures should not reward low absence without considering presenteeism.”

“For workers in more insecure roles, practical measures such as reliable rostering, clear reassurance that illness will not unfairly affect future opportunities, and income support or paid sick-leave arrangements where feasible can reduce the pressure to work when unwell.”

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