Sequence analysis of sickness absence and disability pension days in 2012-2018 among privately employed white-collar workers in Sweden: a prospective cohort study

Objective: The aim of the study is to explore sequences of sickness absence (SA) and disability pension (DP) days from 2012 to 2018 among privately employed white-collar workers.

Design: A 7-year prospective cohort study using microdata from nationwide registers.

Setting: Sweden.

Participants: All 1 283 516 privately employed white-collar workers in Sweden in 2012 aged 18-67.

Methods: Sequence analysis was used to describe clusters of individuals who followed similar development of SA and DP net days/year, and multinomial logistic regression to analyse associations between sociodemographic variables and belonging to each observed cluster of sequences. Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted for baseline sociodemographics.

Results: We identified five clusters of SA and DP sequences: (1) 'low or no SA or DP' (88.7% of the population), (2) 'SA due to other than mental diagnosis' (5.2%), (3) 'SA due to mental diagnosis' (3.4%), (4) 'not eligible for SA or DP' (1.4%) and (5) 'DP' (1.2%). Men, highly educated, born outside Sweden and high-income earners were more likely to belong to the first and the fourth cluster (ORs 1.13-4.49). The second, third and fifth clusters consisted mainly of women, low educated and low-income (ORs 1.22-8.90). There were only small differences between branches of industry in adjusted analyses, and many were not significant.

Conclusion: In general, only a few privately employed white-collar workers had SA and even fewer had DP during the 7-year follow-up. The risk of belonging to a cluster characterised by SA or DP varied by sex, levels of education and income, and other sociodemographic factors.