© 2004 by European Journal of Public Health
Sickness absence and work disability |
A comparison of socio-economic differences in long-term sickness absence in a Japanese cohort and a British cohort of employed men
Yuko Morikawa1,*, Pekka Martikainen2,3, Jenny Head3, Michael Marmot3, Masao Ishizaki4 and Hideaki Nakagawa11 Department of Public Health, Kanazawa Medical University, Uchinada-machi, Kahoku-gun, Ishikawa, Japan, 2 Population Research Unit, Department of Sociology, University of Helsinki, Finland, 3 International Centre for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, London, UK, 4 Department of Hygiene, Kanazawa Medical University, Uchinada-machi, Kahoku-gun, Ishikawa, Japan
Objectives: To compare the magnitude of socio-economic differences in sickness absence rates between a Japanese cohort and a British cohort. To assess the effects of self-rated health and behavioural risk factors on sickness absence in the two cohorts, and whether they explain socio-economic differences in sickness absence within and between cohorts. Methods: An 8 year follow up study of sickness absence in 2504 Japanese male employees in a factory in Japan and 6290 British male employees in civil service departments in London. The rates of first occurrences of long-term (>7 calendar days) sickness absence were determined and compared between these cohorts. Socio-economic status was measured with hierarchical employment grades. Results: The first time sickness absence rates were about two times higher among British men as compared with Japanese men. The rate ratio of lower to higher employment grade was 1.2, 1.3 and 2.1 among Japanese white-collar, Japanese blue-collar and British white-collar employees respectively. Baseline self-rated health and smoking habit predicted sickness absence in both cohorts. After adjusting for these factors a significant difference between the Japanese and British cohorts, and between employment grades remained. Conclusions: The rate of long-term sickness absence was higher in the British cohort than the Japanese cohort.
Keywords: comparative study, sickness absence, socio-economic status
Received 23 May 2002. Accepted 23 June 2003.
* Correspondence: Yuko Morikawa, PhD, Department of Public Health, Kanazawa Medical University, 1–1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920–0293, Japan, tel. +81 (0)76 286 2211, fax +81 (0)76 286 3728, e-mail: ymjr{at}kanazawa-med.ac.jp