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Research Article: Latent classes of unhealthy behaviours and their associations with subsequent sickness absence: a prospective register-linkage study among Finnish young and early midlife employees

Date Published: 2023-05-11

Abstract:
Objectives Unhealthy behaviours are associated with increased sickness absence (SA), but few studies have considered person-oriented approach in these associations. Using latent class analysis, we examined clustering of unhealthy behaviours among Finnish municipal employees and their associations with subsequent SA. Design A prospective register-linkage study. Setting Unhealthy behaviours (low leisure-time physical activity, non-daily fruit and vegetable consumption, insufficient sleep, excessive alcohol use and tobacco use) were derived from the Helsinki Health Study questionnaire survey, collected in 2017 among 19- to 39-year-old employees of the City of Helsinki, Finland. Participants A total of 4002 employees (81% women) of the City of Helsinki, Finland. Primary outcome measures The questionnaire data were prospectively linked to employer’s SA register through March 2020. Associations between latent classes of unhealthy behaviours and subsequent SA (1–7 days/8+ days/all lengths) were examined using negative binomial regression. Results Among women, a three-class latent class model was selected: (1) few unhealthy behaviours (84%), (2) excessive alcohol and tobacco use (12%) and (3) several unhealthy behaviours (5%). Women belonging to classes 2 and 3 had increased SA rates compared with those in class 1, regardless of the length of SA spells. Among men, a 2-latent class model was selected: (1) few unhealthy behaviours (53%) and (2) several unhealthy behaviours (47%). Men belonging to class 2 had increased rates of 1–7 days’ SA compared with men in class 1. Conclusions This study suggests that preventive actions aiming to reduce employees’ SA should consider simultaneously several unhealthy behaviours. Targeted interventions may benefit of identifying the clustering of these behaviours among occupational groups.

Introduction:
Health behaviours have a major contribution to employees’ sickness absence (SA). It is estimated that 15%–31% of SA could be attributed to unhealthy behaviours. 1 2 In addition to their independent contributions, health behaviours can mediate some of the effects of working conditions and socioeconomic circumstances on SA: for instance, unhealthy behaviours (eg, smoking and binge drinking) may be used to cope with stressful working conditions. 3 4 In Finland, as in most high-income countries, the leading causes for…

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