Impacts on work absence and performance: what really matters?

Background A number of factors influence an individual's decision to take sickness absence or to remain at work while ill. The relationship between health, work characteristics, individual perceptions of work and sickness absence and performance is complex and further clarification of the interactions between these factors is necessary. Aims To assess the relative impact of health, work characteristics and perceptions of work on absence and performance. Methods Cross-sectional survey of two public sector organizations (n = 505). Data were analysed using multivariate linear regression to assess the individual and combined influence of each class of independent variables on the following: days sickness absence, spells of sickness absence, VAS performance and presenteeism. Results Characteristics of work were weakly associated with days absence and performance. Perceptions of work were more strongly associated with performance than absence. Measures of mental health, rather than physical health, had the greatest influence on ability to work. Poor health had a greater impact on work performance than work absence. When considered together, health variables accounted for the largest proportion of explained variance in both absence and performance when compared with characteristics of work and work perceptions. Conclusions Using absence as a marker of health-associated compromise at work may lead to an underestimation of the impact of health on work. This study demonstrates the need to manage the impact of health problems on the workforce not only from a bio-medical perspective but also in terms of the psychological pressures and the social context in which employees work.