Socioeconomic Differences in Occupational Health Service Utilization and Sickness Absence Due to Mental Disorders: A Register-Based Retrospective Cohort Study

Jaakko Harkko , Hilla Sumanen , Olli Pietiläinen , Kustaa Piha , Minna Mänty , Tea Lallukka , Ossi Rahkonen , Anne Kouvonen Piotrowska


Occupational health service (OHS) is the main provider of primary care services for the working population in Finland. We investigated whether socioeconomic differences in the utilization of OHS predict sickness absence (SA) due to mental disorders. We used register linkage data covering the employees of the City of Helsinki aged 18–34 years (N = 6545) and 35–54 years (N = 15,296) from 2009 to 2014. The outcome was medically certified long-term (over 11 days) SA due to mental disorders. Cox regression analyses were performed to obtain hazard ratios (HR) and their 95% confidence intervals (CIs). Employees with low socioeconomic position (SEP) used OHS more frequently. The number of OHS visits independently predicted SA due to mental disorders. HRs were 1.59 (95% CI 1.35, 1.86) for those with frequent visits and 1.73 (95% CI 1.30, 2.29) for those with a clustered visit pattern among 18–34 year old employees; and 1.46 (95% CI 1.18, 1.81) and 1.41 (95% CI 1.14, 1.74) among 35–54 year old employees, respectively. In both age groups, lower education and routine non-manual worker position indicated the highest probability of SA. Low SEP predicts both high OHS utilization and subsequent SA due to mental disorders. Medical records may be used to accurately predict future SA, and the results indicate that preventive measures should be targeted particularly to younger employees with lower SEP.
Author Jaakko Harkko
Jaakko Harkko,,
, Hilla Sumanen
Hilla Sumanen,,
, Olli Pietiläinen
Olli Pietiläinen,,
, Kustaa Piha
Kustaa Piha,,
, Minna Mänty
Minna Mänty,,
, Tea Lallukka
Tea Lallukka,,
, Ossi Rahkonen
Ossi Rahkonen,,
, Anne Kouvonen Piotrowska (Filia we Wrocławiu)
Anne Kouvonen Piotrowska,,
- Filia we Wrocławiu
Journal seriesInternational Journal of Environmental Research and Public Health, ISSN 1661-7827, e-ISSN 1660-4601, (N/A 70 pkt)
Issue year2020
Article number2064
Keywords in Englishmental disorders; occupational health service; sickness absence; health inequalities
ASJC Classification2739 Public Health, Environmental and Occupational Health; 2307 Health, Toxicology and Mutagenesis
Languageen angielski
Socioeconomic_tekst.pdf 279.47 KB
Socioeconomic_oswiadczenie.pdf 667.14 KB
Score (nominal)70
Score sourcejournalList
Publication indicators Scopus SNIP (Source Normalised Impact per Paper): 2018 = 1.129; WoS Impact Factor: 2018 = 2.468 (2) - 2018=2.948 (5)
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