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Long term sickness absence

Employees who feel they are treated unfairly at work are at increased risk of being off sick more frequently and for longer, research has suggested. Managing long term sickness absence effectively,  is about more than just managing when someone is off or returning to work; it is about good management all the time.

Employee health and wellbeing – managing long term sickness absence is about much more than just managing someone who is off sick

Workers who feel they are treated unfairly at work are at increased risk of being off sick more frequently and for longer, research by the universities of East Anglia (UEA) and Stockholm has suggested.

Issues such as low job control and lack of autonomy and decision-making opportunities have previously been recognised as possible triggers for sick leave, not least within the Health and Safety Executive’s stress management standards.

However, the academics have made the case for a new determinant of employee health, someone’s perception of fairness in the workplace, or what they call “organisational justice”.

Treatment of employees by managers

The study, published in the journal BMC Public Health, focused on one element of this, so-called “interactional justice”, or the treatment of employees by managers.

Using data from more than 19,000 employees in Sweden, the researchers, from UEA’s Norwich Business School, the Stress Research Institute and Department of Psychology at Stockholm University, investigated the relationship between interpersonal and informational justice and long and frequent sickness absence. They also explored whether times of high uncertainty at work, for example perceived job insecurity, influenced sick leave.

The team found lower levels of justice at work related both to an increase in shorter, but more frequent, sickness absence periods, and to an increased risk of long term sickness absence episodes, irrespective of job insecurity and demographic variables of age, gender, socio-economic position and marital status.

Higher levels of job insecurity turned out to be an important predictor of long and frequent sickness absence.

Dr Constanze Eib, a lecturer in organisational behaviour at Norwich Business School and co-author of the study, said: “While shorter, but more frequent periods of sickness absence might be a chance for the individual to get relief from high levels of strain or stress, long-term sickness absence might be a sign of more serious health problems.

“Our results underline the need for fair and just treatment of employees irrespective of perceived job insecurity in order to keep the workforce healthy and to minimise lost work days due to sickness absence.”

Lead author Dr Constanze Leineweber, from the Stress Research Institute, added: “Perceived fairness at work is a modifiable aspect of the work environment, as is job insecurity. Organisations have significant control over both and our results suggest that they may gain by investing or improving their policies and rules for fair treatment of their workforce and by improving job security.

“Organisations might also gain from the selection of managers for their qualities associated with fair practices, training them in justice principles, and implementing performance management practices for them that consider their use of organisational justice. Indeed, training in justice principles has been shown to be successful in different organisational contexts,” she said.

When, then, should employers make of this?

Growing job insecurity

To an extent, this finding should hardly be earth-shattering. It stands to reason that if someone feels unhappy, insecure or hard done by at work, naturally this is going to make their day-to-day working environment more stressful and may colour how they view and perceive their workplace and colleagues.

Job insecurity, wrapped as it is into fears about how to pay the bills, mortgage or feed the family, can be an especially strong stress trigger in this context.

Moreover, as Dr Constanze Leineweber makes clear, this is often something an employer can tackle and control and change for the better.

As Dr Alexandra Marshall, Occupational Physician at Optima Health and speaker at the Health and Wellbeing @ Work Show suggests, that is the whole point. “Of course, someone being off sick, whether long or short-term, needs to be treated as a medical or health issue. But it’s  also important for employers to recognise that often, the roots of this ‘health’ problem are in organisational, management or cultural factors, especially job insecurity.

“A lot of employers, especially bigger employers, already do a lot of great work around becoming a ‘good’ employer and recognise the link there can be between good work, productivity, engagement and health and wellbeing. Positively, this is something increasingly recognised within government circles, too.

“However, the other side of the coin is that we are seeing a growing trend towards more insecure working which should be a cause for concern within this context. Yes, we all – employers and employees – want to work smarter, but that must not come at the detriment of our health and wellbeing.”