Determinants of Absenteeism According to Health Risk Appraisal Data.

Abstract

The purpose of this project was to identify main determinants of absenteeism and contributing factors using Health Risk Appraisal (HRA) data. Absenteeism was used as the primary outcome metric, due to its quantifiable nature and established links to health. Path analysis was utilized in order to model direct and indirect effects. Sample populations were employees of a US utility provider and employees of a US financial services organization. Findings from this study should be applicable to inform policies and health promotion strategies aimed at reducing absenteeism and improving employee health.

For the utility provider employees, direct determinants of absenteeism were medical condition burden index (MCBI--number of medical conditions) and stress. Job satisfaction negatively correlated with stress, such that lower job satisfaction was predictive of higher stress. Physical activity did not impact absenteeism directly. Instead, physical activity mediated both medical condition burden and stress, such that greater physical activity was associated with lower stress and lower MCBI. Longitudinally, increases or decreases in medical condition burden and stress resulted in corresponding changes in absenteeism. However, the overall impact was greater for stress within the one-year timeframe.

For the employees of the financial services organization, stress impacted both absenteeism and presenteeism (on-the-job productivity loss). Individuals with stress also had increased MCBI and increased odds for 10 of 19 medical conditions after controlling for age, gender, education and body mass index. Caregiving was not associated with absenteeism or stress, but was associated with presenteeism.

In addition to the empirical findings, methodologically this work shows an additional use for HRA data by utilizing path analysis to investigate outcomes of interest. Findings from this work indicate that stress influenced physical health, absenteeism, presenteeism and job satisfaction. The presence of multiple medical conditions was also a determinant of absenteeism. These findings are relevant to employers and health promotion practitioners interested in influencing employee health and related economic outcomes. Policies and wellness program strategies designed to impact employee health should prioritize stress management in conjunction with other health programs designed to impact physical health.