Work demands, job insecurity and sickness absence from work. How productive is the new, flexible labour force?

Background: We investigate one aspect of productivity - sickness absence - and ask whether job insecurity and high work demands are associated with increased sickness absence and, if so, whether mental or physical health mediates this association. We further investigate if having control at work modifies these associations. Methods: We used cross-sectional survey data from 2,248 employees aged 40-44 years living in two cities of south-eastern Australia. Logistic regressions were used to compare the associations between job insecurity and demands among those with short (1-3 days) or long-term (>3 days) sickness absence with those who had no sickness absence in the last four weeks. The mediating effects of mental and physical health were assessed by evaluating changes in the magnitude of the association between these work conditions and sickness absence. Results: High job insecurity (OR=3.28; 95% Cl 1.54-6.95) and high work demands (OR=1.62; 95% Cl 1.13-2.30) were significantly associated with long-term, but not with short-term, sickness absence. These associations were unaffected by job control. Depression and anxiety explained 61% of the association between high work demands and long-term sickness absence and 30% of the association between job insecurity and long-term sickness absence. Conclusion: Difficult working conditions may reduce productivity by contributing to longer absences from work. Implications: Reforms intended to improve economic performance should address any potential health costs of insecurity or intensification, which could inadvertently decrease productivity, possibly through their impact on mental heath.