Editor—Henderson et al write that sickness absence is a major public health and economic problem.1 Undoubtedly, it is a major economic problem, but apparently it does not serve as an appropriate tool to measure public health.
Norway has some of the highest incidences of sickness absence in the world, but only 10% of the working population is responsible for over 80% of the absence.2 Disorders of various origins that often lead to disability and unemployment have largely been neglected in medical research. The core complaints are often subjective and cannot be demonstrated by objective testing.
Apparently reasons for sickness absence have been considered political problems and have not gained sufficient attention from the medical and scientific communities. Methodologically rigorous, longitudinal, and interventional studies are needed to determine characteristics that are associated with the motivation to work rather than the ability. Interventions that seem effective in restoring this interest are needed in most industrialised countries. Such studies need to be directed towards the 10% that contribute to 80% of the absence, and not towards the entire working population.
Competing interests: None declared.
References
- 1.Henderson M, Glozier N, Elliott KH. Long term sickness absence. BMJ 2005;330: 802-3. (9 April.) [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Nielsen PT. Exercise did not lead to less sickness absence [in Norwegian]. 22 October 2002. www.forskning.no/Artikler/2002/oktober/1035182667.9 (accessed 19 Apr 2005).