The contribution of new onset chronic disease to patterns of work absence

Sepideh Modrek, Dominic Coey, Mark R. Cullen

NBER Disability Research Center Paper No. NB 17-19
Issued in September 2017

Underlying many employer efforts to improve the health of their workforce is the proposition that when employees are diagnosed with a chronic disease their absenteeism increases. Yet many factors beyond health affect absenteeism. We estimate the relative relationship between absence and the onset of six chronic health conditions-- hypertension, arthritis, diabetes, incident heart disease [IHD], asthma/COPD, and depression-- using linked claims and daily payroll data. We exploit payroll data to examine over 1000 observations per person on a sample of 4000 men. We infer the date of health events using claims data. We use an interrupted time series framework to estimate the effects of the onset of each health condition on absenteeism while accounting for administratively assessed economic incentives, underlying health in the previous year, a series of time-varying factors and individual fixed-effects. We confirm previous findings that individual heterogeneity explains much of the variation in absenteeism behavior. We find that Asthma/COPD leads to the most overall absences followed by depression, arthritis, IHD and hypertension. We also present varying patterns of absenteeism by condition in the period surrounding a new onset. Our approach presents the holistic relationship between the onset of common conditions and absenteeism, which can be used to inform workplace health policy.

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