Alcohol use-sickness absence association and the moderating role of gender and socioeconomic status: A literature review

Abstract

Issues: How strong is the available empirical evidence for an association between alcohol use and sickness absence? Does type of measures influence the association, and is the association moderated by gender and socioeconomic status?

Approach: We designed a search strategy to find all studies on the alcohol use-sickness absence association using individual-level data, published in peer-reviewed journals from 1980 onwards. The quality of the associations was evaluated, giving a score of 0-4 points.

Key findings: Our inclusion criteria were met by 27 papers containing 28 separate studies, testing 48 associations. There is empirical evidence for an association between alcohol use and both long- and short-term absence. High-quality associations were statistically significant in 100% of the cases. Among low-medium-quality associations, alcohol was less consistently related to long-term than to short-term absence (significant in 25% and 100% of the cases, respectively). Second, the association did not vary systematically across measures of alcohol use. Third, the association applies to both genders and in all socioeconomic strata, but in some instances more strongly in lower socioeconomic strata.

Implications: Preventive strategies have to be targeted at all drinking employees, but more research into group differences for example across gender, socioeconomics, occupations and age, could prove valuable. More longitudinal studies are needed to explore causal mechanisms.

Conclusion: The alcohol use-sickness absence association is well founded in research. The association may be moderated by gender and socioeconomics, but more research is needed to draw firm conclusions on this issue.

Keywords: alcohol use; gender; literature review; sickness absence; socioeconomics.