Association of Contractual and Subjective Job Insecurity With Sickness Presenteeism Among Public Sector Employees

Objective: We examined the associations of contractual job insecurity (fixed-term vs permanent employment contract) and subjectively assessed job insecurity with sickness presenteeism among those who had no sickness absences during the study year. Methods: Survey data from a sample of 18,454 Public sector employees were gathered in 2004 (the Finnish Public Sector study). Results: Fixed-term employees were less likely to report working while ill (odds ratio = 0.88, 95% confidence interval = 0.77 to 0.99) than permanent employees. Subjective insecurity was associated with higher levels of working while ill, and this association was stronger among older employees. These results remained after adjustments for demographics, health-related variables, and optimism. Conclusions: Our results suggest that subjective job insecurity might be even more important than contractual insecurity when a public sector employee makes the decision to go to work despite feeling ill.