BMC Public Health 2007, 7:45 http://www.biomedcentral.com/1471-2458/7/45 Table 4: Prevalence (percentage) of additional outcomes and distribution of explanatory variables in three groups of people with paid employment and no self-reported reduced working capacity due to a longstanding illness: 0–28, 29–90, and >90 SA days. No self-reported reduced working capacity due to a longstanding illness Categories and levels Number of SA days Number of persons Additional outcomes Psychosomatic complaints Anxiety Poor self-reported health status Any additional outcome* Distribution of explanatory variables Sex Age Occupational status Employment Quality of physical Working Environment Presence of stress at Work Work-related social Support Corresponding number of persons in Swedish population American sociologist Talcott Parsons believed that sick persons would rather not be sick [25]. Swedish medical anthropologist Lisbeth Sachs, on the other hand, notes that the role of being sick is not just negative and undesir- able, but can bring benefits, as well. She suggests that peo- ple may sometimes welcome the role for a number of reasons. For example, it can provide relief from obliga- tions and an excuse for failure to achieve a social expecta- tion, such as career success [26]. At the same time, the sick role also involves a duty not to make use of the benefits of ill health and an obligation to try to get well and search for help. An overuse of social sickness insurance can lead to nega- tive effects for the individual, including marginalization, depression, complication of career opportunities, low per- sonal budget, poorer social networks, and an increased risk of a negative lifestyle (smoking, alcohol) [27]. Over- use can also lead to insufficient citizen confidence in the system, severe economic problems for the society as a whole, and a threat to other welfare programs. Female Male 25–34 35–44 45–54 55–64 Unskilled manual workers Skilled manual workers Lower-level employees Middle-level employees and professionals Part-time Full-time Poor Good Yes No Poor Good Estimated (N) 0–28 17,762 16.0 11.7 8.3 27.0 2,647,000 29–90 806 23.6 17.2 17.7 38.8 66.0 34.0 30.9 24.2 27.6 17.2 31.3 22.1 13.9 32.7 27.4 72.6 33.6 66.4 39.6 60.4 7.4 92.6 119,000 >90 374 28.7 22.9 29.7 52.9 64.5 35.5 21.6 21.5 30.2 26.8 27.5 19.6 17.4 35.5 24.8 75.2 33.6 66.4 47.0 53.0 9.8 90.2 55,000 Comparison with findings of other studies Previous research indicates that SA records accurately reflect the health of working populations [11]. Marmot et al. analyzed questionnaires and SA records from the first phase of the Whitehall II longitudinal study, which included all London-based office staff in 20 civil service departments who were between the ages of 35 and 55 years. The Whitehall II study included information on self-certified SA of 1–7 days and on medically certified SA of >7 days. Marmot et al. found that the longer the SA, the more strongly baseline health predicted SA. Most indica- tors of baseline health used in the study also predicted shorter SA, but more weakly [11]. Other research also based on the Whitehall II study found that medically cer- tified SA was an accurate predictor of mortality [28]. This is consistent with our finding that length of medically cer- tified SA is an important indicator of health (or, more pre- cisely, of self-reported longstanding illness that resulted in reduced working capacity), even after taking important confounders into consideration. Page 8 of 11 (page number not for citation purposes) * Any additional outcome = presence of one or more of the following: psychosomatic complaints, anxiety, or poor self-reported health status.