Researchers have long known that obesity is linked to higher rates of absenteeism. A new study from the US has examined this more closely and found that the link is influenced by gender and occupation. The study adds an extra layer of complexity to the issue of obesity and its heavy burden on the economy.
The obesity epidemic is alarming because it is linked to a growing list of health problems such as heart disease, lung disease, diabetes, high blood pressure, sleep disorders and depression. Previous studies have already shown that obesity is a significant drain on the economy, with obese people consuming more health care. Obesity and overweight is estimated to cost the US healthcare system US$93 billion. However, this figure does not reflect the true cost of obesity to the economy, because it does not include workplace costs due to disability, early retirement and absenteeism.
Past studies have found a strong link between excess weight and absenteeism. However, samples used were not often representative of the population and included only a small number of employers. Researchers decided to improve the available literature by documenting absenteeism costs associated with obesity and morbid obesity by occupation, using data from medical expenditure panel surveys between 2000 and 2004. This pooled data was designed to be nationally representative.
Participants were asked to list their current occupation and the number of days they took off work in the previous year due to health reasons. BMI data were calculated using the respondents’ self reported height and weight, corrected for reporting error. This gives an indication of the person’s body shape and size. Individuals were assigned into categories depending on their BMI: underweight, healthy, overweight, obese or morbidly obese. Researchers also noted whether participants had other health problems such as diabetes or high blood pressure.
The sample included a mix of people in the five weight categories, including 8% of women and 6% of men who were morbidly obese, and 21% of women and 23% of men who were obese. Amongst occupations, the rate of obesity varied for women. There was a two fold increase in the rate of obesity for female equipment and transportation officers. The results showed that overall, the rate of absenteeism increased with increasing weight. For example, the overweight were 32% more likely, the obese 61% more likely and the morbidly obese 118% more likely to miss a day of work. However, this pattern varied according to occupation and gender.
Among men, there was a consistent association between absenteeism and increased weight in professionals and sales workers. Among male managers, office workers and equipment workers, only morbid obesity was associated with more days off work. Weight gain was consistently associated with more absenteeism among sales workers. But for male service workers and equipment operators, there was no recognisable pattern of absenteeism. For females, obesity was associated with greater absenteeism in five out of six occupational categories. The study also recognised that the per-employee costs of obesity associated absenteeism vary according to gender and occupation. In particular, these costs appear to be greater for females than for males. For men, managers have the greatest obesity related costs, whereas for females it is professionals.
The study has made a significant contribution to the literature by investigating the effect of gender and occupation on the link between obesity and absenteeism. The authors suggest that given the high costs of obesity, employers may now be more motivated to introduce healthy eating and exercise programs into the workplace. The Tony Ferguson Weightloss Program is an example of a meal replacement strategy, one of several treatments for obesity.
Some of the limitations of the study are that it shows an association only and not a cause, and it doesn’t consider whether obese people are working harder while at work to compensate for greater absenteeism. It is more likely, however, that obesity leads to lost productivity while at work, sometimes called ‘presenteeism’. The authors hope that this question will form the basis of future research into the costs of obesity on the economy.
(Source: Cawley J, Rizzo J, Haas K. Occupation-specific absenteeism costs associated with obesity and morbid obesity. JOEM 2007; 49(12): 1317-24.)