Flexible working environment can reduce absenteeism

A flexible working environment results in a reduction of the incidence of sick leave, according to a research report by the Swedish Karolinska Institute in Stockholm. Addressing the problem of absenteeism, the report applies a new model for studying sick leave, namely the flexibility model. The research shows that employers can reduce absenteeism by applying the so-called ‘adjustment latitude principle’, tailoring work demands to match the capabilities of employees with health problems.

Illness flexibility model

In a study entitled Illness flexibility model and sickness absence (6.5Mb PDF), the Karolinska Institute accepts the universal position that poor health causes sickness absence. However, the Swedish institute points out that poor health does not have to result in employees being absent from work. This shift in focus is based on the assumption that ill-health can be managed in a way that is beneficial to both employers and employees. The report argues that there is a need to ensure that working while being in ill-health does not have long-term negative consequences for the health of individual workers something which the study refers to as ‘sickness attendance’.

Central to the model is the argument that absenteeism is the result of an individual’s rational choice – in other words, that ‘the individual [is]… a product of his or her environment and, at the same time, is a conscious actor who makes choices within a given social framework.’ As the report notes, employees often have ‘good reasons’ for being absent. Two key concepts are used to explain employees’ choices in this respect: ability and motivation. It is argued that poor ‘adjustment latitude’ – that is, the lack of opportunity to change work tasks in light of illness – affects an individual’s ability and motivation to work. 

Work ability and health

The traditional conceptualisation of ability sees a close correlation between human resources and work tasks, or an individual’s ability to complete a work task. While the report partly accepts this definition, it develops the notion of ability further, emphasising the need to consider the issue of ‘adjustment latitude’.

This notion assumes that any definition of ability needs to depart from the concept of ‘work demands’ – that is, the tasks to be completed irrespective of the circumstances (illness) of an employee. The key argument is that an employee’s ability to fulfil such demands depends on the health of the individual. As the the study contends: ‘A heavy physical workload may, for example, act as a barrier when suffering from low back pain but not when suffering from mental problems.’

Motivation to work

The other important variable highlighted by the research relates to motivation of the individual worker. Often a highly controversial issue, especially when it entails state benefits, an employee’s motivation to work is defined as involving an individual’s perception of what they can ‘manage’. The implication is that businesses have the responsibility to provide a working environment which is capable of accommodating employees suffering from health problems; this includes offering employees the chance of either remaining at or returning to work, irrespective of sickness.

Research findings

Using the ‘odds ratio’ (OR) statistical measurement, the study confirms its main hypothesis: namely, that a poor adjustment latitude, or an individual’s inability ‘to adjust work to illness in order to keep sufficient work ability’, increases the likelihood of absenteeism. A low adjustment latitude was associated with an increased risk of being absent due to sickness for between one and seven days, with an average OR of 1.3 recorded for women and 1.1 for men; it also increased the risk of being absent for eight days or more, with an average OR of 1.5 for women and 1.3 for men. Conversely, the report records a high increase in sickness attendance where employees have the option of a variety of four to six adjustment opportunities.

The research also indicates a strong correlation between the kind of work undertaken and attendance rates. Absenteeism was particularly high – with an OR of 2.2 for seven days or more – where work did not catch an individual’s imagination or attention, or allow workers to develop their skills and knowledge. For this reason, employers of manual and repetitive labour affected by high absenteeism levels should consider providing more stimulating tasks to their workers.


The report provides guidance to employers experiencing costly and high absenteeism rates. Moreover, it offers employees the potential to remain at work irrespective of ill-health. For example, the flexibility model can address the problem of skills depreciation and a weakening of the individual’s social competencies, including a lack of confidence, caused by long periods of absenteeism.

In addition, the model challenges the ‘high attendance requirements problem’, whereby employees are forced to work for fear that absenteeism would lead to dismissal or burden fellow colleagues as well as increase their own workload. If applied correctly, the flexibility model can ensure that employees attend work without fear of long-term negative consequences for their health.

Michael Whittall, Technical University Munich

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