The Causal Structure of the Effort-Reward Imbalance Model and Absenteeism in a Cohort Study of German Employees

The present study contributes to previous research by assessing the validity of the causal structure of the Effort-Reward Imbalance model in relation to the psychosocial mechanisms involved in sickness absenteeism. To this end, data from the German Cohort Study on Work, Age, Health and Work Participation are analysed (lidA Study, n = 6,270). The main hypotheses concerning short- and long-term sick-leave rates are investigated with six hurdle regression models. The results suggest that a high effort-reward imbalance, and high efforts and low rewards at work are associated with an increasing likelihood of sick leave. However, the combination of high effort-reward imbalance and high overcommitment was associated with lower sick-leave rates, in contradiction to the hypothesis postulating cumulative adverse effects of increased effort-reward imbalance and high overcommitment on health-related outcomes. Long-term sick-leave rates among workers of higher occupational and educational status were substantially lower in comparison to those among workers of lower status categories. Even though most hypotheses of the Effort-Reward Imbalance model are suitable for explaining the patterns of absenteeism in this sample, the results point to more complex motivational processes and socioeconomic characteristics of employees moderating and mediating the associations between perceived efforts and rewards at work and absenteeism.