Journal Article

Recurring pain, mental health problems and sick leave in Australia

Published: 2021

A substantial proportion of Australians report recurring pain and mental health problems, but their separate and joint contributions to sick leave use has not been examined. This study examines the interaction of pain and mental health problems with sick leave usage and the extent to which unobservable time-invariant factors contribute to these conditions and the propensity to take sick leave. Longitudinal data on self-reported paid sick leave days, pain, mental health problems and multiple covariates, and spanning the period 2005 to 2019, were derived from the Household, Income, and Labour Dynamics in Australia Survey. The analysis included 3404 and 3448 employed women and men, respectively, with paid sick leave entitlements, with an average of 6 observations each. Negative binomial regression models were used to investigate the association while adjusting for multiple covariates. After multiple adjustments, recurring pain was linked to 1.7 additional sick leave days per year among women and 2.3 among men, whereas the corresponding figures for recurring mental health problems were 1.5 and 0.7, respectively. Time-constant between-individual heterogeneity slightly attenuated these estimates, suggesting that unobserved characteristics contribute to both symptoms and a higher propensity to take sick leave. Pain and mental health problems – single-occasion but particularly recurring – are both important contributors to sick leave days in Australia. However, their effects do not appear to interact with one another. Thus, to help the employees continue working, mental health problems and pain have to be tackled early on, aiming to reduce any stigma related to them. Moreover, modification in working conditions could be useful in finding better matches between employees and their jobs, provided that the employer is aware of the mental health problems and pain of their employees.


Aapo HiilamoAllison MilnerMark WoodenNathaniel Marshall

Centre Member

Nick Glozier
Peter ButterworthTea Lallukka


Lallukka, T., Hiilamo, A., Wooden, M., Glozier, N., Marshall, N., Milner, A., Butterworth, P. (2021) Recurring pain, mental health problems and sick leave in Australia,
SSM – Mental Health, Volume 1, 2021,100025,