The benefits of sick leave — and of absenteeism

Most of us know the old adage, “An ounce of prevention is worth a pound of cure.”   That’s why we’re told by teachers to keep our kids home from school when they’re sick, so they get better and they don’t get others sick as well.  It’s why there’s increased focus on leading healthy lives, prevention and wellness.

However, the benefits of prevention seem to have been neglected in recent reports over the absenteeism in the workplace.  Last week, Statistics Canada released a report showing that while public sector workers took more time off for sickness and family leave, most of this this was explained by the higher rates of female, older and unionized workers in the public sector.  Accounting for these differences explains 80% of the gap in sick leave between public and private sectors, with the difference down to just 0.8 days.

Yesterday the Conference Board of Canada came out with a report calculating that absenteeism from work costs the Canadian economy $16.6 billion a year.  This will be the first of three reports in a series on this issue from the Conference Board. But in the coverage of this report, I didn’t see any mention of the benefits of sick leave and of absenteeism, which is to prevent workers (and their families) from getting more sick.  People get sick and sometimes work, or overwork, causes sickness and death.

So what’s the cost of illness in Canada?

There have been a number of recent studies done on the cost of mental illness for the Canadian economy.  Just a year ago, the same Conference Board released a report that calculated the annual costs of just mental illness for the Canadian economy at over $20 billion.  Other analyses estimate the cost of mental illness much higher.  Don Drummond from TD Bank estimated it at $33 billion a few years ago.  A recent report for the Mental Health commission estimated costs of mental illness to be over $40 billion annually.

And what about the cost of other illnesses?  The most recent comprehensive report I found from a quick seach was a fifteen year old archieved report from Health Canada, which calculated the Economic Burden of Illness in Canada at $159.4 billion for 1998, which was equivalent to 17% of Canada’s economic output that year.

Unfortunately, the federal government hasn’t updated or published an updated version of this report, but if we assume ratios are similar, the economic burden of illness would work out to $300 billion in 2011 and $310 billion in 2012, based on 17% of GDP.   So the costs of sickness and illness at over $300 billion a year are almost 20 times the cost of absenteeism at $16.6 billion annually.  Other calculations estimate the cost of “presenteeism”–when people come to work even when they’re too sick, stressed or distracted to be productive–to be be 3 to 15 times the cost of absenteeism.

While the old adage about how “an ounce of prevention is worth a pound of cure” hasn’t been translated to metric terms, it looks like it still holds and quite accurately, with 16 ounces to the pound.   A few days of sick and family leave really are worth it in preventing much higher costs of sickness and mental illness.

As pressures and time stress increases at work and home, it looks like we should have more time for sick and family leave, not less.  With these types of payoffs, it’s worth it.  While prevention certainly won’t end illness and the ratios may not be precise, it appears the old adage does apply: an ounce of sick leave can prevent a pound of illness.


  • Great post, Toby. If policy makers are concerned about the cost of illness in an ageing workforce, they need to look further upstream ( to the social determinants of health. Reducing income inequality and providing social supports such as affordable childcare and affordable housing have a huge payoff in reducing the cost of illness (and improving our wellbeing).

  • Great post Toby- I do think the neo-con charge into this topic is so front loaded and ideologically based, it is just like a bull set into a china shop.

    I am especially concerned about the mental health aspect- it truly is the deep dark dirty secret that nobody wants to discuss. As we transition within the workforce and workplaces – and move through the changing terrain such as increasing components of knowledge work, more precarious work, more aged populations (some new work on age and mental health outcomes, as long term stress can reprogram the brain and create very negative and influential mental health outcomes), and various other dynamics of the 21st century online- always on demand- lower paid- highly productive workforce.

    Absenteeism is highly correlated to shop floor micro group dynamic causation- and undoubtedly strongly related to both physical and mental health. However, physical health aspects have a long very mature traditional interface with modern workplace practices (at least somewhat- and of course we will always have traditional health and safety violators and bad management). But absenteism and mental health truly is at the forefront of a brand new space in the Canadian workplace- we are indeed just witnessing tip of the ice berg on mental health aspects of the workplace. Higher absenteeism is the first sign of an employee falling into mental distress and the key aspect of prevention – is early detection and providing assistance.

    I am glad you addressed that issue, and I am glad to see a lot of union research and shop floor response and solution space congealing to respond to this very human failing of the “modern workplace”.

    The management discourse of the traditional seems to never have fully quite comprehended the simple essence of the human capacity and alienation. Kind of like when you put a rabbit in cage and beat the side of the cage everyday- that rabbit becomes wide eyed stressed and overtime it changes their natural being.

    So for me differences in absenteeism reflects a huge aspect on the state of mental health. Albeit other factors do come into play but the main causation is that mental health aspect.

  • Very good point, Angella.

    There are also excellent resources produced by the McGill Institute for Health and Social Policy, including their Work, Family and Equity global database, available at which has excellent information, particularly on paid and discretionary leave for family reasons.

    This increasingly important around the world as other countries industrialize, with more men and women especially go into formal wage labour; as family networks of support are weakened and public supports in terms of childcare and other forms of healthcare remain insufficient.

    Jody Heymann, who initiated that project, has now gone on to become dean at UCLA’s school of public health, but I hope the work she started at McGill will continue.

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