Rates of death in service and rates of premature retirement due to disability in an employed population of more than 400 000 people under the age of 60 years have been compared with duration rates of certified sickness absence for three years from April 1972. Standardized for age, rates of sickness absence and of death, combined with retirement (medical wastage) for men and women differed between 11 occupational groups by a factor of three. Significant rank correlations were observed between these two measures of ill health, rs = 0-827 for men, rs = 0-857 for women. Similar comparisons for 1974/75 of rates for staff employed in 10 geographical regions of the United Kingdom standardized for age and occupation, revealed twofold differences of rate, and rank correlation coefficients of + 0-794 for men and + 0-649 for women. These observations show that the duration of certified sickness absence is higher in groups of people showing other objective evidence of ill health and who are most in need of preventive health care. The need is discussed for a balanced view of the complex aetiology of sickness absence.
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