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Work-unit social capital and long-term sickness absence: a prospective cohort study of 32 053 hospital employees
  1. Eszter Török1,2,
  2. Alice Jessie Clark1,2,
  3. Johan Høy Jensen1,2,3,
  4. Theis Lange4,
  5. Jens Peter Bonde1,2,3,
  6. Jakob Bue Bjorner1,5,
  7. Reiner Rugulies1,2,5,6,
  8. Ulla Arthur Hvidtfeldt7,
  9. Åse Marie Hansen1,2,5,
  10. Annette Kjær Ersbøll8,
  11. Naja Hulvej Rod1,2
  1. 1 Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  2. 2 Copenhagen Stress Research Center, Copenhagen, Denmark
  3. 3 Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg University Hospital, Copenhagen, Denmark
  4. 4 Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
  5. 5 National Research Centre for the Working Environment, Copenhagen, Denmark
  6. 6 Department of Psychology, University of Copenhagen, Copenhagen, Denmark
  7. 7 Danish Cancer Society Research Center, Copenhagen, Denmark
  8. 8 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
  1. Correspondence to Eszter Török, Department of Public Health, University of Copenhagen, Copenhagen 1014, Denmark; eszt{at}


Objective There is a lack of studies investigating social capital at the workplace level in small and relatively homogeneous work-units. The aim of the study was to investigate whether work-unit social capital predicts a lower risk of individual long-term sickness absence among Danish hospital employees followed prospectively for 1 year.

Methods This study is based on the Well-being in HospitAL Employees cohort. The study sample consisted of 32 053 individuals nested within 2182 work-units in the Capital Region of Denmark. Work-unit social capital was measured with an eight-item scale covering elements of trust, justice and collaboration between employees and leaders. Social capital at the work-unit level was computed as the aggregated mean of individual-level social capital within each work-unit. Data on long-term sickness absence were retrieved from the employers’ payroll system and were operationalised as ≥29 consecutive days of sickness absence. We used a 12-point difference in social capital as the metric in our analyses and conducted two-level hierarchical logistic regression analysis. Adjustments were made for sex, age, seniority, occupational group and part-time work at the individual level, and work-unit size, the proportion of female employees and the proportion of part-time work at the work-unit level.

Results The OR for long-term sickness absence associated with a 12-point higher work-unit social capital was 0.73 (95% CI 0.68 to 0.78). Further, we found an association between higher work-unit social capital and lower long-term sickness absence across quartiles of social capital: compared with the lowest quartile, the OR for long-term sickness absence in the highest quartile was 0.51 (95% CI 0.44 to 0.60).

Conclusion Our study provides support for work-unit social capital being a protective factor for individual long-term sickness absence among hospital employees in the Capital Region of Denmark.

  • workplace social capital
  • employee health
  • work-unit
  • sickness absence
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  • Contributors ET, AJC, NHR, RR and ÅMH participated in the formulation of aim and research questions, design of the study, and choice of statistical methods. JPB, JHJ and UAH participated in establishing and making data available in the WHALE cohort. ET drafted the manuscript and was responsible for data analyses, supported with feedback from JBJ, AKE, TL, AJC and NHR on statistical methods and interpretation of outputs. All authors have critically revised the manuscript and approved the final version.

  • Funding This work was supported by the Danish Working Environment Fund (no 03-2013-09).

  • Competing interests AJC received funding from the Danish Working Environment Fund and TL declared personal fee from Novo Nordisk.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Correction notice This article has been corrected since it first published online. Affiliations 6 and 7 have been transposed.

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