A. Grinyer et V. Singleton, Sickness absence as risk-taking behaviour: a study of organisational and cultural factors in the public sector, HEALTH R SO, 2(1), 2000, pp. 7-21
This article examines the organisational and cultural factors, both formal
and informal, which lead to the inappropriate non-use of sick leave or 'pre
senteeism'. A two-stage research process supplies the empirical data for th
is paper. Preliminary quantitative research was gathered from 200 questionn
aires sent to staff at two centres; however, the results from this stage we
re inconclusive. The article therefore focuses on the findings from qualita
tive data, gathered through the use of in-depth interviews and focus groups
with 30 workers at a single site in the public sector. Taking further the
study by McKevitt et al. (1997), we consider whether presenteeism results i
n subsequently higher rates of sick leave. By understanding the fears assoc
iated with taking sick leave, we suggest that sick leave can be understood
as a 'risk-taking' activity rather than a health-promoting one. In addition
, informal discussions with management suggest that managers do not appreci
ate that policies designed to reduce sick leave may ultimately increase it.
We suggest that a tendency to construct ideal models of the social and wor
king environment may result in unintended and negative consequences for bot
h employers and employees. Finally, we address briefly the social represent
ation of sickness and the sick role. It is not usual for people to resist t
he sick role, and we consider not only the factors which contribute to relu
ctance to take sick leave, but also the attitudes of fellow workers to thos
e who resist.