Low Leadership Quality Predicts High Risk of Long-Term Sickness Absence

Low leadership quality, as rated by employees, is a risk factor for long-term sickness absence (LTSA) in the workforce, according to a study in the August Journal of Occupational and Environmental Medicine.

Jeppe Karl Sørensen, MSc, and colleagues of the Danish National Research Centre for the Working Environment, Copenhagen, analyzed data on 53,157 employees from a wide range of job types and industries. Within one year, 2,270 employees developed LTSA, defined as sickness absence lasting six weeks or longer.

Data included employee ratings of leadership quality, based on an eight-item questionnaire. The questionnaire addressed topics like level of authority in relation to responsibility, recognition and appreciation from management, and help and support from supervisors. On a scale from 8 to 40, average leadership quality score was about 27.

Low leadership quality predicted an increased risk of LTSA, after adjustment for other factors. This was so in both men and women, across age groups and educational levels, and in private- and public-sector employees.

There was evidence of a “dose-response” effect: the higher the quality of leadership, the lower the risk of LTSA. At the lowest level of leadership quality (average score about 19), LTSA risk was about 60 percent higher than at the highest level (average score about 36).

A subgroup of 7,623 employees repeated the leadership quality ratings two years later. For those who changed from high to low leadership quality during follow-up, risk of LTSA increased by about 40 percent, compared to those with high leadership quality at both times. This suggests that “the increased risk of LTSA is likely related to workplace conditions, rather than individual traits of the employees,” the researchers write.

The study provides new evidence that low-quality leadership leads to a sharply increased risk of prolonged (and costly) sickness absences. “[L]eadership quality may be considered an important social stressor at work with considerable consequences,” Mr. Sørensen and colleagues conclude. “Therefore, future intervention studies should examine if improving leadership quality can reduce LTSA among employees.”
About the Author
Mr. Sørensen may be contacted for interviews at JKS@nrcwe.dk.
ACOEM (www.acoem.org), an international society of 4,000 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.
About the Journal of Occupational and Environmental Medicine
The Journal of Occupational and Environmental Medicine (www.joem.org) is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.


Sørensen JK, Framke E, Clausen T, et al. Leadership quality and risk of long-term sickness absence among 53,157 employees of the Danish workforce. J Occup Environ Med. 2020;62(8):557-565.