Resumen de Sickness absence trajectories and its relationship with prior labour market participation patterns: a life course approach
El mercado laboral está cambiando debido al envejecimiento poblacional, la aparición de nuevos empleos tecnológicos, la globalización, el cambio climático, la migración, y la entrada de las mujeres en un mercado laboral segregado por género. A lo anterior hay que sumarle la Gran Recesión de 2008, que golpeó la economía global y amplificó aún más la ya existente inseguridad en el trabajo, precariedad y temporalidad como mecanismos de creación de empleo. Estos cambios están llevando a una “nueva normalidad” en la que el empleo estable tiende a ser menos común, mientras que la mayor movilidad entre diferentes empleos a lo largo de la vida laboral se está convirtiendo en el patrón más frecuente. Esta situación podría entrañar riesgos para la salud si no se dan las circunstancias adecuadas que provean de seguridad en el empleo, o ante el despido, no se garantice la estabilidad en la concatenación de sucesivos empleos.
Estudios previos se han centrado en las situaciones de empleo específicas de manera unidimensional (i.e. empleo, desempleo o inactividad) y, aún menos, en transiciones entre diversas situaciones de empleo (i.e. patrones de participación en el mercado laboral) y su efecto en la salud. Sin embargo, no existen estudios previos que hayan investigado la relación potencial entre las situaciones de empleo y la incapacidad temporal desde una perspectiva de curso de vida.
En esta tesis, proponemos estudiar patrones de participación en el mercado laboral y su relación con el curso futuro de la incapacidad temporal de manera longitudinal y con una perspectiva de curso de vida para averiguar si la inestabilidad laboral puede conducir a trayectorias de incapacidad temporal desfavorables (i.e. acumulación de días crecientes en incapacidad temporal en el tiempo).
Hasta donde sabemos, es la primera vez que la participación en el mercado laboral y la incapacidad temporal se miden de manera longitudinal en el mismo estudio considerando un enfoque de curso de vida. Para ello se han utilizado novedosas técnicas estadísticas, en el campo de la epidemiología ocupacional, como es el análisis de secuencia y de agrupamiento, y el análisis de crecimiento de clases latentes. El enfoque de curso de vida en epidemiología ocupacional enfatiza cómo la vida laboral y el contexto social afectan a la relación entre el mercado laboral y la salud. Además, el análisis se ha separado no sólo por sexo, sino por cohortes según la etapa de vida laboral. La consideración de tres cohortes de vida laboral agrega contexto sobre las condiciones socioeconómicas y las circunstancias de vida a edades tempranas, las cuales comparten las personas dentro de una misma cohorte, lo que puede influir en la relación entre la participación en el mercado laboral y el curso futuro de la incapacidad temporal.
Para llevar a cabo esta investigación, se estudió una cohorte de personas afiliadas, asalariadas, residentes en Cataluña, que tuvieron al menos un episodio cerrado de incapacidad temporal entre 2012-2014. Primero se construyeron trayectorias basadas en cualquier número de días acumulados en incapacidad temporal en algún trimestre del período de seguimiento y también en base a acumular más de 15 días en algún trimestre de dicho período. Posteriormente, en las personas que acumulaban más de 15 días en incapacidad temporal, se identificaron patrones de participación en el mercado laboral de 10 años (2002-2011) y 2 años previos (2010-2011). Finalmente, se analizó la asociación entre dichos patrones de participación en el mercado laboral y el curso de la incapacidad temporal subsiguiente.
En relación al análisis estadístico, aplicamos modelos de crecimiento de clases latentes para identificar trayectorias de incapacidad temporal y análisis de secuencia y de agrupamiento para identificar patrones de participación en el mercado laboral. Finalmente, aplicamos modelos de regresión logística multinomial para evaluar la relación entre los patrones de participación en el mercado laboral y las trayectorias de incapacidad temporal.
Los resultados mostraron que las trayectorias de incapacidad temporal no estaban relacionadas con diez años de participación en el mercado laboral previa, excepto en hombres de la etapa de vida laboral temprana, donde un patrón de empleo creciente se asocia con un menor riesgo de acumular más días en incapacidad temporal en el tiempo. Sin embargo, considerando dos años previos de participación en el mercado laboral se encontraron asociaciones con el curso futuro de la incapacidad temporal en mujeres de la etapa temprana y media de la vida laboral. Las primeras tenían patrones de empleo en forma de U que se asociaban negativamente con trayectorias de incapacidad temporal crecientes, mientras que las últimas tenían patrones de empleo creciente y sin cobertura que se asociaban positivamente con trayectorias de incapacidad temporal crecientes.
En conclusión, conocer la evolución de las transiciones entre situaciones de empleo cercanas a la incapacidad temporal podría proveer información útil para prevenir cursos específicos de incapacidad temporal en el futuro.
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