Long-term sickness absence (LTSA) is most commonly due to common mental disorders and symptom-based conditions. Relatively little research has examined individual, as opposed to occupational, risk factors for LTSA. Individual appraisal of the workplace has been considered in several studies but self-rated health has more often been examined as a consequence of, rather than as a risk factor for, sickness absence. We aimed to study the association between self-rated health and later LTSA.

We used data from the 1970 British Cohort Study (BCS70). LTSA was defined as being in receipt of Incapacity Benefit (IB)/Severe Disablement Allowance (SDA) at age 34. The mother rated the participant's overall health at age 16; the participants self-rated at age 30. Reports of psychological and somatic symptoms were available at age 16; data on major health conditions were available at age 30.

Analyses were restricted to those working, studying or caring for children at age 30 (n = 14 105). One hundred and fifty-six (1.1%) were receiving IB or SDA by age 34. After adjustment for social class at birth, educational attainment, health conditions at age 30 and psychological and somatic symptoms at age 16, those who reported their health as poor had more than five times the odds of being long-term sick at age 34.

The overall appraisal of an individual's health as poor, independent of any diagnosis, is a significant vulnerability factor for LTSA.