SAME GENERATION, DIFFERENT STATE: REGIONAL DISPARITIES IN SICK LEAVE ACROSS BABY BOOMERS, GEN-X, MILLENNIALS, AND GEN-Z IN GERMANY
Author(s)
Jennifer Scarlet Haas, MSc1, Vukasin Viskovic, MA2, Timotheus Stremel, MSc1, Kathrin Gerchow, MPH1, Svitlana Schnaidt, MSc1, Dominik Obermüller, PhD2, Christian Jacob, PhD1.
1Cencora, Hannover, Germany, 2InGef - Institut für angewandte Gesundheitsforschung, Berlin, Germany.
1Cencora, Hannover, Germany, 2InGef - Institut für angewandte Gesundheitsforschung, Berlin, Germany.
OBJECTIVES: We aimed to assess whether sick-leave prevalence among fully insured individuals differed within generational cohorts across German federal states.
METHODS: Anonymized claims data from the Institute for Applied Health Research Berlin (InGef) research database were used. Working-age individuals (16-67 years) in 2024 were classified into four birth cohorts: Baby Boomers (Boomers) (1946-1964), Gen-X (1965-1979), Millennials (1980-1996), and Gen-Z (1997-2012). Annual sick-leave prevalence and sickness absence rates (sick-leave days/insured days) were calculated by German federal state, and regional variation within each cohort was assessed.
RESULTS: Among 3,556,793 individuals, overall sick-leave prevalence ranged from 53.2% (Boomers) to 67.9% (Gen-Z), with similar intermediate values for Gen-X (62.6%) and Millennials (61.9%). Within each cohort, prevalence varied substantially across the 16 federal states: 48.3% (Berlin) to 57.6% (Thuringia) among Boomers, 52.9% (Berlin) to 66.1% (Lower Saxony) in Gen-X, 53.5% (Berlin) to 67.2% (Saxony-Anhalt) in Millennials, and 54.1% (Berlin) to 73.5% (Mecklenburg-Western Pomerania) in Gen-Z with the highest overall prevalence and the widest regional spread (19.4 vs. 9.3 percentage points in Boomers). The overall sickness absence rate was highest among Boomers (5.3%) and lower in younger generations (Gen-X: 4.7%), with near-identical values for Millennials (3.7%) and Gen-Z (3.8%). Regional values ranged from 4.6% (Hamburg) to 6.7% (Saxony-Anhalt) among Boomers, 3.8% (Hamburg) to 5.9% (Saarland) in Gen-X, 3.2% (Berlin) to 4.9% (Saxony-Anhalt) in Millennials, and 3.0% (Hamburg) to 4.9% (Mecklenburg-Western Pomerania) in Gen-Z. Eastern federal states (Brandenburg, Saxony-Anhalt, Thuringia) showed generally higher sickness absence rates.
CONCLUSIONS: Sick-leave prevalence varied substantially within generational cohorts across German federal states, with Berlin showing the lowest prevalence in all four cohorts. Regional variation widened markedly with younger generations, reaching 19.4 percentage points in Gen-Z compared with 9.3 in Boomers. Regional context may be at least as relevant as generational affiliation for sick-leave patterns in Germany, particularly among younger workers.
METHODS: Anonymized claims data from the Institute for Applied Health Research Berlin (InGef) research database were used. Working-age individuals (16-67 years) in 2024 were classified into four birth cohorts: Baby Boomers (Boomers) (1946-1964), Gen-X (1965-1979), Millennials (1980-1996), and Gen-Z (1997-2012). Annual sick-leave prevalence and sickness absence rates (sick-leave days/insured days) were calculated by German federal state, and regional variation within each cohort was assessed.
RESULTS: Among 3,556,793 individuals, overall sick-leave prevalence ranged from 53.2% (Boomers) to 67.9% (Gen-Z), with similar intermediate values for Gen-X (62.6%) and Millennials (61.9%). Within each cohort, prevalence varied substantially across the 16 federal states: 48.3% (Berlin) to 57.6% (Thuringia) among Boomers, 52.9% (Berlin) to 66.1% (Lower Saxony) in Gen-X, 53.5% (Berlin) to 67.2% (Saxony-Anhalt) in Millennials, and 54.1% (Berlin) to 73.5% (Mecklenburg-Western Pomerania) in Gen-Z with the highest overall prevalence and the widest regional spread (19.4 vs. 9.3 percentage points in Boomers). The overall sickness absence rate was highest among Boomers (5.3%) and lower in younger generations (Gen-X: 4.7%), with near-identical values for Millennials (3.7%) and Gen-Z (3.8%). Regional values ranged from 4.6% (Hamburg) to 6.7% (Saxony-Anhalt) among Boomers, 3.8% (Hamburg) to 5.9% (Saarland) in Gen-X, 3.2% (Berlin) to 4.9% (Saxony-Anhalt) in Millennials, and 3.0% (Hamburg) to 4.9% (Mecklenburg-Western Pomerania) in Gen-Z. Eastern federal states (Brandenburg, Saxony-Anhalt, Thuringia) showed generally higher sickness absence rates.
CONCLUSIONS: Sick-leave prevalence varied substantially within generational cohorts across German federal states, with Berlin showing the lowest prevalence in all four cohorts. Regional variation widened markedly with younger generations, reaching 19.4 percentage points in Gen-Z compared with 9.3 in Boomers. Regional context may be at least as relevant as generational affiliation for sick-leave patterns in Germany, particularly among younger workers.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH263
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas