Working When Sick: Presenteeism in Israel

The Taub Center publishes a study that, for the first time, examines “presenteeism” — people coming to their place of work while sick — in the Israeli labor market. The study highlights the prevalence of the phenomenon, the factors influencing it (such as gender, workplace relationships, and employment characteristics), and its health and economic implications. Researcher Haim Bleikh finds that presenteeism rates are quite high in Israel, with notably high rates in the education sector.

Health and economic costs of presenteeism

Studies indicate that presenteeism incurs both health and economic costs. On the health front, sick workers can spread illnesses to others — colleagues, customers, and students — thus increasing the risk of disease transmission both within and beyond the workplace. Additionally, attending work while sick can worsen an individual’s health condition, potentially leading to more extended absences in the future.

On the economic side, both absenteeism and presenteeism reduce productivity. While absenteeism-related costs are relatively easy to quantify due to their documentation, measuring presenteeism costs — such as reduced output, professional errors, and safety violations — is more challenging. Nevertheless, prior research suggests that the costs of presenteeism exceed those of absenteeism.

61% of Israeli workers reported working while sick, with higher rates among women

The study analyzed employed individuals aged 25–64 using data from the Central Bureau of Statistics’ Social Survey and found that 61% reported working while sick at least once during the year. This rate is significantly higher than the EU average of 42%, but lower than in the US, where two out of three workers reported presenteeism.

The research also found that women are more likely than men to work while sick. This gender gap may be partly explained by women’s higher use of sick days for personal or child-related illnesses, which increases absenteeism and may even encourage presenteeism. Additionally, health conditions unique to women (e.g., menstruation or pregnancy-related symptoms) may contribute to higher presenteeism rates.

High presenteeism rates in education

By economic sector, presenteeism is more common among workers in hospitality, food services, local government, public administration, defense, and education, with rates exceeding 70%. Conversely, the lowest presenteeism rates (57%) were found in transportation and postal services.

The high rate in education, the largest employment sector (employing about 15% of salaried workers), is concerning due to the close interpersonal interaction between educators and students and the public health impact of contagious illnesses. This trend may stem from challenges in finding substitutes on short notice, as well as concerns about students’ academic performance.

A lack of managerial support, workplace violence, and discrimination impact presenteeism

The study reveals that higher managerial support correlates with lower rates of presenteeism. Managers who maintain close relationships with employees are more likely to recommend taking sick leave when unwell, helping reduce presenteeism. This finding underscores the role of leadership in promoting employee health within organizational culture.

In contrast, exposure to workplace violence (e.g., bullying and harassment) or perceived unfairness can lead to emotional stress, anxiety, and overall health deterioration, all of which may contribute to presenteeism. Employees who feel discriminated against may attend work while sick out of fear for their job security or status.