Impact of the Norwegian Agreement for a More Inclusive Working Life on diagnosis-specific sickness absence in young adults: a difference-in-difference analysis

Rachel L. Hasting,Jon Michael Gran,Therese N. Hanvold,Petter Kristensen,Suzanne L. Merkus,Ingrid S. Mehlum

doi:10.1186/s12889-022-12636-9

Abstract

BackgroundThe Norwegian Agreement for a More Inclusive Working Life (the IA Agreement) aims to reduce sickness absence (SA) and increase work participation. Potential impacts of the IA Agreement have not been thoroughly evaluated. The study aimed to estimate the impact of the IA Agreement on musculoskeletal and psychological SA prevalence and duration among young adult men and women, and to identify whether the impact was modified by economic activity or SA grade.MethodsData from national registries were combined for 372,199 individuals born in Norway 1967–1976. ICPC-2 codes identified musculoskeletal (L) and psychological (P) diagnoses. A difference-in-difference method compared prevalence and mean duration of first SA > 16 days between 2000 and 2005 separately for men and women working in IA companies relative to non-IA companies. Analyses were adjusted for mean company size and stratified by economic activity and SA grade (full/graded). Average marginal change was calculated with 95% confidence intervals (CI).ResultsThe impacts of the IA Agreement on SA prevalence were mixed as the direction and size of marginal changes varied according to diagnosis, gender, and economic activity. However, there was a general tendency towards reduced mean SA duration for both diagnosis groups, and in particular men with musculoskeletal SA (− 16.6 days, 95% CI -25.3, − 7.9). Individuals with full SA in IA companies had greater reductions in mean SA duration. Only the wholesale and retail economic activity indicated a beneficial contribution of the IA Agreement for both SA prevalence and duration, in both diagnoses and genders.ConclusionsPotential impacts of the IA Agreement on SA in young men and women varied according to diagnosis and economic activity. However, results indicated that the IA Agreement could reduce SA duration. Further research should identify reasons for gender and economic activity differences.

Highlights

IntroductionThe Norwegian Agreement for a More Inclusive Working Life (the IA Agreement) aims to reduce sickness absence (SA) and increase work participation
The Norwegian Agreement for a More Inclusive Working Life aims to reduce sickness absence (SA) and increase work participation
There was a higher proportion of individuals in the control group both in 2000 and 2005 (80 and 73%, respectively); women were more likely to be in the intervention group at both time points (64 and 56%, respectively)

Summary

Introduction

The Norwegian Agreement for a More Inclusive Working Life (the IA Agreement) aims to reduce sickness absence (SA) and increase work participation. High costs and productivity losses are associated with SA; in 2018, European Union states combined spent 1% (roughly €160 billion) of their GDP on sickness benefits [2]. These challenges have resulted in an increased focus on measures to prevent and reduce SA in the working population. Companies who signed the IA Agreement (so-called IA companies) gained access to different resources, including measures to prevent SA (e.g. workplace risk assessment training) and to aid in faster return to work (e.g. grants to help modify the workplace) [3]. The IA Agreement is in its fifth term (2019–2022), where it has been extended to include all Norwegian companies [6]

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