The understanding of Norwegian women’s sickness absence: towards a holistic approach?

Abstract

Background: In Norway men's sickness absence from work has been stable or reduced over the last decades while women's sickness-absence ratio has increased, but the reasons for these developments are complex and unclear. There have been considerable efforts introduced and implemented to reduce sickness absence, but they have not succeeded. One reason for this may be the insufficient knowledge about the reasons for sick leave, and especially for women's sick leave. The aim: This article aims to examine how social factors influence sickness absence and how long-term absentees interpret and explain their ill health and sickness absence. Method: In one Norwegian county in 2010 we performed individual in-depth interviews with 20 women and ten men between the ages of 25-60 years who had been or were sick-listed for more than 30 days during the last year with a mental illness or musculoskeletal diagnoses. Results: The study illustrates how social factors influence sickness absence in different ways. The women indicated complex causes for their sickness absence, and often described an interaction between work-related and domestic-related aspects. Some accounts illustrate that their ill health might have roots in life occurrences from childhood and adolescence that have made them vulnerable to domestic and work-related strains during their adult years. The study also indicates that women, especially single mothers, seem to be especially vulnerable to domestic strains, and that these strains may lead to a paradoxical pattern of women's sick leave: they take sick leave in order to deal with domestic strains along with the intention of prolonging their presence at the workplace in the longer term. Thus, these periods of sickness absence appear to be a necessary accompaniment of a high rate of participation among vulnerable groups in the labour market. Conclusion: Women's ill health and sickness absence should be understood as a manifestation of an interplay of the strains found at both the workplace and the home. A successful effort to reduce sickness absence in Norway, therefore, requires a holistic perspective that accounts for both the work and the domestic spheres.