Developments in sickness absence

Up to 2003, total sickness absence climbed to more than eight per cent. This was followed by an abrupt, pronounced decline. Several factors may have affected developments in sickness absence. Amendments to regulations introduced in connection with the first IA Agreement to promote better follow up of employees on sick leave and entailing stricter rules for taking sick leave for more than eight weeks, as well as more use of medical certificates allowing graded sick leave, may be among the most important causes of the decline in sickness absence. Since 2005, the percentage of sickness absence has been more or less stable, with a temporary increase in the early half of 2009, which was exceptional and a result of the financial crisis.

The extent to which cyclical economic fluctuations have had an impact on sickness absence is debatable. Research gives no clear answer as to whether there is causality between the situation on the labour market and sickness absence, and, if so, what the correlation is.

The trend in sickness absence is also influenced by developments in the receipt of other benefits. A study from the Ragnar Frisch Centre for Economic Research indicates that sickness absence would have been higher if more people had remained on the job rather than leaving the labour market through retirement due to disability or other benefits.³⁰

Table 3.2 shows developments in total and self-certified absenteeism, as well as in total absenteeism, by gender, during the period from 2001 to 2014. Sickness absence has been reduced for men and women alike since

30Biørn et al. (2013)

Table 3.2 Total sickness absence by gender, and self-certified

absenteeism, overall. Lost person-days ensuing from sickness absence as a percentage of agreed working days (percentage of sickness absence). 2001– 2014.

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Total, Both genders 7.4 7.8 8.2 7.1 6.7 6.9 6.9 7.0 7.5 6.8 6.7 6.5 6.5 6.4

Total, men 6.1 6.4 6.8 5.8 5.4 5.6 5.5 5.6 6.1 5.4 5.3 5.0 5.0 4.9

Total, women 9.1 9.5 10.0 8.7 8.3 8.6 8.7 8.9 9.3 8.5 8.6 8.4 8.3 8.2

Self-certified, both genders 0.8 0.9 0.9 0.9 0.9 0.9 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0

Source: Statistics Norway

2001. From 2012–2014, the total annual rate of sickness absence was 6.5 per cent.

This was lower than in the period 2009–2011.

Since the first IA Agreement was signed in 2001, total annual absenteeism has never been lower than it was in 2012, 2013 and 2014, but the goal of a 20 per cent reduction in total sickness absence has not been reached.

The annual total sickness absence for men was 5.0 per cent in 2013 and 4.9 per cent in 2014, which was also the lowest registered annual level since the IA Agreement was signed.

The annual total sickness absence for women was 8.2 per cent in 2014 and is at the lowest level registered since the IA Agreement was signed in 2001.

Self-certified sickness absence saw a slight increase from 2001–2014 and is currently at 1 per cent. This has taken place in industries dominated by public administration, in particular. This may indicate that increasing the self-certification period due to the IA Agreement has had an effect.

Differences in gender and age

Women have substantially higher sickness absence than men in all age groups. Sickness absence for men increases with age, except for the oldest age group, 65–69 years, where employment is low. Women's absenteeism has a somewhat different age pattern. Women between 25 and 44 years of age have higher absenteeism than the subsequent age groups. A great deal of this absenteeism can be related to illness during pregnancy. Examining the absenteeism of non-pregnant women only, women's sickness absence is nonetheless higher than men's. The complications and maladies of pregnancy alone do not explain why women's absenteeism is higher than men's. Nor does it explain why sickness absence increases with age for all age groups. Non-pregnant women aged 35–44, for example, have higher

absenteeism than women aged 45–49. The difference between women's absenteeism and men's absenteeism is greatest in the 25–39 age group.

Gender differences in sickness absence

Ordinary explanations of gender differences in respect of sickness absence are that they are ascribable to pregnancy-related disorders, other health differences, that women find it easier

to consult the public health service, that women are subject to a double burden of work and responsibility for children, and experience special work-related stress in occupations with a high preponderance of women. Official Norwegian Report (NOU) 2010: 13 Work for health (Almlid Committee) reviews the knowledge status regarding gender differences in rates of sickness absence. The Almlid Committee concludes that many of the gender differences cannot be explained on the basis of available knowledge, and that many of the causes of the gender differences in sickness absence are unknown.

The report from the Almlid Committee states that pregnancy is one important reason for the gender differences in sickness absence. Nonetheless, gender differences in sickness absence can only partially be explained by the difference in sickness absence in connection with pregnancy. Explanations for gender differences in sickness absence have been discussed often. In 2011, the Norwegian Institute of Public Health held a meeting of researchers who are experts in their fields about the causes of gender differences in sickness absence. One

important part of the task was to draw up a report summarising the discussion. One of the main findings of the report is that there are large gender differences in sickness absence in other countries as well, and that it is the high overall sickness absence that makes Norway stand out, not the fact that there are significant gender differences. According to the report, there are no reliable explanations for why sickness absence is higher among women than among men. The selection of women's or men's occupations does not appear to be a valid explanation for gender differences in respect of sickness absence, and ongoing studies suggest that the differences cannot be explained by gender differences in connection with medical problems either. Further, the report concludes that the double-work hypothesis³¹ cannot be rejected, but that the underlying mechanisms are not sufficiently well understood. To

understand these, the researchers were of the opinion that one should examine roles, attitudes and identities linked to the double-work hypothesis.³² As a follow-up to this report, the Ministry of Labour and Social Affairs commissioned the Ragnar Frisch Centre for Economic Research to examine whether different attitudes, norms and preferences can explain gender differences in respect of sickness absence.³³ The resulting study indicates that men and women are somewhat different as regards attitudes, norms and preferences. Further, the study concludes that certain attitudes, norms and preferences correlate with sickness absence.

However, the researchers did not find that the differences between the genders help to explain gender differences in respect of sickness absence.

There is also recent research that emphasises the importance of the psychosocial working environment and the connection between the gender-divided labour market and women's occupational health.³⁴ The research communities are divided on this point, and there is still uncertainty attached to the correlation between gender and sickness absence. More research efforts are in progress, not least in conjunction with the programme on sickness

31The combination of paid work and unpaid care work

32Mykletun and Vaage (2012)

33Hauge et al. (2015)

34Sterud (2014) and Ose et al. (2014)

absence, work and health under the auspices of the Research Council of Norway. Gender differences in medical problems as a cause of sickness absence are a topic that has been studied to a lesser degree. Chapter 5 contains a more detailed discussion of working life and gender differences in health.