Risk factors for health-related absence

Professor Kjell Vaage is project leader in the project “Health, work and society – multi‑disciplinary studies of determinants of sickness absence and disability” Foto: UiB

Why is such a high proportion of the workforce of the relatively healthy Norwegian
population on health-related benefit programmes? This is the subject of a major
cross-disciplinary research project at the University of Bergen.

Most of the Norwegian population enjoy good health as well as easy access to healthcare services. The economy has seen steady long-term growth, and unemployment has been next to nonexistent. However, despite these apparently good conditions, a remarkably large number of people depend on sickness benefits or disability pensions.

The traditional assumption has been that absence due to illness tends to increase in times of economic growth and low unemployment, because people with lower-than-average work capacity and at higher risk of absence are needed and are incorporated into the workforce. In difficult times, sick leave will fall, because this part of the workforce will be the first to be excluded, and also because employees who fear for their jobs are likely to make an extra effort to keep them.

But recently, this explanation does not seem to be holding. What, then, can explain the high level of sickness absence and disability? Researchers in medicine, psychology, sociology and economics cooperate in the project “Health, work and society – multi‑disciplinary studies of determinants of sickness absence and disability”, which is the most wide-ranging ever undertaken to date in this field. According to project leader Professor Kjell Vaage , the project makes use of population-based national registers that offer detailed longitudinal information about socioeconomic and demographic variables, as well as about the use of social security programmes and changes in the labour market. For employees in the municipal sector, a register of absenteeism provides information about short-term healthrelated absence. By using information from a range of different sources, the researchers are able to cover absence ranging from short-term, self-certified sick leave to absence leading to the granting of disability pensions. Data from two
large-scale health surveys will enable the project to compare subjective perceptions of health with GPs’ sickness certification practices in order to examine the role played by GPs in confirming the validity of claims of illness.

The researchers plan, for instance, to investigate whether mental illness is a factor in granting disability pensions on the grounds of somatic illness. However, the topic of sick leave is complex, and the project will also look into social norms, workplace culture and work environment as determinants of absence. Factors such as social class, gender and ethnicity will also be investigated. In the course of the project,
therefore, the researchers hope to fill several important gaps in our knowledge about a topic that is central to development and policymaking in all modern welfare states.

The article is published in Features 2009/2010

Photo: IStockphoto