Predictors and mechanisms for gender differences in sickness absence and disability retirement

The current project aims to study mechanisms that may contribute to the gender differences in sickness absence and disability retirement. We apply historical, theoretical and empirical approaches when planning the studies and discussing the results. We use the Hordaland Health Study (HUSK), in linkage with a complete national registry on payment of social insurance benefits (FD-trygd). We are interested in exploring other measures of inequality between genders than those traditionally used by epidemiology, such as pension points. Pension point reflects taxable income during the course of working life and may be a compound indicator of equality between genders. Thus, women?s lower income and subsequent pension points may reflect cumulative disadvantages among women over the course of working life. We examine the gender distribution of pension points, and the associations between pension points, and social positions among men and women. This paper is published in Scandinavian Journal of Public Health (2017): Skogen, J. et al. The gender gap in accrued pension rights - an indicator of women?s accumulated disadvantage over the course of working life. The Hordaland Health Study (HUSK). The aim of this publication was to examine the gender difference in the relationship between average earned pension points and 1) education and 2) current occupational prestige and to discuss pension points as a possible indicator of socio-economic marginalization. We found substantial differences in earned pension rights between men and women across socioeconomic status, and a significant interaction between pension rights and gender related to education and occupational prestige. Our findings indicate that men as a group can have lower levels of education and professional prestige than women, yet earn more pension points through their careers. These differences put women at risk for future economic vulnerability and socio-economic marginalization beyond their male counterparts with equal education and professional prestige. Earned pension rights can be a useful indicator when gender equality is measured and discussed. Thirdly, we are interested in how the co-constitution of gender, education and age situate men and women in social positions that affect their likelihood of exit from working life with disability pension. In this study, we use an intersectionality approach, meaning that we address combinations of social positions (e.g. men/higher educated, women/higher educated and so on) and examine their relative risk for disability pension in a perspective of equity and power dynamics. This paper has been published: Haukenes I et al. Inequity in disability pension: an intersectional analysis of the co-constitution of gender, education and age. The Hordaland Health Study. Critical Public Health 2018 2017 May 7 [Epub ahead of print]. https://doi.org/10.1080/09581596.2018.1469730 The study provides a better understanding of social gradients in disability pensions that go beyond investigating gender, age and education separately in relation to the risk of disability pension. By linking the HUSK-study with a national register of disability pension (FD-Trygd), we found that men with higher education aged 35-57 had the least probability of disability pension compared to all other categories. By comparison, women with higher education were more likely to receive disability pension. Surprisingly, the patterns of disability pension risk among higher educated women and lower educated men were relatively similar. These findings have not been shown previously and are made possible by departing from a one-dimensional approach to an intersectional approach. Women with lower education were most disadvantaged, with a greatly increased risk of disability pension far earlier than the other groups. Moreover, we have participated in the public discourse on the gender difference in sickness absence and disability pension by writing feature articles: Women's sickness absence is not radically high; however, their working participation is. http://www.aftenposten.no/meninger/kronikker/Kvinners-sykefravar---langt-fra-himmelhoyt-7535346.html Women and men's sickness absence are fluctuating over time, but the fluctuations are parallel. Thus, women has not become 'sicker' than men. http://www.bt.no/meninger/kronikk/Kvinner-er-blitt-friskere-3239439.html Sickness absence is not about public health. The Norwegian 'health', measured as burden of disease, is not better than countries we often use as comparison. http://www.bt.no/meninger/kronikk/Sykefravar-handler-ikke-om-folkehelse-3381345.html

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Sickness absence and disability retirement have increased dramatically in Norway and across the Western world since the 1980s, with devastating individual and socioeconomic consequences. Women are notably more at risk of occupational disability, but despi te significant efforts to illuminate the gender gap, the reasons for the gender differences remain poorly understood. Current hypotheses aimed at explaining these discrepancies include gender differences in health, socio-economic status, work situation, f amily and social factors, and the double-burden hypothesis. However, few of these suggested mechanisms have been tested using a scientific rigorous design. To examine this, we will utilize data on self-reported and measured health status and indicators (i ncluding physical and mental health as well as sleep patterns), in addition to educational level, occupational social class, job control, social support at work and in private life, health behaviours and lifestyle factors, and family situations with respe ct to burden of disease. Exposure data come from the Hordaland Health Study (1997-1999) (N=18 581), linked to concurrent and subsequent data from a Norwegian national administrative registry on employment and benefits through 2012 (FD-Trygd). We also hav e information on cause of death through 2011. Data will be analyzed with combinations of multiple linear and logistic regression models, and survival analyses. The increasing rates of women being excluded from the labor market is an escalating problem in Norway and across the Western world, both in terms of the welfare burden to society, but also equally important for the individual. Therefore, improved knowledge about important risk factors contributing to gender differences is imperative to inform polic y and interventions to prevent further increase of occupational disability in women. Webpage: http://www.fhi.no/eway/default.aspx?pid=239&trg=Content_6501&Main_6157=6213:0:25,5852&MainContent_6213=6501:0:25,5853&List_6366=6370:0:25,5853&Left_6370=6623:0:24,6849:1:0:0:::0:0&Content_6501=6424:112173::1:6576:1:::0:0