Sickness absence: could gender divide be explained by occupation, income, mental distress and health?

Women have more spells of sickness absence than men but the reasons for this are unknown. We wanted to see if occupation, working conditions, income, health and mental distress may explain this gender difference.

In a health survey in 2000-01 of all Oslo inhabitants aged 40, 45, and 59/60 years, 11,072 (48.7%) participated. Survey data were linked to the National Insurance Administration and Statistics Norway for the 8,174 eligible for sickness pay in the next four years. Occupation, working conditions, general health and mental distress were self-reported, and income was from official statistics. Long-term sickness absence (>16 days) was calculated for 2001-04 as cumulative incidence and number of days reimbursed.

Cumulative incidence was 50.1% for women and 34.7% for men in the four years after the survey. An age-adjusted female overweight of 48% was only reduced to 41% by adjusting for occupation, working conditions, income, self-reported health and mental distress. Duration of long-term sickness absence was 17 days more for women than for men, and was not influenced by adjustments.

We have not explained why women have more sickness absence than men, either by work-related factors or by general health or mental distress. Factors explaining the gender divide should be sought elsewhere.