Women’s sickness absence in contemporary Norway. The impacts of class, motherhood, and pregnancy
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- Department of Sociology 
It is well known that in many countries, women have higher levels of sickness absence than men. In spite of several attempts to explain this gender gap in Norway, it is not very well understood. This thesis contributes to this research field by investigating the impact of class, and class specific impacts of motherhood and pregnancy on Norwegian women’s sickness absence. Women’ heightened level of sickness absence is important for several reasons. First, it may indicate that relative to men, women still face obstacles which should be prevented in order to facilitate gender equality in the labor market. This is in turn important for women’s financial independence. Second, women’s heightened sickness absence makes them more prone to accusations in the heated public debate about the costs of sickness absence. Third, any possible prospective retrenchments of sickness benefits will affect women to a larger degree than men. Such retrenchments are frequently addressed in the public debate. However, women’s heightened sickness absence should also be considered in the light of other characteristics of the Norwegian society. In particular, Norway has succeeded in combining high levels of female employment and fertility. In this context, it seems reasonable to question if the higher rates of sickness absence among women may is a precondition for preventing labor market exclusion of women during periods of strain and family obligations. If so, women’s heightened sickness absence may reflect that women’s experiences and life courses differ fundamentally from those of men’s, and that gender equality in sickness absence may be neither realistic nor desirable. In other words, a better understanding of the complex mechanisms behind women’s sickness absence is important in order to ensure a sound development of sickness absence prevention policies. Although the political concerns associated with women’s sickness absence make this topic relevant for a wide audience, there is also a risk that the dominant perception of sickness absence in society too strongly influences the research questions and interpretations of findings in scientific research on this topic. In order to establish a more nuanced understanding of sickness absence than what is presented in the media, this thesis draws on sociological literature on class, gender, welfare, and the life course. This literature has also guided the empirical investigations. Inspired by literature on gender and the life course, the theoretical starting point of this thesis is that Norwegian women’s sickness absence must be considered in the light of the substantial social changes which have occurred in the Norwegian society since the 1970s. During this period, the social services have been substantially expanded, which has brought about creation of new occupations. Many of those have been female dominated. This development has brought about considerable sociological debate about the relationship between inequalities in contemporary welfare states and the class differentials of industrial societies. Also, it has been discussed whether the traditional class schemes accounts for the particular occupational structure among women. In this context, new and revised class schemes have been presented to better account for women’s occupations. Further, women’s level of education and employment has grown sharply, while men spend increasingly more time on household chores and child care. Still, the extent of these changes varies across social classes. Part-time employment is still widespread among working class women, and working class couples have a more traditional division of domestic work than middle class couples do. In contrast, the gender roles have converged more strongly in the middle class, where long working hours has become common among both genders, and men contribute substantially to domestic work. Because middle class women pursue higher education and an occupational career, postponement of pregnancy has become increasingly common in this group. In the light of these changes, it seems relevant to ask if women’s sickness absence is influenced by the current class structure and its interplay with pregnancy and motherhood in the contemporary Norwegian society. Still, this question has received little attention in previous research. This thesis contributes to filling this gap. Article 1 provides empirical analyses of The Norwegian Level of Living Survey, and revealed that although statistically significant class differentials in sickness absence were found, controlling for class did not lead to any substantial improvement of the model, regardless of which of the four different class scheme that was used. Articles 2-4 were based on the population registry “FD-Trygd”. Article 2 investigated the impact of motherhood on sickness absence among married women. Although motherhood did not increase the risk of sickness absence neither in the middle class nor working class, it entailed prolonged spells in both groups, although the increase was particularly strong among working class women. Article 3 found that although sickness absence during pregnancy has increased since the early 90s, this development was not due to the fact that postponement of pregnancy has become increasingly common among highly educated women. Finally, Article 4 revealed that occupational class accounts for the increased sickness absence among pregnant women in their early twenties, but only among first-time pregnant women. Article 1, Article 3, and Article 4 have been published in peer reviewed journals. To summarize, the empirical findings of the articles suggest that even though class does not have a strong direct impact on women’s risk of sickness absence, the impact of both motherhood and pregnancy on women’s sickness absence is highly class specific. Both motherhood and pregnancy entailed heightened sickness absence among working class women, while postponement of pregnancy – which particularly applied to middle class women - was not associated with higher sickness absence. This conclusion further supports previous literature which has highlighted the need for combining class analyses with a life course perspective in order to fully account for the complex structure of inequality in contemporary welfare states. Further, the findings of the thesis indicate that future research should aim to illuminate both the risk of sickness absence and the number of sick days, as these are differently influenced by class and motherhood. However, the exact measure of women’s class seems to be of secondary importance in sickness absence research.
Has partsPaper I: Steinsland, A., Hansen, HT. (2010) Klasseforskjeller i sykefravær i Norge. En sammenligning av ulike klasseskjemaer [Class differences in sickness absence in Norway. A comparison of different class schemes]. Sosiologisk Tidsskrift, 18, 355–377. Full text not available in BORA due to publisher restrictions. The article is available at: https://www.idunn.no/st/2010/04/art03
Paper II: Ariansen, AMS. Parenthood and sickness absence: Class and gender variations. A population registry analysis of married employees in Norway. Full text available in the main thesis.
Paper III: Ariansen, A.M.S., Mykletun, A. (2014) Does postponement of first pregnancy increase gender differences in sickness absence? A register based analysis of Norwegian employees in 1993–2007. Plos One, 9, e93006. The article is available at: http://hdl.handle.net/1956/8804
Paper IV: Ariansen, A.M.S. (2014) Age, occupational class, and sickness absence during pregnancy: A retrospective analysis study of the Norwegian population registry. BMJ Open, 4, 10.1136. The article is available at: http://hdl.handle.net/1956/8887