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

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 despite 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, family 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 (including 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 respect 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 have 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 policy and interventions to prevent further increase of occupational disability in women.