To Örebro University

The focus of this thesis is the study of social and psychosocial aspects of sickness absence. In Essay 1, Sickness Absence and Peer Effects – Evidence from a Swedish Municipality, detailed employment records from a Swedish public employer are used to investigate whether sick leave among work group colleagues influences individual sick leave. Our results indicate that a worker’s level of sick leave is positively correlated with sick leave among peers. When length of employment is taken into account, however, we find that this positive peer effect emerges initially after the first few years of employment. In Essay 2, Who Cares about the Colleagues? – Insights into Peer Effect Heterogeneities in Sickness Absence across Gender and Age, I scrutinize the data used in Essay 1 to further investigate the nature of peer effects in sickness absence in relation to gender and age. The results indicate that men, as well as women, are sensitive to their female colleagues but not to their male peers. Moreover, somewhat surprisingly, I find that young and middle-aged workers are sensitive to younger peers, whereas the oldest workers are not sensitive to any of their peers. Essay 3, Sickness Absence and Local Culture, investigates the effect of geographical and presumed cultural context on sickness absence. Our results indicate that the region of residence is important to individual ‘illness-related absence’. In Essay 4, Sickness Absence, Working Conditions and Gender – An Empirical Analysis using Multiltvel Models, I analyse how psychosocial working conditions are related to short- and longterm sick leave and if, and how, these relation-ships vary with gender. The results show that employees who enjoy higher levels of autonomy in their post take fewer periods of short-term sick leave, and that this effect is significantly greater for male workers. The results also show that for female workers, stronger work-group cohesion is related to a lower likelihood of long-term sick leave. 

Sickness absence rates vary substantially across geographical areas in Sweden. There exist striking differences in absence patterns between southern and northern counties as well as between rural and urban areas. Some of the observed differentials have been suggested in the literature to be caused by differences in local norms regarding the legitimacy of living of benefits. The aim of our study is to investigate the effect of geographical and presumed cultural context on sickness absence. The effect is identified and measured by comparing the outcome of sickness related absences for individuals that move across clusters of municipalities to the outcome on individuals that move within clusters. Our results suggests that individuals that move from a cluster of municipality with high (low) rates of sickness absence to clusters with low (high) rates have a larger (smaller) change over time of their sickness related absence compared to individuals that move within the original region.

In this paper we use data that combines employment records with employee survey responses to study to what extent psychosocial working conditions, measured at the work group level, relate to individual short-term and long-term sick leave. In order to take interdependencies of workers and work groups into consideration we use multilevel modeling as our modeling strategy. Our results suggest that in order to reduce the number of spells of short-term sick leave (shirking), employers should increase the worker’s job autonomy. This is particularly important for male workers. In addition, increasing work group cohesion is important in order to reduce the number of women being on long-term sick leave.

In this paper we use detailed employment records to study to what extent sickness absence among work group colleagues influences individual sickness absence. Our results indicate an overall positive peer effect. However, further analysis show peer behavior to be important for women’s sickness absence, but not for men’s, and that woman are only affected by their female co-workers. Our findings also suggest that it, on average, takes two to three years for a new employee to become influenced by the absence pattern of the work group. In light of our results, we cannot rule out the possibility of social norms being important to the individual sick leave decision.