A follow-up of the introduction of a maximum entitlement period for receiving sickness benefits in Sweden: A nationwide register-based study.

In 2008, Sweden introduced a policy change to limit the number of days for sickness benefits (SB). This study aimed to elucidate the characteristics of those who reached the maximum entitlement period for receiving sickness benefits (MEPSB) and their future main source of income. Methods: All 5,309,759 individuals, aged 20-63 and residents of Sweden in 2009 were followed from July 2008 to July 2010 regarding SB-days and date of MEPSB and then categorised into three groups: I) no SB-days, II) ongoing SB-days, and III) MEPSB. Mean numbers of SB-days 2.5 years before and 2 years after the policy change and main source of income in 2011 were assessed. Associations between sociodemographic factors, occupation and paid work as main source of income were estimated by odds ratio (OR). Results: A total of 0.7% reached MEPSB in 2010. The mean numbers of SB-days before and after the policy change were higher in the MEPSB group than in the other two groups. In the MEPSB group, 14% had their main source of income from paid work in 2011; this was more common among women born in Sweden (OR = 1.29), people living with a partner and children (women OR = 1.29; men OR = 1.48), and those with occupations representing high educational levels. Conclusions: One out of seven individuals with MEPSB in 2010 had their main source of income from paid work in 2011, although they had a long-term SB before and after the policy change. Further research is warranted to address the long-term effects of this policy change.

Age, period, and cohort effects for future employment, sickness absence, and disability pension by occupational gender segregation: a population-based study of all employed people in a country (> 3 million).

OBJECTIVES: The occupational gender segregation of the labour market is very strong, both in Sweden and in North America. Nevertheless, there is little knowledge on how this is associated with employees' future employment or morbidity. The objectives of this study were to explore age, period, and cohort effects on future employment and morbidity in terms of sickness absence (SA) or disability pension (DP) among women and men employed in numerically gender-segregated or gender-integrated occupations. METHODS: Based on Swedish nationwide register data, three population-based cohorts of all people living in Sweden, with a registered occupation, and aged 20-56 years at inclusion in 1985 (N = 3,183,549), 1990 (N = 3,372,152), or 2003 (N = 3,565,579), respectively, were followed prospectively for 8 years each. First, descriptive statistics of employment and SA/DP at follow-up were calculated, related to level of gender segregation/integration of occupation at inclusion. Second, differences between birth cohorts (those born in 1929-1983, respectively) were estimated within each of the periods 1985-1993, 1990-1998, and 2003-2011, using mean polish analyses. RESULTS: Women and men in gender-segregated occupations differed in relation to future employment rates and SA/DP. However, these differences decreased over time. Furthermore, the results show a birth cohort effect; those born in 1943-1956 remained in employment to a higher extent and also had lower rates of SA/DP than all other birth cohorts. CONCLUSION: Differences between people in the five categories of gender-segregated occupations decreased over time. Although age and period are important when explaining the outcome, also birth cohort effects have to be considered, both from a public and an occupational health perspective.

Changes in the gender segregation of occupations in Sweden between 2003 and 2011.

AIM: The aim of this study was to analyze possible changes in the gender composition of occupations in Sweden, using register data covering the whole working population. METHODS: Cross tabulations on gender by occupation were computed and comparisons made of numbers and proportions of women and men aged 20-64 years to illustrate occupational gender-segregation categories in 2003 and 2011, respectively. All of those in working ages, employed in 2003 and 2011 (4.2 resp 4.7 millions individuals), were included. Differences in the distribution of women and men in all occupations were summarized using two gender-segregation indexes from 2003 and 2011, separately. RESULTS: The proportion of women increased in the gender-integrated (⩾40-<60% women) occupations. Also, the proportion of women in high-skilled professional occupations in the male-dominated category increased, as well as the proportion of men in mostly low-skilled female-dominated occupations, mainly in the service sector. The gender-segregation of occupations measured by the Index of Dissimilarly and the Karmel and MacLachlan Index was lower in 2011 than in 2003. CONCLUSIONS: The process of de-segregation has continued during our study period, from 2003 to 2011. The proportion of women increased in occupations that demand higher education, both in gender-integrated and in male-dominated occupations, which can contribute to a decrease in the level of sickness absence for women. Men increased their proportion in low-skilled, female-dominated occupations - a group with high levels of sickness absence or disability pension.

Gender segregation of occupations and sustainable employment: A prospective population-based cohort study.

BACKGROUND: Although the labour market is characterized by a strong numerical gender segregation of occupations, there is little knowledge about the associations of this with the future labour market situation for an individual person. OBJECTIVES: This study aimed to elucidate whether working in a gender-segregated or gender-integrated occupation is associated with future labour market attachment and sickness absence or disability pensions among women and men. METHODS: We used a population-based prospective cohort study with univariate and multiple logistic regression analyses stratified by gender, including all people living in Sweden aged 20-56 years and in paid work in 2003 ( n=3,239,989). They were followed up eight years later with regard to employment status, sickness absence and disability pension. RESULTS: Women and men employed in extremely female-dominated occupations in 2003 had the highest employment levels and the lowest unemployment levels at follow up in 2011. When adjusting for age, level of education and sector of employment, the highest odds ratios (ORs) for not being employed in 2011 were found for women working in extremely male-dominated occupations in 2003 (OR 1.27; 95% CI 1.21-1.33) and for men in female-dominated occupations (OR 1.42; 95% CI 1.39-1.45) relative to those in gender-integrated occupations. Women in extremely male-dominated occupations had the highest ORs for sickness absence or the receipt of a disability pension at follow up (OR 1.26; 95% CI 1.17-1.36) and men in female-dominated occupations had the highest OR 1.15 (95% CI 1.11-1.20). CONCLUSIONS: For both women and men, the gender composition of the occupation they work in seems to be of importance for their future labour market attachment and sickness absence or receipt of a disability pension.