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Mastekaasa A, Dale-Olsen H, Hellevik T, Løset GK, Østbakken KM. Gender difference in sickness absence: Do managers evaluate men and women differently with regard to the appropriateness of sickness absence? Scand J Public Health 2019; 49:125-131. [PMID: 31825274 DOI: 10.1177/1403494819890783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: Women have much higher rates of sickness absence than men, but the causes of the difference are not well understood. This study examines whether managers have more lenient attitudes towards women's than towards men's absence, as this might contribute to higher rates of sickness absence among women. Differences between managers and other employees are also assessed. Methods: Vignettes were used to measure attitudes towards the legitimacy of sickness absence. The vignettes consisted of brief case descriptions of individuals considering asking their physicians for sick leave, with information about the medical condition (mainly taken from the descriptions in ICPC-2), occupation and gender. Respondents judged how appropriate sickness absence was in each case. Quota sampling was used, and the effective sample size was 899 managers and 1396 other employees, with each respondent evaluating either four or six vignettes. Generalised ordinal logistic regression was used. Results: The gender of the vignette person had no effect on the managers' evaluations of the appropriateness of sickness absence. Irrespective of the gender of the vignette person, however, managers were generally more restrictive than non-managers. Conclusions: Different attitudes on the part of managers towards sickness absence in men and women do not seem to contribute to gender differences in sickness absence, but managers are generally more restrictive compared to non-managerial employees.
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Affiliation(s)
- Arne Mastekaasa
- Department of Sociology and Human Geography, University of Oslo, Norway
| | | | - Tale Hellevik
- Norwegian Social Research (NOVA), Centre for Welfare and Labour Research, OsloMet - Oslo Metropolitan University, Norway
| | - Gøril K Løset
- Norwegian Social Research (NOVA), Centre for Welfare and Labour Research, OsloMet - Oslo Metropolitan University, Norway
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Dorrington S, Roberts E, Mykletun A, Hatch S, Madan I, Hotopf M. Systematic review of fit note use for workers in the UK. Occup Environ Med 2018; 75:530-539. [PMID: 29735750 DOI: 10.1136/oemed-2017-104730] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 02/23/2018] [Accepted: 03/09/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The fit note, introduced in England, Wales and Scotland in 2010, was designed to change radically the sickness certification process from advising individuals on their inability to work to advising them on what they could do if work could be adapted. Our review aimed to evaluate the following: (1) Is the 'maybe fit' for work option being selected for patients? (2) Are work solutions being recommended? (3) Has the fit note increased return to work? (4) Has the fit note reduced the length of sickness absence? We considered the way in which outcomes vary according to patient demographics including type of health problem. METHODS Studies were identified by a systematic search. We included all studies of any design conducted in the UK with working age adults, aged 16 or over, from 1 April 2010 to 1 Nov 2017. Risk of bias was assessed using a modified Newcastle-Ottawa Scale. RESULTS Thirteen papers representing seven studies met inclusion criteria. In the largest study, 'maybe fit' for work was recommended in 6.5% of fit notes delivered by general practitioners (GP; n=361 801) between April 2016 and March 2017. 'Maybe fit' recommendations were made in 8.5%-10% of fit notes received by primary care patients in employment, and in 10%-32% of patients seen by GPs trained in the Diploma in Occupational Medicine. 'Maybe fit' was recommended more for women, those with higher socioeconomic status, and for physical, as opposed to psychiatric disorders. The majority of fit notes with the 'maybe fit' option selected included work solutions. There was inconclusive evidence to suggest that the introduction of the fit note has reduced sickness absence among patients in employment. CONCLUSIONS Fit notes represent a major shift in public policy. Our review suggests that they have been incompletely researched and not implemented as intended.
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Affiliation(s)
- Sarah Dorrington
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Emmert Roberts
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Arnstein Mykletun
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway.,Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway.,Research Unit, Directorate of Labour and Welfare, Oslo, Norway.,Centre for Research and Education in Forensic Psychiatry and Psychology, Haukeland University Hospital, Bergen, Norway.,Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Stephani Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ira Madan
- Department of Occupational Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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