Striving for excellence, learning to cope? Employer strategies for managing sick leaves and emplyee health over the decades.

• Godøy, Anna Aasen & Huitfeldt, Ingrid Marie Schaumburg (2020). Regional variation in health care utilization and mortality. Journal of Health Economics. 71. doi: 10.1016/j.jhealeco.2019.102254. Full text in Research Archive Show summary

  Geographic variation in health care utilization has raised concerns of possible inefficiencies in health care supply, as differences are often not reflected in health outcomes. Using comprehensive Norwegian microdata, we exploit cross-region migration to analyze regional variation in health care utilization. Our results indicate that place factors account for half of the difference in utilization between high and low utilization regions, while the rest reflects patient demand. We further document heterogeneous impacts of place across socioeconomic groups. Place factors account for 75% of the regional utilization difference for high school dropouts, and 40% for high school graduates; for patients with a college degree, the impact of place is negligible. We find no statistically significant association between the estimated place effects and overall mortality. However, we document a negative association between place effects and utilization-intensive causes of death such as cancer, suggesting high-supply regions may achieve modestly improved health outcomes.

• Mastekaasa, Arne (2020). Absenteeism in the Public and the Private Sector: Does the Public Sector Attract High Absence Employees? Journal of public administration research and theory. 30(1), p. 60–76. doi: 10.1093/jopart/muz003. Full text in Research Archive Show summary

  Evidence from many countries show that public sector employees have considerably higher rates of absenteeism than have private sector employees. Based on regression analyses of a large probability sample of the Norwegian population, this article shows that most of the sector difference in long-term absence can be accounted for by taking into consideration the socio-demographic characteristics of the workforce and the occupational composition in the two sectors. A clear sector difference in short-term absenteeism cannot be accounted for in this way. A direct effect of the working or employment conditions in the two sectors is also not a likely explanation, since workers who switch between the sectors are not more absent when they are in the public than when they are in the private sector. Thus, the high level of short-term absenteeism in the public sector seems to be due to a selection of absence prone individuals to the sector. Since motivational factors are likely to be relatively more important for short-term than for long-term, these findings indicate that lower work attendance motivation in among public sector employees may be the main driver. These patterns are consistent with an economic explanation in which people with low attendance motivation select to the public sector, since the work attendance incentives are weaker there. The degree to which the results are compatible with the theory Public Service Motivation (PSM) is also discussed.

• Bryson, Alex; Dale-Olsen, Harald & Nergaard, Kristine (2019). Gender differences in the union wage premium? A comparative case study. European journal of industrial relations. doi: 10.1177/0959680119840572. Full text in Research Archive Show summary

  Trade unions have changed from being male dominated to majority-female organizations. We use linked employer–employee surveys for Norway and Britain to examine whether, in keeping with a median voter model, the gender shift in union membership has resulted in differential wage returns to unionization among men and women. In Britain, while only women receive a union wage premium, only men benefit from the increased bargaining power of their union as indicated by workplace union density. In Norway, however, both men and women receive a union wage premium in male-dominated workplaces; but where the union is female dominated, women benefit more than men. The findings suggest British unions continue to adopt a paternalistic attitude to representing their membership, in contrast to their more progressive counterparts in Norway.

• Bratsberg, Bernt; Raaum, Oddbjørn & Røed, Knut (2018). Job Loss and Immigrant Labour Market Performance. Economica. 85(337), p. 124–151. doi: 10.1111/ecca.12244. Show summary

  While integration policies typically focus on labour market entry, we present evidence showing that immigrants from low-income countries tend to have more precarious jobs, and face more severe consequences of job loss, than natives. For immigrant workers in the Norwegian private sector, the probability of job loss in the near future is more than twice that of native workers. Using corporate bankruptcy filings for identification, we find that the adverse effects of job loss on future employment and earnings are twice as large for immigrant employees from low-income source countries.

• Melsom, Anne May & Mastekaasa, Arne (2018). Gender, occupational gender segregation and sickness absence: Longitudinal evidence. Acta Sociologica. 61(3), p. 227–245. doi: 10.1177/0001699317691583. Full text in Research Archive Show summary

  Women have much higher sickness absence rates than men. One prominent hypothesis is that this is a result of gender segregation in the labour market and the differences in employment or working conditions that follow from this. Previous studies assessing this idea give mixed results, but they do not take into account the possibility of selection effects. Longterm health differences between individuals may, for instance, influence both what jobs people end up in and their levels of sickness absence. In this paper, we provide new evidence on employment and working conditions as a cause of gender differences in sickness absence. We use individual fixed-effect models to account for selection based on stable individual characteristics. Like several previous studies, we find a U-shaped relationship with high absence in both male- and female-dominated occupations. However, the fixed-effect models show that this relationship is primarily caused by overrepresentation of absence-prone individuals in female-dominated occupations. Accounting for selection, the association between the proportion of women in the occupation and sickness absence is negative. As far as sickness absence is concerned, the gender segregation in the labour market thus seems to work to the advantage of women.

• Dale-Olsen, Harald (2018). Sykefravær og inntektskompensasjon ved sykefravær. Søkelys på arbeidslivet. 35(1/2), p. 77–95. doi: 10.18261/issn.1504-7989-2018-01-02-05. Full text in Research Archive Show summary

  I artikkelen vises det at sykelønn utover hva som ytes av folketrygden, oftere blir tilbudt i 2012 enn i 2003. Slik sykelønn blir tilbudt oftere blant virksomheter tilknyttet tariffavtale, virksomheter som har mange høytlønte og hvor opplæringstiden er lengre, dvs. slik sykelønn kan oppfattes som et frynsegode som tilbys til/fremforhandles av attraktive og sterke arbeidstakergrupper. Studien avsluttes med en analyse om vi kan se forskjeller i sykefraværsmønsteret tilknyttet legemeldt ettersom ansattes inntekt passerer folketrygdens grense for inntektskompensasjon grunnet sykdom. Dette viser at selv om noen grupper tilpasser sitt fravær til grensen for kompensasjon fra folketrygden, gjelder dette langt fra alle.

• Godøy, Anna Aasen & Dale-Olsen, Harald (2018). Spillovers from gatekeeping – Peer effects in absenteeism. Journal of Public Economics. 167, p. 190–204. doi: 10.1016/j.jpubeco.2018.08.015. Full text in Research Archive Show summary

  We study peer effects in absenteeism among workplace colleagues. Gatekeeping is an essential task in many insurance systems. In this study we exploit exogenous shifts of general practitioners (GPs) occurring when physicians quit or retire. We find that these shifts induce changes in absenteeism for affected workers. By utilizing high-quality Norwegian matched employer-employee data with detailed individual information on certified sick leave during the period 2003–2012, we can study how the transfer of workers between GPs affects co-workers’ absenteeism. We identify strong causal positive peer effects in absenteeism: a one day change in focal worker sickness absence transfers to a 0.41 day shift in peer absence.

• Dale-Olsen, Harald (2017). Labour demand and supply changes in Norway following an imposed harmonization of geographically differentiated payroll-tax rates. Labour. 32(2), p. 261–291. doi: 10.1111/labr.12119. Full text in Research Archive Show summary

  The payroll-tax is an important source for public financial revenues. Utilising Norwegian population-wide linked-employer-employee register-data for 2001-2012 while exploiting the harmonizing of the geographically-differentiated payroll-tax imposed by the EU, I show that payroll-tax increases are shifted onto workers’ hourly wages thus reducing these. Annual earnings also drop as the payroll-tax grows. Neither unemployment nor employment levels are affected in the short-run, but the payroll-tax levels and the number of sick leave days appear positively correlated. In the long run, entry into retirement and DI rolls increase. Thus the tax hike induces the withdrawal of workers from the labour force.

• Bratsberg, Bernt & Røgeberg, Ole (2017). Childhood socioeconomic status does not explain the IQ-mortality gradient. Intelligence. 62, p. 148–154. doi: 10.1016/j.intell.2017.04.002. Show summary

  Background Cognitive ability correlates with mortality risk, but confounding from childhood social class has been a persistent concern. While studies controlling for indicators of childhood social status report limited attenuation of coefficients, important parental and family factors are likely to vary substantially within social class. Methods Norwegian administrative register data with high-quality intelligence scores measured at age 18–19 for the large majority of males in the 1962–1990 birth cohorts (n = 720,261) were used to assess the IQ-mortality gradient using progressively stronger controls for childhood social class in Cox proportional hazard and linear probability models. A family-fixed effects specification avoids confounding from any family or childhood characteristics fixed over time within families (e.g., childhood socio-economic status, parenting style, and neighborhood environment). Results A large difference in mortality risk is evident across Norwegian males: We find that the mortality risk of the lowest ability bracket, relative to that of the median bracket, is 2.31 (Confidence Interval (CI): 2.12, 2.52, p < 0.0005), declining to 0.64 (CI: 0.56, 0.73, p < 0.0005) for the highest ability bracket. Estimated differences are similar in linear probability models with and without controls for birth year and parental SES, in Cox models with birth year and parental SES controls, and in a linear probability model with family-fixed effects. Conclusions The IQ-mortality gradient is not due to confounding from family background or childhood SES. Higher IQ-scores are associated with substantially reduced mortality risk within a modern welfare-state setting, and the relationship was largely stable across a 30-year period.

• Mastekaasa, Arne (2016). Sykefravær i offentlig og privat sektor. Søkelys på arbeidslivet. 33(4), p. 311–326. doi: 10.18261/issn.1504-7989-2016-04-02. Show summary

  Data fra Statistisk sentralbyrås arbeidskraftundersøkelser 2006-2012 kombinert med registerdata brukes til å undersøke forskjeller i sykefravær mellom stat, kommunal og privat sektor. Det samlete sykefraværet er klart høyest i kommunene, mens det ikke er noen signifikant forskjell mellom staten og privat sektor. En god del av forskjellen mellom kommune, stat og privat sektor skyldes de ansattes kjønns- og alderssammensetning; også med kontroll for disse forholdene samt blant annet utdanning og yrke er imidlertid fraværet tolv prosent høyere i kommunal enn i privat sektor. For fravær av inntil én ukes varighet ligger både staten og kommunene klart høyere enn privat sektor, og her er forskjellene lite påvirket av kontroll for andre variabler.

• Godøy, Anna Aasen (2016). Profiting from presenteeism? Effects of an enforced activation policy on firm profits. Labour Economics. 43(December), p. 122–128. doi: 10.1016/j.labeco.2016.06.012. Full text in Research Archive Show summary

  Activation requirements and graded benefits are strategies for reducing social insurance costs in comprehensive welfare states. In Norway, a policy of issuing graded rather than full time sickness absence certificates, is viewed as a strategy not just to reduce direct costs of sick pay but also to facilitate returns to work and reduce inflows to permanent disability. This paper analyzes effects of graded sick leave on firm profits, on average and across different firm groups. A series of panel data models are formulated to estimate the effects of grading on firm profits. In these models, grading is found to mitigate the negative effects of sickness absence on firm profit. A one percentage point increase in full time sickness absence leads to a 1.7% reduction in return on assets relative to the sample mean; this negative effect is reduced by 70% when absence is graded. Effects are robust to inclusion of firm fixed effects as well as time-varying proxies for labor demand.

• Mastekaasa, Arne (2015). Social and demographic variations in short-term sickness absence. Søkelys på arbeidslivet. 32(1-2), p. 3–20. Full text in Research Archive Show summary

  Short-term sickness absence, defined as absence periods of less than one week’s duration, has been given limited attention in research. In this article, data from Statistics Norway’s Labour Force Surveys (2006–2013) are used to examine the degree to which associations with gender, age, care for children, level of education and occupation are all similar in the case of both short-term and long-term sickness absence, although generally weaker in short-term absence. Causal conclusions cannot be drawn on the basis of these analyses, but the findings are reasonable in view of established knowledge on the social and demographic distribution of different diseases and medical complaints.

• Dale-Olsen, Harald & Hagelund, Anniken (2015). Arbeidsgiverne og arbeidslinja. In Bay, Ann-Helén; Hagelund, Anniken & Hatland, Aksel (Ed.), For mange på trygd? : Velferdspolitiske spenninger. Cappelen Damm Akademisk. p. 107–130.
• Mastekaasa, Arne & Melsom, Anne May (2014). Occupational segregation and gender differences in sickness absence: Evidence from 17 European countries. European Sociological Review. 30(5), p. 582–594. doi: 10.1093/esr/jcu059. Full text in Research Archive Show summary

  Previous research indicates that women fare less well than men on a wide range of healthrelated measures, including sickness absence from work. Possible explanations are that women have—on average—less healthy jobs than men, or that they are more vulnerable to job-related stressors. We address these issues using comparative data on 17 European countries from the EU Labour Force Surveys. Employing logistic regression, we find that gender differences in sickness absence tend to increase if we control for up to 147 detailed occupational categories, thus indicating that women are, if anything, in more healthy jobs than men in most countries. We also examine to what extent the gender differences in sickness absence are systematically related to the gender mix of the occupation, e.g. whether women have particularly high sickness absence in occupations that are strongly male dominated. There is a tendency towards smaller gender differences in female-dominated occupations in a few countries, but in most cases the gender difference is of similar magnitude in female-dominated, male-dominated, and gender-balanced occupations.

• Mastekaasa, Arne (2014). The gender gap in sickness absence: long-term trends in eight European countries. European Journal of Public Health. 24(4), p. 656–662. doi: 10.1093/eurpub/cku075. Full text in Research Archive Show summary

  Background: Most studies show that women have considerably higher rates of sickness absence than men, but little is known on how the gender gap has developed over time. Methods: Data are taken from the EU Labour Force Surveys. The dependent variable is whether the respondent reports being away from work the entire reference week or not. Trends are shown from 1980 onwards. Poisson regression is used to estimate relative risks for women vs. men, with various sets of control variables. Results: Increasing gross differences in sickness absence between women and men are found in five countries: Spain, Ireland, France, Belgium and the UK. No trend in the gender gap is found in Netherlands and Portugal, and probably even in Italy. The trends in the gender gap have been largely the same for men and women without children at home as in the population as a whole. The trends are little affected by control for detailed occupation and industry. Conclusion: The gender gap in sickness absence has increased in five out of eight countries. This is not due to increased labour force participation by mothers of small children, and neither can it be explained as a result of changes in how women and men are distributed across occupations or industries.

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• Godøy, Anna Aasen; Haaland, Venke Furre; Huitfeldt, Ingrid Marie Schaumburg & Votruba, Mark E (2019). Impacts of hospital wait time on patient health and labor supply. Discussion papers.
• Midtsundstad, Tove Irene & Nielsen, Roy A. (2017). The effect of retaining measures on sickness absence & disability retirement .
• Midtsundstad, Tove Irene (2016). Employment promotion policies, social benefits, and the interaction of social protection schemes for senior workers in Norway.
• Midtsundstad, Tove Irene (2016). Hva vet vi om effekten av seniorgoder?
• Bratsberg, Bernt; Dale-Olsen, Harald & Mastekaasa, Arne (2015). Long-term detrimental health-effects from performance pay?
• Dale-Olsen, Harald (2015). When the EUs competition rules require non-member state action – Labour demand and supply changes in Norway following an imposed harmonization of payroll-tax rates.
• Midtsundstad, Tove Irene (2015). Virksomheter og arbeidstakeres tilpasning til aldersgrensene.

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