ANALYSIS: Why four in five Swedes off sick with stress are women

Gender inequality in workplaces, household chores and healthcare prejudices are all factors behind Sweden's gender gap in stress-related sick leave, according to experts.

ANALYSIS: Why four in five Swedes off sick with stress are women
Women are more often than men diagnosed with stress-related illnesses. Photo: Stina Stjernkvist/TT

Sweden has been regarded as a leading example of gender equality around the world, but when it comes to work-related stress, things are far from equal.

Eighty percent of workers on sick leave because of stress between July 2019 and July 2022 were women, statistics by Sweden’s Social Insurance Agency show.

Recent numbers show the amount of women on sick leave increased more than men between October 2021 and October 2022, with a 9.8 percent and 7.2 increase, respectively.

Gender segregation in the workplace

“I think the horizontal segregation of the Swedish labour market, and also in the Scandinavian countries as a whole, is one reason why we find these big gender differences,” says Gunnel Hensing, professor in social medicine at Gothenburg University.

“Women more often work in communication-intensive occupations, occupations where you relate to other people and you are personally involved in the work, while men more often work in administrative and technical occupations.”

Ulrik Lidwall, an analyst at the Social Insurance Agency, agrees, pointing out that the healthcare, welfare and education sectors are dominated by women.

“This kind of work is hard to just drop and they often take the work home with them, becoming a job without ‘limits’,” he says.

The pandemic, as a consequence, impacted women more negatively, since they were less likely to be able to switch to remote working.

“You need to be at the hospital if you work in healthcare, you have to be at the daycare centre if it’s open. That is where women work,” says Hensing.

She mentions that reports suggest that if men work in a female-dominated area, they tend to develop the same type of symptoms as women.

“It’s not particularly that you are a woman or the female biology, but rather that you are exposed to a work environment where it’s easy to develop stress.”

But Lidwall adds: “You can have it easier or more difficult depending on your gender. For instance, in the priest occupation, women have been working against all odds. They face complications and get other tasks than men in the same workplace. Women tend to get the administrative tasks and men the more technical ones.”

Women from minority groups are especially vulnerable, with discrimination, which according to a report by The Swedish Gender Equality Agency affects them more than men, adding an extra layer of stress. And domestic violence towards women often leads to other side effects, like sleeping problems, depression or PTSD, which again increases stress.

Lidwall also points to unequal share of housework as a big cause of stress.

“Women tend to take more responsibility, which contributes to a higher risk of stress-related mental health issues.”

A 2021 report by Hensing for the Equality Agency focusing on women’s unpaid labour at home found that there are connections between unpaid work and sick leave. However, the difficulties when measuring the personal challenges that women face has resulted in a great lack of research in this field.

Ida Ahl, a rehab coordinator at health centres in the Västra Götaland region and a former insurance investigator at the Social Insurance Agency, also mentions housework inequalities as a reason for the increasing gender gap in sick leave.

“We still don’t have an accurate workload in the home. Even if there have been changes, there are probably many families where the woman clearly takes a bigger responsibility when it comes to her private life.”

Differences in treatment within Swedish healthcare

Men and women are treated differently within the healthcare system based on their gender, a report by the Swedish National Audit Office concluded in 2019.

Masculinity norms can cause men to be underdiagnosed, argues Hensing.

“Men do not seek care for their mental health issues, and if they don’t seek help they do not get their diagnosis or sickness absence note,” he says.

Ahl’s experience from Västra Götaland health centre backs up the claim.

“I believe (…) that men seek healthcare less than women. I have noticed that when men seek help at our place, they often refer to a relative, boss or someone else who has pushed them to seek help,” she says.

Extended definition of illness

Ahl includes two other reasons why stress diagnoses are on the rise.

The first one is the patient self-diagnosing before they meet the doctor.

“When they call the health centre for the first time, they are certain they have exhaustion syndrome. That makes it more difficult for us, because it might be that the patient does not at all meet the criteria for the diagnosis, but still have made that conclusion themselves,” she explains.

The second one is an extended definition of illness, which is not always accurate or helpful to the patient.

“A lot of patients seeking help have pretty normal reactions to different kinds of loads in life and maybe a little bit too often put a sickness label on things that don’t have sickness value,” Ahl adds.

Article by Gothenburg University students Anna Hallgren, Mireia Jimenez and Khorambanoo Askari

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Stockholm in crisis mode after hacker attack on major hospital

Stockholm's regional authority is stepping up security after one of the major hospitals in the Swedish capital was targeted by unknown perpetrators in a cyber attack.

Stockholm in crisis mode after hacker attack on major hospital

The hacker attack knocked out telephones at the privately run Sophiahemmet overnight between Monday and Tuesday. In response, the hospital shut down all its computers as a security measure.

Region Stockholm on Tuesday evening activated what’s known in Swedish as stabsläge, the lowest level on a three-point scale of heightened preparedness used in healthcare services.

It’s an official term which generally means that a specially designated management group within the healthcare services stays informed about the situation and how it develops, and acts accordingly.

“It’s a security measure, to be able to monitor the situation and quickly be able to make decisions if needed. But we have no indication that anyone else in the region is affected,” Elda Sparrelid, chief physician for Region Stockholm, told Swedish news agency TT on Wednesday.

It was on Wednesday morning not clear who was behind the cyber attack.

In the meantime, the hospital continues to operate according to backup procedures.

Sophiahemmet said it was looking after all its patients according to plan, but that waiting times may be longer than normal due to staff carrying out administrative duties by hand, using pen and paper.

It’s the latest in a spate of cyber attacks targeting Swedish businesses and public authorities in recent weeks, although it is not known whether or not this attack is connected to previous incidents.

The Dagens Nyheter newspaper reported on Tuesday that Bjuv, a small municipality of some 16,000 residents in southern Sweden, had received threats from Russian hacker group Akira.

Akira is threatening to leak data, which it stole from the municipality, in the form of “confidential documents, contracts, agreements, personal files” on the darknet market, an encrypted part of the internet which can only be accessed with the help of special software or settings.

Akira was also behind a major attack on IT supplier Tietoevry last month, which affected tens of thousands of employees at Swedish businesses and public authorities. However, the attack on Bjuv is believed to be a separate incident, according to Dagens Nyheter.