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