Trends in long‐term sickness absence in Sweden 1992–2008: the role of economic conditions,legislation, demography,work environment and alcohol consumption

Lidwall U, Marklund S. Trends in long‐term sickness absence in Sweden 1992–2008: the role of economic conditions, legislation, demography, work environment and alcohol consumption Int J Soc Welfare 2011: 20: 167©179 © 2010 The Author(s), International Journal of Social Welfare © 2010 Blackwell Publishing Ltd and the International Journal of Social Welfare. In Sweden, absence from work because of illness or injury has fluctuated considerably over time. This study aimed to identify potentially important factors behind variations in long‐term sickness absence. Aggregated data were used to assess factors correlated with the number of ongoing cases of sickness absence lasting more than 59 days. Trends were analysed using statistics from national social insurance records, labour force surveys and other official statistics. Although specific changes in the degree of generosity in the sickness insurance scheme were important in some cases, the results showed no consistent associations for the study period 1992–2008. Men were generally more sensitive to macroeconomic factors than women. Furthermore, compared with earlier findings, workforce composition had less impact on variations in long‐term sickness absence. Notably, public health indicators such as alcohol sales and working conditions were clearly related to long‐term sick leave during the period under investigation.     

Comparison of the educational deficiencies of delinquent and nondelinquent students

This article assesses the differences in educational deficiencies between a statewide sample of delinquent students and a matched sample of nondelinquent students. Employing a research design that controls for a series of relevant individual and school variables, the study's findings document that delinquent students are characterized by a series of disproportionate educational deficiencies as compared to their nondelinquent student counterparts. Delinquent students were found to attain lower grade point averages, have poorer school attendance records, be retained more often in the same grade, and receive more school disciplinary actions. The article concludes that these documented educational deficiencies may play an integral role in the process of delinquency and, therefore, pose a number of public policy implications in relation to the prevention and treatment of delinquency.     

Previous sickness presence among long‐term sick‐listed in Norway and Sweden: A retrospective study of prevalence and self‐reported reasons

The aim of the present study was to analyse previous sickness presence among long‐term sick‐listed individuals in Norway and Sweden and the reasons given for sickness presence. The study was based on survey data for 3,312 persons in Norway and Sweden who had been sick‐listed for at least 30 days. Two questions were used. One measured prevalence: During the last 12 months prior to your current sick leave, did you go to work even when feeling so ill that you should have taken sick leave? The second question concerned reasons for sickness presence. Large differences were found between Norway and Sweden in the prevalence of sickness presence. More long‐term sick‐listed Norwegians than Swedes reported sickness presence [adjusted odds ratio (OR) for Sweden 0.65 (0.53–0.80)]. The Swedes more often reported financial reasons for sickness presence [adjusted OR 2.77 (2.1 to ?3.54)], while the Norwegians more often gave positive reasons related to work. The national differences may be related to differences in sickness insurance strategies.     

Social workers' attitudes towards the unemployed in the Nordic countries

Kallio J, Blomberg H, Kroll C. Social workers' attitudes towards the unemployed in the Nordic countries In recent decades, municipal social workers have become the implementers of new types of social policy measures aimed at activating the unemployed. These policies put a greater emphasis on the individual's own responsibility for being unemployed. Little is known, however, about how social workers view the unemployed – one factor that might influence how policies are in fact implemented. Therefore, our purpose was to analyse Nordic social workers' attitudes towards the unemployed and their determinants: Do social workers' attitudes correspond with a more individualistic view on unemployment? We utilised the data from surveys of professional social workers in four Nordic countries. Our analyses showed that individualistic attitudes towards the unemployed appeared to be rather rare among Nordic social workers. However, attitudinal differences were found between and within countries.     

How do men with paraplegia choose activities in the light of striving for optimal participation? A qualitative study,based on a phenomenological–hermeneutical method

The objective of this study was to explore the experiences of men with paraplegia with regard to how they choose activities. The study involved a qualitative research design, based on a phenomenological–hermeneutical method. The findings revealed that the activities participants were choosing could be on a continuum between the individual’s self and the influence from their environment. On this continuum, the choice to perform activities was influenced by two mediating factors: the individual’s activities performed during their life-history, and their activity challenges for the future. We conclude that choosing activities is an individually constructed internal process of negotiation. Feelings of resignation and revolt appear in combination with feelings of justice and injustice when balance is not found. This knowledge provides a better understanding of the impact of spinal cord injury, sheds light on the development of distress after spinal cord injury and sheds new light on individuals’ feelings of participation.     

The relationship between perceived employability and subsequent health

Abstract

Being capable of getting new employment may enable an employee to cope with turbulent situations or deteriorating job conditions. Individuals who have higher perceived employability are likely to appraise a situation at work more favourably, and consequently experience better health and well-being. The aim of the present study was to investigate the relationship between perceived employability and subsequent health, while controlling for baseline health, background factors, and work environment exposures. The study is based on 53 items in the National Working Life Cohort in Sweden from two data collections (2004 and 2005), comprising 1918 individuals. Forced entry hierarchical regression analysis showed that, after controlling for demographics, psychological demands, control, and ergonomic exposures, perceived employability was positively associated with global health and mental well-being, but unrelated to physical complaints. When baseline health status was added, perceived employability was still a significant predictor of two out of three outcome variables. Individuals with higher perceived employability had a tendency to report better health and well-being a year later. It is concluded that how an employee perceives his or her possibilities in regard to acquiring new employment is relevant for well-being at a later stage. Perceived employability, which has been little studied before, is therefore a useful concept in health promotion, both at the individual and at the organizational level.     

Privatisation as professionalisation? Attitudes,motives and achievements among Swedish social workers

The purpose of this article is to discuss the relationship between privatisation and professionalisation in social work. In social services, privatisation is often seen as a politically planned (policy-driven) process as part of liberalisation strategies for market orientation of the welfare state. However, there are several reasons to believe that there is also a process of spontaneous privatisation (sometimes driven by demand), where professionals go private and provide various types of services to local welfare authorities. In this article, our aim is to explore the extent, impact and consequences of such profession-driven privatisation and to discuss whether privatisation is a strategy for professionalisation.

This article investigates: (1) attitudes among social workers and social work students toward privatisation in general and private practice in particular; (2) the extent and types of activities being performed privately; (3) the motives whether or not to choose self-employment; (4) the differences between public and self-employed social workers in terms of professionalisation.

Data are based on surveys of 1,000 Swedish social workers and 801 social work students. The results show ambivalence among professionals toward privatisation. The authors discuss the reasons for this at an individual and collective level. Although the share of social workers in private practice in Sweden is low, between 6 and 8%, more than one third of Swedish social workers expect to be working in private practice within 10 years. The circumstances faced by self-employed social workers, who rank higher on almost every professionalisation indicator (i.e. formal education, attitude toward research, internal status, wage level, autonomy), support the hypothesis about profession-driven privatisation.     

Navigations between regulations and gut instinct: the unveiling of collective memory in decision‐making processes where teenagers are placed in residential care

The decision to take a young person away from his or her family into out‐of‐home care and treatment is the most drastic intervention within the statutory powers bestowed upon social services. The results of reports on the quality of residential treatment reveal that state supervision has not proven to be a good substitute for parental care. In this paper we analyse the decision‐making process when young persons are placed in residential care. Focus groups and individual interviews with different stakeholders were conducted. The results show that the placements are a collective process involving negotiations between the different parties with a coordinating social worker in the middle, with the aim to bring something to build hope on in often desperate situations, regardless of the specific treatment method used. To inform the process, the social workers draw on a ‘collective memory’ shared among colleagues in the department. Important signs of quality of a residential unit were the relational and collaborative competence from the staff. The inclination to use soft, diffuse information in decision‐making shows a striking lack of evidence upon which social workers can build well‐informed and knowledge‐based decisions.     

Transitions Between Compensated Work Disability,Joblessness, and Self-Sufficiency: A Cohort Study 1997–2010 of Those Jobless in 1995

Associations between unemployment, work, and disability have been researched in many studies. The findings are often based on cross-sectional data and single outcomes. The present study analysed multiple outcomes over a period of 15 years among long-term unemployed individuals. Based on all individuals aged 20–40 living in Sweden in 1995, prospective cohort analyses were conducted. Individual annual labour market proximity 1995–2010 was estimated and categorised into three mutually exclusive categories: “Jobless”, “Self-sufficient” (i.e. main income from work), or “Disabled”. Individuals in the category “Jobless” (n = 638,622) in 1995 constituted the study population. Using autoregressive multinomial logistic regression, transitions between the three states during 1997–2010 were analysed. Socio-economic factors, previous inpatient care, and national unemployment rates in different time periods were included in the regression models. Among those “Jobless” in 1995, 17 % were also “Jobless” in 2010, while 10 % were “Disabled” and 61 % “Self-sufficient”. The transitions were stable over time periods for transitions into “Self-sufficient” and “Disabled” but less so for “Jobless”. Previous state was the best predictor of subsequent state. “Jobless” individuals with previous morbidity had a higher transition probability into “Disabled” and a lower transition probability into “Self-sufficient”. The transition rates into “Self-sufficient” were higher in periods with lower unemployment levels. The study supports the interpretation that return to work was affected both by the individuals’ previous health status and by the national unemployment level. Transition from being “Jobless” into “Disability” may be influenced by previous ill health and by negative health effects of being “Jobless”.