title: Medically certified sickness absence with insurance benefits in women with and without children.
abstract: BACKGROUND
  Sickness absence in Sweden is high, particularly in young women and the reasons are unclear. Many Swedish women combine parenthood and work and are facing demands that may contribute to impaired health and well-being. We compared mothers and women without children under different conditions, assuming increased sickness absence in mothers, due to time-based stress and psychological strain.
  
  
  METHODS
  All women born in 1960-79 (1.2 million) were followed from 1993 to 2003. Information on children in the home for each year was related to medically certified sickness absence with insurance benefits the year after. We used age and time-stratified proportional hazard regression models accounting for the individual's changes on study variables over time. Data were retrieved from national administrative registers.
  
  
  RESULTS
  Sickness absence was higher in mothers than in women without children, the relative risks decreased by age, with no effect after the age of 35 years. An effect appeared in lonely women irrespective of age, while in cohabiting women only for the ages 20-25 years. Mothers showed increased sickness absence in all subgroups of country of birth, education, income, sector of employment and place of residence. The relation between number of children and sickness absence was nonlinear, with the highest relative risks for mothers of one child. The upward trend of sickness absence at the end of 1990s was steeper for mothers compared to women without children.
  
  
  CONCLUSIONS
  Despite the well-developed social security system and child care services in Sweden, parenthood predicts increased sickness absence, particularly in young and in lone women.
authors: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden. birgitta.floderus@ki.se
authors: Birgitta
authors: B
authors: Floderus
authors: Maud
authors: M
authors: Hagman
authors: Gunnar
authors: G
authors: Aronsson
authors: Staffan
authors: S
authors: Marklund
authors: Anders
authors: A
authors: Wikman
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007342:Insurance Benefits; D007348:Insurance, Health; D008875:Middle Aged; D009035:Mothers; D012042:Registries; D018582:Sick Leave / Q000639:trends*; D012923:Social Class; D013548:Sweden; D014931:Women, Working; D055815:Young Adult