Provisions regarding organizational and social work environment and future sickness absence in Sweden

BACKGROUND: Sickness absence is high among healthcare employees in many European countries, including Sweden. In addition to physical workload, the importance of psychosocial work factors for this is emphasized. To promote a good psychosocial work environment, provisions on organisational and social work environment, mandatory to all work sectors, was launched in 2016 in Sweden. We compared sickness absence (SA) due to mental diagnoses two years before and two years after these provisions were introduced, among healthcare employees, employed by the municipality, the region, or private organisations. METHODS: Register microdata were used for analyses of all employees in the healthcare sector in Sweden in 2014 (N = 260,709) and in 2018 (N = 277,901). The odds ratios (OR) with 95% confidence intervals (CI) of new SA (in SA spells >14 days) and of long-term SA (>90 days) with a mental diagnosis in 2018 compared to 2014 were calculated, using logistic regression. RESULTS: The ORs of new SA and long-term SA with mental diagnoses among healthcare employees were somewhat higher in 2018 than in 2014 (OR = 1.14; 95% CI 1.11-1.17), (OR = 1.12; 1.07-1.17). The OR for the private sector for a new SA spell was 1.11; 1.02-1.19, and for the regional sector, OR 1.05; 1.01-1.08. The highest probability of long-term SA with mental diagnoses in 2018 compared to 2014 was found among employees in the municipal sector, OR 1.33, CI; 1.11-1.61, and in the private sector, OR 1.15, CI; 1.03-1.29. DISCUSSION: The mandatory provisions aim to promote good work environment and prevent risks of ill health due to organisational and social conditions at work. We observed a somewhat higher probability of SA with mental diagnoses two years after the provisions were introduced. SA due to mental diagnoses is influenced by many factors of which psychosocial work environment is only one part and maybe longer follow-ups are needed. KEY MESSAGES: • Sickness absence due to mental diagnoses among healthcare employees was somewhat higher two years after the introduction of an organisational and social work environment provision. • Many factors influence sickness absence with mental diagnoses; other factors and longer follow-ups are needed to gain knowledge on possible effects of the work environment provision.