Response to interpellation 2023/24:449 on women's sick leave due to stress
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
The debate concerns women's sick leave due to stress. L argues that the work environment is central 1, that the government has a strategy against work-related stress 1, and that increased equality in all areas of life is crucial 1. L argues that the government has invested 12 billion in healthcare and is working to reduce stress-related sick leaves 2. S argues that women's stress-related sick leave is due to unequal working conditions and underfunding of the welfare system 3. S argues that high workload and understaffing are risk factors and that the heroes of the welfare system need prioritization of the work environment over tax cuts 4.
Written by AI in advance and may contain errors. The numbers lead to the speech a statement builds on; check against the text below.
Statsrådet Paulina Brandberg (L)
Madam Speaker! Jessica Rodén has asked me what measures I intend to take within my area of responsibility to address the fact that women are affected by stress-related illnesses linked to work life to a greater extent than men.
I welcome the member's commitment to the issue, a commitment that I fully share. As Minister for Equality and Deputy Minister for Employment, I am pleased that this important issue is raised and debated in the Riksdag. Sick leave has major consequences for lifetime earnings and thus future pension. This affects women to a greater extent than men.
In the government's work environment strategy 2021-2025 (skr. 2020/21:92), the work against work-related stress is included, among other things, as it is a major work environment problem. More women than men work in occupations with requirements for high emotional and psychological engagement, so-called contact professions, which can contribute to women having a higher risk of being signed off sick with psychiatric diagnoses, including stress-related ill health.
Even though the work environment is completely central when it comes to stress-related illnesses, I also want to point out that there may be other factors that influence whether or not a sick leave occurs. It could be about a high burden in unpaid home and care work as a contributing cause to women's higher absenteeism, or that women and men are met and treated differently within the health and medical care system when it comes to sick leaves. I am convinced that increased equality in all areas of life will also lead to a reduction in women's sick leaves.
Jessica Rodén (S)
Madam Speaker! I thank the Minister for the answer.
The Minister says that there are many factors that influence whether or not a sick leave is granted, and I truly agree with that.
We know, for example, that failing in school has an unexpectedly high impact on mental health in the 50s age group. We know that leisure activities, cultural school, and association life have a large positive impact on mental health. We know that parents who have children with disabilities, for example neuropsychiatric disabilities, have a higher risk of being signed off sick due to stress. We know that preventive work environment work is incredibly important. We know that sickness absence is affected by how the healthcare system functions. We know that women account for 79 percent of cases with a stress-related diagnosis. We also know that one does not become healthier by being made poor.
Madam Speaker! Mental ill-health among our young people is a major and growing problem. Every other 15-year-old experiences mental health issues. The proportion of children receiving a diagnosis of anxiety disorder or depression has tripled in recent years. This must also be seen in the perspective that how one succeeds in school affects mental health in one's 50s. Mental health issues have lifelong and socio-economic consequences. This too is addressed by the Minister in his response.
In the report From risk factors to health factors, TCO writes that mental ill-health is the most common cause of sick leave in all of TCO's sectors. As risk factors, they mention high workload, lack of influence over the work, and lack of support from the manager.
Kommunal also testifies that stress-related issues are the cause of long-term sick leaves within the female-dominated occupations. Risk factors that Kommunal, as well as TCO, highlight are lack of influence and understaffing, which lead to mental pressure and a feeling of inadequacy.
Sickness absence is higher among women than among men, and it is higher for workers than for white-collar workers. It is worth mentioning in this context that it appears in the Office for Sustainable Working Life's partial report that women in Sweden generally have healthier lifestyle habits.
Women are overrepresented in occupations with high demands and with low influence over working hours and how the work is to be performed. Such working conditions are closely linked to health risks.
Preventive health work needs to be prioritized. Many policy areas are affected. I would like to pin down the last sentence in the Minister's response: "I am convinced that increased equality in all areas of life will also reduce women's sick leaves." The Minister is welcome to go through what measures she intends to take within her area of responsibility to address this.
Anna Wallentheim (S)
Madam Speaker! "Never before have so many been on sick leave due to stress." These are Försäkringskassan's own words regarding the situation on the Swedish labor market. Just as the interpellator and my party colleague Jessica Rodén mention, we can read in Försäkringskassan's report From back pain to exhaustion that between June 2019 and June 2023, the number of people who were absent from work due to stress increased from 28,000 to 42,000 people. That is an increase of 49 percent. Who is it then that is affected? Yes, above all women.
As we have already heard in the debate, women therefore account for 79 percent of sick leave due to stress. And it is not just any women, but this primarily concerns working-class women. These are women who largely work in healthcare, schools, and elderly care. These are women like my little sister Malin, who is an assistant nurse. These are women like one of my best friends, Eleonor, who is a teacher. These are working-class women who, due to the stressful situation, are forced to take sick leave.
Madam Speaker! It is high time that we address the worrying trend we see, where far too many women within welfare professions are forced to take sick leave due to stress. Part of the explanation for the high sickness absence lies, among other things, in the imbalance between demands and resources.
These women, who work in the heart of our society, face daily challenges and demands that exceed the boundaries of what is actually acceptable. It is unacceptable that they should have to sacrifice their own health to meet the needs of society.
We must acknowledge the fact that the stress within these professions is not just an individual issue but also a sign of a structural and societal problem. Inequality, understaffing, low wages, and a lack of resources are just some of the factors that contribute to the stress that women within healthcare and welfare professions experience.
These women do not only deserve our recognition but also concrete measures to improve their working conditions and reduce the stress they are exposed to. It is simply time for political leaders and employers to take responsibility and act on these issues. It is time to act to improve the working conditions. It is time to increase resources and create a culture of support and solidarity with these women. They deserve this respect because they are the ones who uphold society.
My question to the Minister is therefore: How do the government and the Minister intend to act so that working women, who are already being signed off on sick leave due to stress today, can handle the fact that the welfare crisis we see within both municipalities and regions entails savings requirements that mean they either risk being laid off or are expected to run even more?
Louise Thunström (S)
Madam Speaker! I would like to begin by thanking Jessica Rodén, who is raising this important interpellation tonight.
On Friday is International Women's Day - another day to highlight the importance of equality work both here in Sweden and in the rest of the world. In many places, we unfortunately see that equality is receding, and Sweden must continue to be an important voice for equality throughout the world. Today, however, the debate is about stress-related sick leaves here in Sweden.
I want to begin by looking back at the pandemic years, when those who were then called the heroes of the welfare state were cheered and applauded and hearts filled social media. Women in welfare professions bore a great responsibility during the pandemic, but instead of being thanked – and I do not mean with applause – they now have to bear the responsibility for the economic crisis as well. It is a tragic irony that those who carried us through one of the most difficult health crises in modern times now must fight for their own welfare, their rights, and their health.
Madam Speaker! I had not originally intended to participate in this interpellation debate today, but I changed my mind. I did so after a telephone call with a good friend this morning. She told me that she is considering stepping down from her position because she can no longer manage to work full-time as a nursing assistant. It is a completely terrible situation, and she is far from the only woman who feels this way.
I hardly need to tell the minister what it means, not only for the individual's health and personal finances but purely in terms of the economy of society, when we have a labor market that people cannot manage to work in. The welfare system is about to be stressed to the breaking point. Furthermore, it will lead to more and more people choosing not to work in the welfare sector. In that case, it doesn't matter if the Riksdag votes through minimum requirements for staffing within elderly care and preschool, or has high ambitions for maternity care, because who wants to or can manage to work there?
It is primarily women who pay the price for the cuts we are now seeing, in the form of increased stress and worse working conditions. It is also women who are forced to step in when welfare retreats, to take care of an aging parent or another close relative. It is the same women who bore the responsibility during the pandemic who now go home and are signed off sick.
Mental health and stress account for over half of all cases of illness. The Prime Minister said in his government statement 2022, regarding mental health, that more people must care and that more people must show that they care.
My question therefore is: In what way does the government care, and what is being done concretely to improve the alarming working environment in the welfare sector?
Statsrådet Paulina Brandberg (L)
Madam Speaker! If we are to come to terms with this enormous problem, we must begin by looking at why it looks the way it does.
There is a knowledge overview of current Nordic research that the Gender Equality Authority compiled last year regarding women's sick leaves due to mental ill-health. In that, work life and work environment-related factors are highlighted as the main explanation for women's higher risk of sick leave due to mental ill-health. It is therefore crucial that we look at the work environment specifically, and this is part of the work environment strategy that the government is working according to, and where the work against work-related stress is included.
I have previously stood here in the chamber and debated fatal accidents in working life, and in several of these debates I have been careful to point out that it is important that we manage to hold two thoughts in our heads at the same time, namely that we can both combat the fatal accidents that happen at work and see all those who become very ill and in some cases also die from work. We must manage to work with both parts simultaneously.
In this context, I want to point out the work that the government is performing within the work environment strategy, where we are working according to the zero vision that the interpellator and other debaters are well acquainted with. I also want to mention in this context that the government is allocating 1.6 billion kronor for the area of maternity care and women's health.
It is important money for the target group itself, for example those who are having children, but there is also an agreement with SKR which, among other things, contains measures to develop working methods that contribute to a good working environment for healthcare workers, not least within maternity care and obstetric care. These are, as is well known, professions where we have a large majority of women who need to have a better working environment.
We must, however, not forget that there are other factors than the work environment that affect mental well-being. There are no watertight partitions between work life and private life, and of course, everything affects mental well-being.
Here I want to particularly highlight something. As I said in my first post, we need to look at equality broadly to see that there are several factors that affect mental well-being. We have the goal of equal health, where this is an important part, and we have the goal of equal education, which is also very much an important factor in this.
We need to counter violence in the home, which has a tremendous impact. We know that many women are subjected to different forms of violence. It can be physical violence, it can be sexual violence, and it can be economic violence, which also affects how one feels and contributes to the overall picture.
Not least, we have the unpaid home and household work. In that regard, it is important to see that we have a new situation after the pandemic. For many people, the boundary between work time and leisure time has been blurred through increased remote work within certain professions, and there we must carefully monitor how it affects the distribution of unpaid household work.
Jessica Rodén (S)
Madam Speaker! I serve on the Committee on Social Insurance, which handles issues regarding, among others, financial security in the event of illness and disability and for families with children.
I would like to mention to my colleague, Member Wallentheim, the report "From back pain to exhaustion," where it is stated that a record number of people are on sick leave due to stress. The Försäkringskassan analysts and the authors of the report say that if the work environment is characterized by high or increasing demands that are not balanced with sufficient resources, such as control over one's own work situation, social support, or recognition and appreciation, the risk of stress-related sick leave increases.
We see a changed pattern of sick leave after the turn of the millennium. Previously, people had pain in the back, neck, and shoulders. But today, it is precisely the stress-related illnesses that dominate.
The sickness insurance is a central part of the welfare and constitutes an important social contract between society and the individual. The insurance shall provide security in the event of loss of income or when one lacks work capacity. Illness can affect anyone at any time. That we have a strong sickness insurance is not only a question of economic security for the individual but also an expression of our collective sense of responsibility.
It is no secret that we have challenges when it comes to equality in the working life. The issue that we are debating here today is not only a question of a health crisis, but it is also an equality issue. Research shows time and again that women are affected to a greater extent than men, and this is a direct consequence of unequal working conditions, uneven workload, and a lack of support and resources.
To just address the stress-related illnesses that affect women in the working life is not only a matter of individual health but also a matter of creating a more equal and just society.
Occupations dominated by women in, for example, certain areas of healthcare and care are characterized not only by hard work but also by little influence and a lack of resources. This creates an unsustainable situation that not only affects the employees negatively, but it also affects the quality of the care that is to be provided.
There are many areas that affect whether a sick leave occurs or not. But in my eyes, there is a common denominator, and that is the welfare. And despite promises to strengthen the welfare and thereby the work environment work, we see a continued underfunding of the areas that are crucial for preventing stress-related illnesses. I think it is deeply regrettable and worrying.
I therefore want to ask in what way the preventive work environment work will be strengthened when welfare is underfunded by the government.
Anna Wallentheim (S)
Madam Speaker! I want to start by thanking the Minister for the answer. I hope that the Minister's commitment to these issues also leads to actual proposals being put on the table. I hope, in fact, that the Minister understands that there are many of us who would stand behind some of these proposals.
The high level of stress and sick leaves among women is, as said, a problem that we must address. This is also an incredibly important equality issue.
Women continue to be overrepresented in these professions while they more often face discrimination, unequal wages, and a lack of career opportunities. The increased stress and the large number of sick leaves are a clear sign of structural inequality that women still face in the labor market, in private life, and from society.
It is high time that we address the underlying causes of the stress and the sick leaves that we see within the working life, but that we also tackle the causes that the Minister mentioned which we see in private life and from the justice area - which I work with because I sit in the Justice Committee. Indeed, more proposals are needed in these areas.
By doing this, we can not only improve the quality of life for the women who work in these professions but also promote a more just and equal labor market and a society for all women.
On Friday is, as has already been mentioned in the debate, International Women's Day. For my own daughter, for my sister, for my friend, whom I mentioned in my previous contribution, and for all women, these issues must be brought forward.
I am therefore incredibly grateful for Member Rodén's interpellation which allows us to discuss this today. For if we, with political influence and power, do not shed light on these issues and attempt to make real proposals that can make a difference, who will then do it? I hope that in the near future we can see more political proposals on the table that seriously make a difference for both women's life situations and women's working environments.
Louise Thunström (S)
Madam Speaker! Isn't it absurd that it is always the working-class women in the welfare sector who are expected to act as crash pads through crises? Isn't it absurd that the activities that we all in this country are so dependent on - healthcare, school, and care - cannot be valued higher? I have no reason to believe that the Minister does not agree with me on this. But the heroes of the welfare sector do not need more applause. They do not need more hearts on social media. That does not make them healthier. What is required is a policy that prioritizes the welfare sector and women's working environment instead of tax cuts and luxury-rot. It is about priorities, and it is about will. It is that simple.
Statsrådet Paulina Brandberg (L)
Madam Speaker! I thank you for all the contributions that have been made in this debate so far.
This is a question where we must look at different parts of the solutions. One solution is, of course, money. Money and financing of welfare, healthcare, and so on are important pieces of the puzzle in this. There, I want to specifically mention that the government allocated 6 billion SEK in the state budget for 2024 to healthcare and is now adding 6 billion SEK in the supplementary budget, which was announced the other day. This means that this government is spending a total of 12 billion SEK on this, which is the same as the Social Democrats had in their shadow budget. We therefore seem to be making the same prioritization. And this money is important, for many reasons. It is, of course, important for those who need healthcare, but it is also important for work environment reasons and to reduce stress in working life.
I want to go back a little bit to what I concluded my previous post with, that is, the broader picture here. We must look at the work environment issues - how we solve the skills shortage, of course, how we manage the physical work environment and what tools that, among others, the Work Environment Authority has to work with on these very issues. But we must not stray from the unpaid home and household work. Here I feel a concern that this is moving too slowly.
The pandemic brought about certain developments that we benefit from, but where we must not forget to see the risks. Here I want to be careful to say that this is very industry-specific. It is not all professions that have the possibility to offer remote work. But in the professions where it is a possibility, it can of course facilitate the life puzzle while at the same time it can reinforce the imbalance that still exists in unpaid home and household work. This is important. When we look at the combination of work life and the great work it involves to take care of a household, not least during the years with small children, we must see the risks that this is associated with and how it affects mental health. In the professions where there is a possibility for remote work, we see that women to a greater extent than men choose to work remotely. We must see that we have a new situation after the pandemic and find strategies that handle just these factors.
In addition to that, we obviously have the economic situation, which is also a factor that plays a larger role now than it did a few years ago, as we are now in an economic crisis with high inflation, where many households are struggling to make the money stretch to pay the bills and simply to make the finances work.
Here, the government has done a solid job to combat inflation. For that, it is important that the money in the wallet still remains worth something. But we have done it while simultaneously supporting households and welfare. That combination, I believe, is very important to ward off the stress that precisely that economic inequality can lead to.
Jessica Rodén (S)
Madam Speaker! The government's 6 billion to the regions are welcome, but they are not sufficient in the long run. The hospitals in Västra Götalandsregionen, where I come from, have a deficit of 3.3 billion kronor. Sahlgrenska warns of a budget deficit of 1.7 billion kronor, which corresponds to approximately 2,000 employees. We have an ongoing healthcare crisis where, according to the regions, approximately 24 billion kronor are missing. We may have different views on that, but that is what the regions express.
Madam Speaker! Life expectancy is increasing in our country, and the recruitment needs within the public sector will increase significantly until 2035. The largest increase in the population will in the coming years occur in the age group 80 years and older. To meet this challenge, we must address work-related ill health, and as I mentioned in my first contribution, we know that it is today the women who account for 79 percent of the sick leaves with stress-related diagnoses.
We need a policy based on solidarity, cohesion, and equality. We need investments in the welfare system. I wish that the government could realize that investments in preventive measures are not just a cost but also a necessary investment in our society's health and in our future.
Statsrådet Paulina Brandberg (L)
Madam Speaker! I would like to begin by thanking you for this important debate.
These are issues where we can never accept that we move backwards. We must move forward. Now that several factors have emerged that risk increasing stress in working life, particularly for women, we must ensure that we look more actively at this within the framework of the systematic work environment management. We must not forget these factors because we simultaneously have factors in the physical work environment that we must manage. Here, a functioning cooperation, both between the work environment authorities and the labor market parties and locally at the workplaces, is absolutely crucial for us to be able to have a good and systematic work environment management.
From the government's side, we have several assignments and measures rolling out. For example, Mynak, the Agency for Occupational Health Knowledge, is currently working on several government assignments that can provide a basis for continued and new measures to reduce specifically stress-related sick leaves. One example is an assignment to collect and compile knowledge on the connection between certain groups' vulnerability and work-related stress.
Another example is the assignment to Mynak to report on exactly how increased remote work after the pandemic continues to affect equality between women and men in the labor market. Mynak is also involved in the EU program Healthy workplaces in a digital working life which is ongoing 2023-2025 and where the impact of remote work is also included.
We continue to work on this, and from the government's side, we are working hard precisely so that we can move forward and not backward.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.