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The gender gap in musculoskeletal-related long term sickness absence in Norway

Objective — To examine the gender differences in long term (> 14 days) sickness absence due to musculoskeletal health problems. Design — Analysis of data from the National Sickness Benefit Register, 1994. Setting — The economically active population in Norway, except civil servants ( n = 1,978,030). Subjects — All persons, 16—66 years old, with long term sickness absence episodes due to musculoskeletal health problems in 1994 (n= 141,839). Main outcome measures — Cumulative incidence, episode frequency, and episode duration of sickness absence. Results — Women had higher cumulative incidence of sickness absence than men—80.6 pr 1,000 vs. 64.1 pr 1,000, and longer mean duration of episodes—94 calendar days vs. 86 days counted from the first day of absence. Episode frequency did not differ between the genders. After adjustment for age and income the gender ratio (men/women) in cumulative incidence changed from 0.80 to 1.08, and in mean duration from 0.91 to 0.96. Conclusion — Long term sickness absence due to musculoskeletal health problems was strongly associated with gender, age, income, and diagnosis. Multivariate analysis indicated that the large gender differences in sickness absence might be overstated due to lack of adjustment for income and income-related factors.