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Peer-reviewedCC BY 4.0Scandinavian Journal of Work, Environment & Health

A review of reviews exploring gender differences in sickness absence

  • Amber R McKenzie1,2,3
  • Bethany Croak1,2,3
  • Lise Gulli Brokjøb1,4
  • Sharon A M Stevelink1,2,3
  • Ira Madan5
  • Beate Brinchmann1
  • Wendy Nilsen6
  • Karen Walker-Bone7
  • Nils Abel Aars1
  • Arnstein Mykletun1,8,9
9 affiliations
  1. 1Centre for Health and Work, Nordland Hospital, Bodø, Norway .
  2. 2King’s Centre for Military Health Research (KCMHR), King’s College London, London, UK .
  3. 3Department of Psychological Medicine, King’s College London, London, UK .
  4. 4Centre for Population Health, Haukeland University Hospital, Bergen, Norway .
  5. 5Occupational Health Department, Guy’s and St Thomas’ NHS Foundation Trust Work.
  6. 6The Work Research Institute, Centre for Welfare and Labour Research OsloMet – Oslo Metropolitan University, Oslo, Norway .
  7. 7School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia .
  8. 8Norwegian Institute of Public Health, Oslo, Norway .
  9. 9Department of Community Medicine, University of Tromsø, Norway .
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Abstract

Objectives: Long-term sickness absence is a risk factor for leaving the workforce, causing economic stress and deteriorating health. Women have higher rates of sickness absence compared to men in most, but not all, European countries. Reasons for apparent gender differences are currently poorly understood, but hypotheses include that women may have more health problems (particularly those associated with reproductive health). Other hypotheses for gender differences include gendered health beliefs, attitudes/norms to sickness absence, work factors, work–family conflict, or barriers to return-to-work. This umbrella review aimed to synthesize and critically appraise the empirical evidence underpinning these hypotheses.

Methods: Following PRISMA and Joanna Briggs Institute methodological guidelines, a systematic search of seven electronic databases was conducted for peer-reviewed reviews (eg, systematic reviews, scoping reviews, critical reviews) and meta-analyses reporting on gender and sickness absence. The review protocol was pre-registered on PROSPERO.

Results: In total, 133 reviews were eligible for inclusion, of which 12 directly focused on gender differences in sickness absence. Only three hypotheses were investigated frequently and, although there was strong face validity, there was limited and mixed-quality underpinning empirical evidence. There was a surprising lack of focus on men and sickness absence.

Conclusion: Despite much research, the underlying causes for a gender gap in sickness absence remain poorly understood. Our findings highlight the need for caution when interpreting proposed hypotheses as established explanatory evidence. Whatever the cause, any gender difference in sickness absence is a gender equality problem, regardless of the cause. Future research should aim beyond describing gender differences to critically evaluating risk factors to develop prevention strategies.

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Cite

BibTeXRIS
BibTeX
@article{mckenzie2026review,
  title = {{A review of reviews exploring gender differences in sickness absence}},
  author = {Amber R McKenzie and Bethany Croak and Lise Gulli Brokjøb and Sharon A M Stevelink and Ira Madan and Beate Brinchmann and Wendy Nilsen and Karen Walker-Bone and Nils Abel Aars and Arnstein Mykletun},
  journal = {Scandinavian Journal of Work, Environment \& Health},
  year = {2026},
  month = nov,
  doi = {10.5271/sjweh.4321},
  url = {https://doi.org/10.5271/sjweh.4321},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - A review of reviews exploring gender differences in sickness absence
AU  - Amber R McKenzie
AU  - Bethany Croak
AU  - Lise Gulli Brokjøb
AU  - Sharon A M Stevelink
AU  - Ira Madan
AU  - Beate Brinchmann
AU  - Wendy Nilsen
AU  - Karen Walker-Bone
AU  - Nils Abel Aars
AU  - Arnstein Mykletun
PY  - 2026
DA  - 2026/11/01
JO  - Scandinavian Journal of Work, Environment & Health
DO  - 10.5271/sjweh.4321
UR  - https://doi.org/10.5271/sjweh.4321
AB  - Objectives: Long-term sickness absence is a risk factor for leaving the workforce, causing economic stress and deteriorating health. Women have higher rates of sickness absence compared to men in most, but not all, European countries. Reasons for apparent gender differences are currently poorly understood, but hypotheses include that women may have more health problems (particularly those associated with reproductive health). Other hypotheses for gender differences include gendered health beliefs, attitudes/norms to sickness absence, work factors, work–family conflict, or barriers to return-to-work. This umbrella review aimed to synthesize and critically appraise the empirical evidence underpinning these hypotheses.  Methods: Following PRISMA and Joanna Briggs Institute methodological guidelines, a systematic search of seven electronic databases was conducted for peer-reviewed reviews (eg, systematic reviews, scoping reviews, critical reviews) and meta-analyses reporting on gender and sickness absence. The review protocol was pre-registered on PROSPERO.  Results: In total, 133 reviews were eligible for inclusion, of which 12 directly focused on gender differences in sickness absence. Only three hypotheses were investigated frequently and, although there was strong face validity, there was limited and mixed-quality underpinning empirical evidence. There was a surprising lack of focus on men and sickness absence.  Conclusion: Despite much research, the underlying causes for a gender gap in sickness absence remain poorly understood. Our findings highlight the need for caution when interpreting proposed hypotheses as established explanatory evidence. Whatever the cause, any gender difference in sickness absence is a gender equality problem, regardless of the cause. Future research should aim beyond describing gender differences to critically evaluating risk factors to develop prevention strategies.
SN  - 0355-3140
SN  - 1795-990X
ER  -