Is it masculine to turn up ill at work? A study on the association between traditional male role norms and sickness presenteeism amongst Danish ambulance workers

Background
It is well established that men have less frequent and shorter
episodes of sickness absence than women. Could it be that men
have less absenteeism because they more often turn up ill at
work? And if so, are there differences between men related to
their adherence to traditional male norms? Very little is known
about the way sickness absence and presence is practised and
the influence of gendered norms.

Methods
Data is taken from MARS - Men, accidents, risk and safety, a
two wave panel study of ambulance workers and fire fighters in
Denmark (n = 2585). Information was collected from questionnaires on work environment (COPSOQ) and traditional
male role norms (MRNI). The response rate for round 1 was
62%. The primary outcomes in this presentation are selfreported absenteeism and presenteeism analysed using Poisson
regression. In addition a measure of the ratio of presenteeism
to absenteeism was analysed using ordinary least squares
(OLS).

Results
The results indicate that higher scores on MRNI were
associated with an increase in the number of sickness presence
episodes (from 1.5 for those scoring lowest to 2.0 for those
scoring highest) and a decrease in spells of sickness absence
(from 1.8 to 1.2) (p < 0.01 for both), i.e. the more an
individual adheres to traditional norms of masculinity the
more likely were they to have more episodes of sickness
presence and fewer spells of sickness absence. This was
confirmed when regressing MRNI on the measure of the
ratio of presenteeism to absenteeism: higher scores on MRNI
lead to higher ratios ( = 0.011, p < 0.01). All analyses were
adjusted for self-rated health and a range of work environment
factors.

Conclusions
Adherence to traditional male role norms was associated
with an increase in the number of episodes of sickness
presence and a decrease in spells of sickness absence even
after adjusting for health and work environment factors. This
indicates that the gender difference in absenteeism observed
in many studies may - in part - be a consequence of different
sickness absence practices between men and women although
this study cannot confirm that directly. This emphasizes the
caution one should take when analyzing sickness absence
alone instead of in combination with sickness presence, and
that gendered norms in these practices might be
underestimated.