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In summer 2000, it became clear that increasing numbers of young people, and especially women, are now claiming WAO disability benefit in the Netherlands, and that they are suffering disproportionately from psychological complaints. These trends have caused some alarm among the the government and social partners, and the response is to stress prevention of sickness and disability, taking into account gender differences.
The perennial issue of occupational disability benefit, and the rising number of claimants under the Occupational Disability Insurance Act (Wet Arbeids Ongeschiktheid, WAO) (NL9902124F), was again in the headlines in summer 2000. This time the issue is that new groups of employees with new health complaints are now receiving WAO benefits en masse. Current trends in disability benefit, which have sounded the alarm among the parties involved, are that: large numbers of people under the age of 35 are now claiming WAO benefits, with more than half of them citing psychological complaints as the reason for disability (NL9904133F); and increasing numbers of women are claiming benefits.
Gender and workload
Since 1994, the number of female WAO beneficiaries has exceeded the number of women joining the labour force, and women are more than twice as likely as men to end up receiving WAO benefits. The absolute number of new WAO claimants has been higher among women than men since 1996. Given the fact that sickness absence generally precedes claiming WAO, it is notable that women are generally twice as likely as men to be absent from work due to illness, and five times more likely among the 25-35 age group. Although fewer young women participate in the labour market than young men, 45,000 women under the age of 35 receive WAO benefits compared with 22,500 men. More women than men are employed in the healthcare sector, where both male and female employees face a higher risk of illness, according to research conducted in 2000 for the National Institute for Social Security (Landelijk Instituut Sociale Verzekeringen, LISV). In 1998, one-third of the female labour force was employed in the healthcare sector, as opposed to 5% of working men. A quarter of all young women now receiving WAO benefits worked in the healthcare sector. Psychologically taxing working conditions - such as limited career opportunities, lack of chances for promotion, low wages and scarce possibilities for developing individual abilities - apply to a far greater extent to jobs held by women than men.
It should, however, be noted that a higher percentage of men are employed in physically demanding jobs, shiftwork and jobs with irregular schedules. These all constitute risk factors, according to a survey conducted by the Central Bureau of Statistics. A pan-European study of risk factors at work conducted in 1996 also indicated that men face the highest number of risks. In addition to previously mentioned factors, it was noted that Dutch men work an average of 40 hours a week, which is considerably more than the average 28-hour working week for women. More men are employed in blue-collar jobs where they are confronted with noise, heat, grime and heavy physical labour and they experience more on-the-job pressure. The study also pointed out that more women are employed on a temporary basis, enjoy a lower degree of independence in their jobs and experience more strain from repetitive tasks and lifting.
The abovementioned LISV study, Women, working conditions and disability (Vrouwen, (werk)omstandig-heden en arbeidsongeschiktheid), also illustrates that women are more sensitive to certain working conditions such as an unpleasant workplace atmosphere and lack of enjoyment in work. According to the study, age, level of education, "breadwinner" status, part-time position and household composition do not play different roles between men and women with regard to contributing to an increased risk of claiming WAO benefits. Parenthood poses a risk to both women and men under 35, but serves as a protective factor for employees older than 35. Working conditions play the most significant role, particularly those typically encountered in the healthcare sector, where work is physically demanding and there is a great deal of pressure. Sickness absence is high in this sector, hovering around 10% of the workforce on average and reaching the highest levels in home care (14%) and care for physically disabled people and the welfare sector (13%).
The assumption is often made that working mothers run an increased risk of sickness absence and will eventually claim WAO benefits as a result of the double burden. This is not entirely true, according to the statistics. Combining childcare with work does not negatively affect women any more than it does men. The combination is difficult for both groups under 35, but actually serves as positive factor for those above that age. The figures indicate that single women - usually without children - are disproportionately represented among WAO claimants.
Prevention
The government and the social partners have responded to these new data. Employers are requesting more government funding, while at the same time the government is urging employers, examining doctors and industrial insurance associations to handle complaints from female employees with more precision. The Dutch Trade Union Federation (Federatie Nederlandse Vakbeweging, FNV) dismisses the claim that the influx of women claiming WAO benefits will ultimately render insurance unaffordable. It believes that differing methods of coping with sickness and health, the differing meaning of work for female and male employees and the provisions made by company doctors and insurance agencies influence the gender-specific differences among WAO beneficiaries. According to FNV, preventative measures must address and offset these differences rather than duplicate them.
Social science research indicates that women perceive health and the meaning of work differently from men; women place greater value on health and men view work as more important. Company doctors and insurance agency doctors appear to adapt their advice to the situation, often advising a female employee to take it easy for a while, while encouraging a male employee to get on with work (according to "Women and reintegration" [Vrouwen en reintegratie], TNO-Arbeid, Hoofddorp, 1999). Another gender-specific discrepancy is that employers exert more effort to reintegrate or attract full-time employees, while three-quarters of the part-time jobs are held by women. This information, combined with the fact that women are more sensitive to the workplace atmosphere, provides a starting point for formulating measures to curb sickness absence and thus prevent reliance on WAO benefits.
Hans Hoogervorst, the Secretary of State for Social Affairs, also believes that prevention is the key to dealing with this new problem. He wishes to help companies and health and safety services realise that, since women pose a different type of sickness absence risk to a company, a new preventative approach is necessary. In his view, paying individual attention to female employees should go hand-in-hand with sound absence supervision, career guidance and, ultimately, better management. He sums up his approach by stating that earlier attention to sickness absence and earlier supervision of the workers involved means a quicker return to work. Prevention is crucial in preventing employees from claiming WAO benefits, since it appears that re-entering the labour market is extremely difficult for claimants. In summer 2000, it came to light that, of 30,000 WAO recipients that LISV expected to complete a government-subsidised path back to work, only 10,000 actually succeeded.
Commentary
Based on the sharp rise in the number of women participating in the workforce, it was predictable that the number of women becoming unfit to work would likewise increase. Now that this is occurring at a faster rate, alarms are being sounded, especially as the Netherlands has more disability benefit recipients than other European countries. However, other countries tend to have greater numbers of unemployed people, which means that there are few differences in the total number of all benefit recipients on balance (NL0006195F). Nevertheless, the WAO statistics are still cause for concern, since they increasingly include young adults, in particular women, with psychological complaints (NL9910167F). The government, employers' representatives and trade unions share the opinion that these individuals cannot be written off for the rest of their lives. Given the current labour market shortages, arguments from both a humanitarian and an economic perspective are valid. Out of the potential labour force, an increasing number of young women are claiming WAO benefits. For the government and the social partners, the viable solution to this problem is the development of a specific sickness and absence guidance policy. (Marianne Grünell, HSI)