Bakgrunn: Hensikten med studien var ? estimere kj?nnsforskjeller og sosiale gradienter i sykefrav?r med varighet over 16 dager blant unge norske kvinner og menn.Materiale og metode: Ved hjelp av registerkobling etablerte vi en populasjonsbasert kohort av alle 263 605 kvinner og 286 227 menn som var f?dt i Norge 1967-76, som bodde i riket 1. januar 2000 og som hadde registrert sysselsetting under oppf?lging 2000-03 (alder 23-36 ?r). I oppf?lgingsperioden ble sykefrav?ret registrert i Rikstrygdeverkets (n? Arbeids- og velferdsforvaltningen, NAV) register, og sysselsettingsdata ble innhentet i FDTrygd. Antall frav?r per 100 sysselsettings?r og antall frav?rsdager per sysselsettings?r ble estimert, i tillegg til fire?rs risiko for frav?r og diagnosespesifikt frav?r. Assosiasjoner med kj?nn og eget og foreldres utdanningsniv? (innhentet i SSBs utdanningsregister) ble estimert i multivariate regresjonsmodeller. Analysene ble utf?rt i subgrupper av barnl?se, foreldre og vordende foreldre.Resultater: Totalt ble 390 664 frav?r registrert som i varighet utgjorde mer enn 90 000 ?r. Det var en sterk kvinneovervekt i sykefrav?r, spesielt under graviditet. Graviditet kunne forklare omtrent en tredel av kj?nnsforskjellen. Justert hasardratio for kvinner med menn som referanse var 2,78 (95% konfidensintervall 2,71-2,85) for barnl?se, 2,01 (1,94-2,08) for sm?barnsforeldre og 18,02 (17,03-19,08) for vordende foreldre. Det var en sterk og konsistent gradient med ?kende frav?r for lavere eget utdanningsniv?, spesielt for muskel- og skjelettfrav?r utenom graviditet. Det var en svakere men konsistent gradient etter foreldres utdanningsniv?, ogs? denne var sterkest for muskel- og skjelettfrav?r utenom graviditet. Utdanningsgradientene var n?rmest frav?rende for frav?r under graviditet.Konklusjon: Det ble funnet en markant kj?nnsforskjell i sykefrav?r 2000-03 i en ung voksen befolkning som bare delvis kunne forklares av frav?r under graviditet, og som ikke kunne forklares av utdanningsniv?, n?ringsgruppe, familietype, arbeidstid eller inntekt. Sosiale ulikheter i frav?r vurdert etter eget og foreldres utdanningsniv? var sterkest for muskel- og skjelettsykdom utenom graviditet.?Kristensen P, Bjerkedal T. Gender differences and social gradients in sickness absence 2000-03 among Norwegians born 1967-76. Nor J Epidemiol 2009; 19 (2): 179-191.?ENGLISH SUMMARYBackground: The study aim was to estimate gender differences and social gradients in long-term (>16 days) sickness absence among young Norwegians.Material and methods: All live born in Norway, 1967-1976, were identified in the Medical Birth Registry of Norway and linked to several national registers by means of the unique national identification number. The study cohort included all 549 832 subjects who were residents in Norway as of January 1 2000 and who had registered employment during follow-up 2000-2003 (age 23-36 years). Sickness absence spells were registered in the National Insurance Administration and employment history was collected in Norway's events data base (FD-trygd) during follow-up. Number of absence spells per 100 employment years and number of absence days per employment year were computed as were the four-year risk of absence and diagnosis-specific absence. Associations with gender and parental and own education level were estimated in multivariate regression models. The analyses were performed in subgroups of childless, parents, and expecting parents.Results: A total of 390 664 absence spells with a total duration of more than 90 000 years was registered. The female absence excess was strong. The absence was particularly high during pregnancy, and pregnancies could explain approximately one third of the female excess. Adjusted hazard ratios for women (reference men) were 2,78 (95% confidence interval 2,71-2,85) for childless, 2,01 (1,94-2,08) for parents to small children and 18,02 (17,03-19,08) for expecting parents. We found a strong and consistent gradient with increasing absence in association with decreasing education level, in particular for musculoskeletal absence. A weaker but still consistent gradient was found for parental education level, strongest for musculoskeletal spells as well. Absence during pregnancy showed nearly no educational gradients.Conclusions: We found a clear gender difference in sickness absence in this young adult population. The difference was only partly explained by absence during pregnancy, and was not explained by education level, employment industry, working hours, income or family characteristics. Social inequalities in sickness absence assessed from parental and own education level was strongest for muskuloskeletal spells.
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