‘You Need to be Healthy to be Ill’: Constructing Sickness and Framing the Body in Swedish Healthcare

Abstract

Recent trends have seen a move from 'welfare' to 'workfare' in Europe to increase labour flexibility and reduce state expenditure on sickness absence. This shift in healthcare logics has meant an increasing role for individuals to take an active part in the political process of managing their health and sickness absence. This paper draws upon empirical cases of observations of status meetings, in which the employee's medical situation and work capacity are evaluated, as well as interviews with participating actors. The study finds that governmental standards are, at times, incompatible with each other and this complexity allows for local strategies in managing the sickness absence process. These findings are discussed in relation to employment and it is concluded that local actors' translations of policies have important material consequences for employees' health, rehabilitation opportunities and access to sickness benefits. This contributes to our understanding of how political interventions to govern the population are appropriated locally to govern individual bodies.

‘Doggy-biopolitics’: Governing via the First Dog

“…Biopolitics, traditionally understood as management of 'the population', that is, regulating aggregate phenomenon among the human 'species' by creating (moral) self-regulation (Foucault, 1975(Foucault, -1976(Foucault, /2003Rose, 2007: 41-76), has in other fields been extended to include nonhuman animal life (Boggs, 2013;Chrulew, 2011;Holloway, 2007;Palmer, 2001;Rinfret, 2007;Taylor, 2013) and posthuman life (Evans and Reid, 2014;Reid, 2014). This article will thus draw on these literatures to complement previous research within OMS that has touched upon the conceptual interrelationship between 'management', 'life' and 'self' (see, for example, Ahonen et al, 2014;Grey, 2009;Munro, 2012;Nyberg, 2012;Weiskopf and Munro, 2012). The study is thus designed and pursued with the aim to explore how self-management and biopolitics are linked (Hansson et al, 2015).…”

“…For example, in Nyberg's (2012) account of how employers target the individual unhealthy body of employees to govern the population, the term 'biopolitics' is left out. Leclercq-Vandelannoitte (2011) likewise touches upon regulation of the population as 'calculated life management' but also leaves out the term 'biopolitics'.…”

Social insurance literacy: a scoping review on how to define and measure it

“…In a study of status meetings between the Swedish social insurance agency, employers, employees and medical professionals, it was noted how illness must be described according to a predefined vocabulary, using diagnostic classifications and being placed within the regulatory context, including the various time limits in the system [11], where the level of adherence to such language may influence the access to sickness benefits. Further, the client was the actor with least knowledge of regulations, but also the actor who had to deal with decisions made over their heads: "[f]ailure to engage competently in the discussion, often due to illness, meant decisions were made for them."…”

“Dis-able bodied” or “dis-able minded”: stakeholders’ return-to-work experiences compared between physical and mental health conditions

“…Several studies demonstrated that employers appear to have the upper hand in decisions about RTW issues, for example about work(place) adjustments or the timing and speed of the RTW. [9][10][11][12] In making these decisions, employers seem to base their approach, inter alia, on their perceptions of the sick-listed employee's image, attitude, personality and openness about the illness and the RTW. [13,14] Moreover, employers' actions appear influenced by the value and the replaceability of the sick-listed employee, and by the presence of goodwill and trust.…”

“…[4,23] This is because scholars have either addressed RTW experiences in relation to a specific symptom group, such as musculoskeletal disorders, [7,14] cancer, [13,17] common mental disorders [19,24] and depression, [20] or have not distinguished between the two health conditions in their findings. [6,9,11,12,15,16,18] As a result, the limited available research has proven inconclusive so far: While some literature reviews suggest the existence of similarities between RTW experiences in physical (here, musculoskeletal) and mental health conditions, [23] such as the importance of work adjustments, [4,25] qualitative studies noted differences in RTW experiences between both health conditions. For instance, with regard to early contact, Tjulin et al [26] found that supervisors and coworkers felt that the timing of the RTW should vary between physical and mental illnesses, and Hoefsmit et al [10] observed that in mental cases, supervisors and employees tended to not have early contact, compared to physical cases.…”