His, Her, or Their Divorce? Marital Dissolution and Sickness Absence in Norway

For many years, researchers have repeatedly observed that married individuals have better psychological and physical health (including longevity) than those who are unmarried, divorced, or widowed (see, e.g., Kiecolt-Glaser & Newton, 2001; Koball, Moiduddin, Henderson, Goesling, & Besculides, 2010; Ross, Mirowsky, & Goldsteen, 1990; Waite & Gallagher, 2000). There are three main explanations for such differences (Amato, 2000, 2010; Booth & Amato, 1991; Johnson & Wu, 2002; Wyke & Ford, 1992). First, according to the social role model, they are a result of the protective effect of marriage and the chronic strain of other marital roles. Second, the crisis model attributes these differences to a temporary stress reaction to the event of a marital dissolution. These two models both represent marriage as having a causal (chronic or temporary) impact on an individual's health. In contrast, in the third model, the social selection model, observes that health differences are the result of certain health problems and personality characteristics of individuals who are less likely to marry in the first place and, if they do marry, are more likely to divorce (i.e., reverse causality). It has long been acknowledged that the health differences observed between marital groups could be the result of different mechanisms, but only comparatively recently, with the availability of longitudinal data and new statistical methods, has it become possible to distinguish these explanations. New data and methods have also revitalized the old debate about which gender enjoys more benefits from marriage and-the converse question-which suffers more from divorce (Amato, 2000; Aseltine & Kessler, 1993; Kiecolt-Glaser & Newton, 2001; Simon, 2002). In this study, we used a large-scale longitudinal database that covers the entire Norwegian population and makes it possible to trace individual histories (N = 1,638,912) over a 14-year period. We use fixed effect panel methods to investigate the health impact of marriage and divorce and to determine whether the effect of parenthood at the time of marital dissolution is different for men and women. Thus, we followed the recent trend in research on divorce (see Amato, 2010) by using a large, national, representative, longitudinal database and statistical methods that allow us to control time-invariant sources of unobserved heterogeneity.Whereas most studies investigate the mental health consequences of marital disruption, we studied medically certified (by a physician) sickness absences longer than 14 days. Such long-term absences are more likely to reflect health problems than shorter absences, because the impacts of individual behavior, choices, and seasonal fluctuations are less than they would be for short absences. Sickness absence is related to individual health (Marmot, Feeney, Shipley, North, & Syme, 1995), work disability, and mortality (Alexanderson et al., 2003). As in most European countries, sickness absence is viewed as a serious problem in Norway. According to figures from the Organisation for Economic Co-operation and Development (OECD, 2013), Norway has the highest rate of absence of full-time employers in the OECD, and, on a typical day, 7% of employees are absent because of sickness. Sickness absence payments from the National Insurance Scheme (NIS) amounted to 51 billion Norwegian Kroner in 2012 (2.3% of the gross domestic product). Approximately 44% of all marriages (12.3 per 1,000 existing marriages per year) are expected to end in divorce (Statistics Norway, 2012). The Norwegian welfare state, together with those of the other Scandinavian countries, is described as being among the greatest spenders on welfare in the world (see, e.g., Kautto, Fritzell, Hvinden, Kvist, & Uusitalo, 2001), and these countries have also been characterized as being especially women friendly (Hernes, 1987). The Norwegian welfare states provide free and relatively easy access to the health care system for the whole population and relatively generous support in cases of poverty and single parenthood. …