Why is the mental health of working Swedish women among the worst in the developed world? Isn’t Sweden the Mecca of work-life balance, where heavily subsidised childcare and other family friendly policies make it a model state for women’s equality?

Maybe, but something seems to have gone wrong. Over the last two decades in many OECD countries younger workers increasingly have been exiting the workforce on disability pensions (mainly related to mental illness and back problems) but the psychiatric trend has been more pronounced among younger women, and most pronounced of all among Swedish women workers.

New cases of disability pension among women 20–29 and 30–39 years of age. Graph: BMJ

Because of the “heavy socio-economic burden” on countries that this trend represents, researchers from the Division of Insurance Medicine at the Karolinska Institute in Stockholm set up a study of all women born in Sweden between 1960 and 1979. By analysing data gathered between 1993 and 2003 they sought to identify the social circumstances of women receiving disability pensions.

The journal Family in America summarises the results -- which are not at all surprising:

Their analysis clearly identified prolonged maternal employment and single marital status as predictors of women’s receiving such pensions.

The researchers’ analysis highlighted the contrast between “cohabiting” Swedish women and “lone” Swedish women. However, the researchers define their terms somewhat peculiarly: “Cohabitation meant either married or cohabiting with children in common. Thus, if they were cohabiting without children in common, [the women in the study] were classified as lone.”

Even if the terminology is disorienting, the statistical results are clear: those results indicate that in the short run “cohabiting working mothers” enjoyed “a beneficial health effect,” evident in notably low DP rates among these women, a health effect “which may be explained by a protective effect of social integration provided by living with a partner and children.” However, in the long run, out-of-home maternal employment takes its toll: in the five-year follow-up data, the researchers found that “cohabiting working mothers were at a higher risk of receiving a DP compared with those without children.”

But the most markedly elevated Disability Pension rates emerge not among “cohabiting” women but rather among “lone” women. “Overall,” the researchers report, “lone women showed higher H[azard]R[isks] than cohabiting women, and among employed lone women, the HR was highest for those who had children.”

The researchers acknowledge that their finding that “lone working mothers had the highest risk of DP both in the short and long term” is “in line with expectations.” After all, “Previous studies have clearly pointed out the vulnerability of this group, which may be explained by the heavy workload and greater responsibility that is shouldered by many of these women, as well as weak financial resources.”

Summarizing their findings, the researchers conclude, “A considerable part of the social expenses due to DP should be attributed to lone working women with children. Their illness and decreased work capacity have implications not only for the mothers but probably also for the children.” American policymakers should recognize this study’s cautionary implications: policies that promote maternal employment while inhibiting marriage will cost the country dearly.

(Birgitta Floderus et al., “Disability Pension among Young Women in Sweden, with Special Emphasis on Family Structure: A Dynamic Cohort Study,” BMJ Open 2.3 [May 30, 2012]: e000840.)

US Political economist Nicholas Eberstadt has identified worker disability benefits as a major cause of the ballooning of the American welfare state and of the "corruption" it breeds. Perhaps a gender analysis of the US data would be enlightening too.