This article presents an analysis of Swedish sickness insurance in the 2000's, outlining cultural and structural shifts in political and institutional design. The study is based on analytic dualism and Margaret S. Archer's morphogenetic model, which is used to create an analytical narrative focusing on political and institutional developments. The narrative identifies two distinct phases: one period of rapid cultural and structural change (morphogenesis), and one of institutionalization of the new structure (morphostasis). The narrative describes how a key element of the Swedish welfare state, sickness insurance, underwent a transition from an encompassing and generous to a strict and suspicious system, and how this was effectively solidified politically and organizationally. This is related both to a broader shift toward neoliberal and workfare policies, and to the specific socio-cultural and social interactions between agents to reform the system. The analysis provides a contribution to the literature by providing an internationally relevant empirical case of how an encompassing system has undergone a period of substantial decline, and by presenting a coherent long-term narrative which temporalizes this development into specific timepoints and phases.

Purpose – Knowledge regarding the importance of the psychosocial work environment for health and wellbeing in the workplace is extensive. However, more knowledge is needed about how the managers’ organizational conditions are related to what occupational health and safety management (OHSM) is actually conducted and how this relates to the work-related health of employees. The aim of this study is therefore to investigate if managers’ organizational conditions are associated with the conducted OHSM, and if the conducted OHSM is associated with the psychosocial work environment and well-being of the employees.

Design/methodology/approach – An electronic questionnaire was sent to managers and their employees working in 10 different organizations in Sweden, resulting in 1,097 valid responses. Structural equation modeling (SEM) was used to analyze the results.

Findings – The SEM analysis showed that managers’ conditions were related to employee well-being via OHSM and psychosocial work environment (job demands and job resources).

Originality/value – This study contributes to the existing literature in the field of OHSM by placing explicit focus on the role of organizational conditions for conducting OHSM. By studying not only the link between work environment and health, but also focus on the underlying organizational structures for OHSM, provides additional possibilities for prevention of the increasing work-related illness. As such, this paper contributes to a more holistic perspective in the field of OHSM.

PurposeFor clients to understand social insurance decisions and processes, information from authorities needs to be comprehensible, and clients need sufficient individual abilities. These dimensions are captured by the concept social insurance literacy, which has been operationalized into a measure, the Social Insurance Literacy Questionnaire (SILQ). The aim of this study was to describe the development of the SILQ and evaluate its psychometric properties using Rasch measurement theory.MethodsThe development of the SILQ included a Delphi study and cognitive interviews. A preliminary version, divided on four scales corresponding to the domains of the concept (obtaining information, understanding information, acting on information, and system comprehensibility) was psychometrically evaluated according to Rasch measurement theory, in a survey to a stratified random sample of people on sick leave (n = 1151) sent out in the fall of 2020.ResultsOverall, the items in the final version of the SILQ demonstrated good fit to the Rasch model, and the response scale worked as intended. Unidimensionality was supported for all scales, but minor problems with local dependency was detected for three items. The person separation was 0.80 for the Obtain scale, 0.82 for the Understand scale, 0.68 for the Act scale, and 0.81 for the System scale. Corresponding ordinal alpha values were 0.91, 0.91, 0.86, and 0.91, respectively.ConclusionThis study is a first step toward exploring literacy in the social insurance field. The SILQ covers individual abilities and systems' comprehensibility, and the results show that it has acceptable psychometric properties.

Purpose The purpose of the paper is to investigate managers experiences of managing work environment and risks during the Covid-19 pandemic and to explore how managers might use these experiences to develop future risk management. Design/methodology/approach Semi-structured interviews were carried out with 18 Swedish managers at different hierarchical levels working in 11 different organizations. A directed content analysis was carried out, informed by theory on risk management. Findings The results point to the pandemic as a societal crisis which workplaces needed to manage through large means of improvisation. Regular work environment routines were put to the test, and several deficiencies in the work environment and risk management were identified. Organizations that handle occupational safety and risks on a daily basis through established routines were less affected and could easier adjust work environment and risk management, compared to organizations prioritizing the social and organizational work environment, which had to re-prioritize and start paying more attention to the physical work environment and to bring risk management into their daily routines. Originality/value The study offers an account of how managers in different labor market sectors in Sweden have acted in the midst of the pandemic by handling real-time crises, how these experiences can be used for engaging in retrospective learning and how this may imply changes to their prospective risk management.

Purpose This article focuses on the risk that work disability policies lock people into work disability rather than promote durable health and return to work. We outline the concept of a work disability trap as a heuristic device to explore this policy paradox inherent in the design of most social insurance systems. Materials and methods This is a conceptual paper drawing on examples from existing research. Results We identify three manifestations of the disability trap: not overcoming disability; underperforming; and returning to work prematurely. The causes of these manifestations are identified as structural rather than based on malingering clients, while negative consequences are identified both on client and system levels. Conclusion We emphasize the need for systems built on trust and reasonable expectations, and the need for providing rehabilitation support independently of economic compensation. Universal basic income is introduced as a potential tool to ameliorate some of the consequences of the disability trap.