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The Inclusive Workplace Agreement (IA) contributed to keeping paid employment

Working in an IA company increased the probability of returning to work after more than 16 days’ sick leave and of maintaining paid employment, a recent study from the National Institute of Occupational Health in Norway (STAMI) and Oslo University Hospital found.



  • 25. April 2023

The Inclusive Workplace (IA) Agreement was established in Norway in 2001 to reduce sick leave and increase work participation. This is the first study on the effects of this population-wide initiative that analyses a large dataset with longitudinal multistate outcomes.

The study included close to 190,000 individuals who were absent from work with full-time sick leave benefit.

20 years with the IA Agreement

Companies that signed the first IA Agreement committed to working systematically to prevent and reduce sick leave and withdrawal, both through two-party cooperation within the company, and through cooperation with the Norwegian Labour and Welfare Administration (NAV). IA companies and their employees gained access to several measures, including support from regional Working Life Centres established by NAV. By 2004, 55 % of workers in Norway were employed in IA companies.

The IA Agreement has been further developed and renewed several times, and the current agreement runs until December 31st, 2024. The present study evaluated the IA Agreement in the period 2004-2010, which corresponds to the second and third Agreement periods.

Based on data from NAV and Statistics Norway, the researchers have studied effects of working in an IA company and having access to IA measures on return- to -work after a period of sick leave.

More days at work

The study showed that being employed in an IA company at the onset of a sick leave period increased the probability of returning to work and maintaining paid employment. This was true also when adjusting for differences between workers and companies who had access to IA measures and those without such access, including differences in workers’ gender, age and level of education, company industry and size, and geographical variations.

– We found that workers in IA companies had, on average, 8.4 more days at work the first year after the onset of a sick leave period than their peers in non-IA companies, says Ingrid Sivesind Mehlum, Senior Physician and Researcher at STAMI.

The researchers also found that employees of IA-companies had, on average, 7.6 fewer days of full-time sick leave, and 1.6 fewer days without employment (on unemployment benefits or for other reasons), the year following the onset of sick leave.

– Another interesting discovery was that the IA-Agreement seems to affect men more positively than women and also have a longer-lasting effect. There may be various explanations for this. For instance, the Norwegian labour market has an uneven gender distribution in certain industries and occupations. Even though the available measures are the same for every IA company, it is reasonable to expect that their implementation and effect will vary substantially across workplaces, occupations, and industries, says Sivesind Mehlum.

Has been successful

– Our findings indicate that the IA -Agreement contributes to keeping people in paid employment, both by reducing overall sick leave and by enabling workers to hold on to a job and stay connected to working life. No previous studies have shown this, says Ingrid Sivesind Mehlum.

The main objective of the IA- Agreement is to create a working life with room for everyone through preventing sick leave and withdrawal and increasing general employment. This study shows that IA- companies have succeeded in this endeavour, both by reducing full-time sick leave and by enabling a sustained connection to the workplace and the labour force.

– This also shows the importance of focusing on other issues than just sick leave in IA-related efforts. Having a place to work and belong may matter more in the long run, Sivesind Mehlum states.

Method and scope

In this study, the researchers used longitudinal registry data from a cohort consisting of all individuals born in Norway between 1967 and 1976. Everyone in the cohort with sick leave of more than 16 calendar days between 2004 and 2010 was included. This group, consisting of 187,.930 individuals, was followed for 500 days. Data about their company’s IA -status was obtained from NAV.

The study did not investigate the effects of more recent IA -Agreement periods. This will, however, be the subject for a new study by Sivesind Mehlum and her colleagues when updated data are available.

To determine the causal relationships between the IA- Agreement and work participation, the researchers have used statistical and causal methods for large -scale registry data, including multistate models.