AUTHOR=Stöllman Åsa , Stoetzer Ulrich , Svartengren Magnus , Molin Fredrik 

TITLE=Organizational factors behind low sickness absence in Swedish municipalities—An explorative qualitative study

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1519981

DOI=10.3389/fpubh.2025.1519981

ISSN=2296-2565

ABSTRACT=IntroductionThis study explores organizational factors that contributes to low sickness absence in Swedish municipalities.MethodsA qualitative, explorative design was used, including semi-structured individual interviews with 63 managers across 12 municipalities with either high or low sickness absence. Interviews were conducted with Human resources managers, Administration managers and Unit managers in senior care and schools.ResultsThe results revealed that municipalities with low sickness absence demonstrate leadership practices that emphasize proximity and accessibility, promote employee development, integrate systematic work environment management, including employee participation into daily routines. Additionally, an open and effective communication was identified as a crucial factor in fostering sustainable organizations. The results show that municipalities with lower sickness absence rates tend to have more sophisticated organizational strategies, especially in clear and manageable areas, it requires strategic planning and well-defined structures.DiscussionA recurring theme in the analysis is the proximity and interconnectedness observed in leadership, communication, and employee participation, with leaders that show a high degree of involvement in day-to-day activities. This “proximity principle,” emerges as a potential significant factor influencing health outcomes in working life.