Employees under strict attendance policies face a difficult choice when they are “technically” physically able to be present at work, but may not feel healthy enough to perform their job well. Debating whether or not to call in for the day, employees ask themselves not only if they feel sick, but if they seem sick enough to convince their superiors and coworkers. Talcott Parsons’ classic work on “the sick role” helps us understand why. Sickness inhibits a person’s ability to perform as others expect them to. However, people in the sick role are excused if their symptoms seem to be beyond their control and if they try to get better. Whether or not a person is really sick, taking on the sick role requires those around them to be convinced, granting the sickness legitimacy. Social science research shows how the ease of attaining the legitimated sick role differs depending on gender and class.

• Talcott Parsons. 1975. “The Sick Role and the Role of the Physician Reconsidered.” Milbank Memorial Fund Quarterly, Health and Society 53(3): 257-278.

More recent and critical research shows why taking the plunge and calling into work can be so difficult. First, a person has to ascertain whether they are truly sick by analyzing how their body feels, and whether or not certain symptoms constitute true illness in the eyes of others. The dripping nose and general malaise of a cold, for example, is never pleasant. Perhaps as children we might think it truly disrupts our daily routines. As we grow older, however, we learn what sociologists of health call illness behavior, which is how an individual interprets specific bodily symptoms (like those of a cold) and reacts to them. Adults learn that the proper reaction to a cold is taking some over-the-counter medicine and heading into work with a box of tissues. This means that learning to interpret the way your body feels is in large part a social process.

• J.T. Young. 2004 “Illness Behaviour: A Selective Review and Synthesis.” Sociology of Health & Illness 26(1): 1-31.
• David Mechanic. 1995. “Sociological Dimensions of Illness Behavior.” Social Science and Medicine 41(9): 1207-16.

Many working-class jobs perpetuate “toughing it out” illness behavior; employees often attribute moral value to being “hard working” and going into work no matter what. This comes with a set of beliefs about what constitutes real illness and what is mere laziness. Research finds that this kind of labor market shapes working mothers’ illness behavior. After developing a worker identity, working mothers often recognize physical symptoms as relatively unimportant compared to building a good reputation with their superiors and defending themselves from job insecurity. The economy, then, is at play when they assess how they physically feel. They then encourage their children to “tough out” common health problems. This learned behavior does not end when a child leaves home either – they are socialized into this practice and are likely to continue “toughing it out” when they are adults.

• Sarah Cunningham-Burley, Kathryn Backett-Milburn, and Debbie Kemmer. 2006. “Constructing Health and Sickness in the Context of Motherhood and Paid Work.” Sociology of Health & Illness 28(4): 385-409.
• Maria Carla Barnes, Rhiannon Buck, Gareth Williams, Katie Webb, and Mansel Aylward. 2008. “Beliefs About Common Health Problems and Work: A Qualitative Study.” Social Science & Medicine 67(4): 657-665.
• Claus D. Hansen and Johan H. Andersen. 2008. “Going Ill to Work.” Social Science & Medicine 67(6): 956-964.