'cultures of Sick Leave': Institutional Categorization, Legitimacy, and Moral Order at the Intersection of Research and Politics in Sweden

In line with what has been described as a ’cultural turn’ in the social sciences over the last decade, ’cultures of sick leave’ has become an important concept in Swedish social insurance studies as well as in political debates. ’Culture’ has been used for understanding variations in sickness benefit usage between groups and between different geographical areas in Sweden. Examining how the concept is used and what it does, this study offers an ethnomethodological understanding both on the empirical level and on a meta-level. It is found that ’culture’ tends to be used (or refuted) as explanation, without much theoretical or methodological grounding. Instead, culture is often applied in a common-sense manner, rarely problematizing how it translates into empirical studies. The paper discusses how the concept of culture works to negotiate the institutional category ’sick absentee’ in the intersection of research and politics, positioning the individual in relation to the welfare state and bringing notions of accountability, legitimacy and morality into play: whose fault is a ’culture’ anyway, and what can be done about it? As an alternative approach, the paper suggests ethnomethodology’s way of studying culture as it is being ’done’. Seeing culture as constituted in discourse, and placing culture in action rather than action in culture, opens up for a bottom-up analysis in which members’ situated practices are in focus. Furthermore, conversation analysis provides a rigorous methodological framework for analyzing institutional categorization processes by closely attending to linguistic detail in interaction. Drawing on a Swedish study of meetings between people on sick leave, their doctor, and the state official administering their sickness benefit, the paper illustrates the use of such an approach, showing just how the legitimate boundaries of the category are co-constructed and negotiated: how ’cultures of sick leave’ are done in the fine details of interaction.