THE GREAT DUTCH WORK DISABILITY EPIDEMIC: CULTURAL CONSTRUCTION AND INSTITUTIONAL ACTION

We propose that institutional actors do not just ceremonially comply with the cultural values in their environment, as institutional theorists have suggested. Instead, we argue that institutional actors can use conflicting cultural values as tools to further their interests and, in doing so, affect significant social problems and cause unanticipated changes in their core goals and policies. To present support for that proposition, we describe an epidemic of work disability that occurred in the Netherlands between 1967 and 1988. The epidemic is examined in light of conflicting Dutch cultural conceptions of the meaning of work and the meaning of economic security in the welfare state. The behavior of key institutional actors, including the government, medical institutions, employers, and labor unions, is examined to identify their roles in the epidemic. We assert that, by pursuing its own interests while upholding Dutch cultural values, each institutional actor produced conditions in which the work disability epidemic could occur.