Purpose <p>This study investigates the impacts of three major diseases (stroke, myocardial infarction, cancer) and three chronic diseases (diabetes, dyslipidemia, and hypertension) on working decisions, working status, and working hours in Japan. We focus on hospital visits for these diseases, estimating the effects of individuals’ own diseases and spousal diseases on respondents’ working conditions by gender.</p> Methods <p>We use propensity score matching (PSM) for the estimations to control for causality. The main estimations used are a logistic regression for the working decision function, a multinomial logit model for working status, and ordinary least squares (OLS) for working hours.</p> Results <p>The results confirm that these diseases do not necessarily have a uniformly negative effect on individuals’ working decisions, working status, and working hours. That is, men are more likely to retain regular employment to take advantage of insurance coverage regardless of their own or their wife’s disease, whereas women are more likely to handle the situation by choosing to be workless during the span of their own or their husband’s condition.</p> Implication <p>The Japanese insurance system allows both married men and women to access companies’ medical insurance if one of them continues to work full-time, and comparative advantages in the labor market could lead to an increase in the probability of regular employment for husbands. Notably, typical gender divisions in the contexts of work and life also clearly distinguish the roles of men and women who need to visit hospitals.</p>