The paper discusses the role of the welfare state by focusing on regional variations in sick leave in Sweden. Working with comparative community studies we found that the community where illness and absence from work was high simultaneously stood out as a community with strong equality ideas, almost no cultural diversity, and a low degree of urbanization. The number of people on sick leave ran parallel with a strong suspicion of the welfare state. In the community shaped by industry we found physically strenuous jobs, a pronounced class structure, many immigrants, and dependency on the global economy. However, people had a strong belief in their own ability to embrace the future. Here solidarity with the welfare state was also strong—at the same time as the need of it was minimal.