The Impact of Diabetes on Employment and Work Productivity

Abstract

OBJECTIVE -The purpose of this study was to longitudinally examine the effect of diabetes on labor market outcomes.RESEARCH DESIGN AND METHODS -Using secondary data from the first two waves (1992 and 1994) of the Health and Retirement Study, we identified 7,055 employed respondents (51-61 years of age), 490 of whom reported having diabetes in wave 1. We estimated the effect of diabetes in wave 1 on the probability of working in wave 2 using probit regression. For those working in wave 2, we modeled the relationships between diabetic status in wave 1 and the change in hours worked and work-loss days using ordinary least-squares regressions and modeled the presence of health-related work limitations using probit regression. All models control for health status and job characteristics and are estimated separately by sex.RESULTS -Among individuals with diabetes, the absolute probability of working was 4.4 percentage points less for women and 7.1 percentage points less for men relative to that of their counterparts without diabetes. Change in weekly hours worked was not statistically significantly associated with diabetes. Women with diabetes had 2 more work-loss days per year compared with women without diabetes. Compared with individuals without diabetes, men and women with diabetes were 5.4 and 6 percentage points (absolute increase), respectively, more likely to have work limitations.CONCLUSIONS -This article provides evidence that diabetes affects patients, employers, and society not only by reducing employment but also by contributing to work loss and healthrelated work limitations for those who remain employed. Diabetes Care 28:2662-2667, 2005T he medical care costs associated with diabetes create a considerable economic burden for patients, families, and society (1,2). Productivity losses from diabetes have been estimated to be almost half ($40 billion) of the medical costs ($92 billion) associated with diabetes in 2002 (1). As the prevalence of diabetes in the U.S. has increased (3), so too have associated economic burdens (4). The increased prevalence (5) among younger individuals suggests that diabetes will become more common in the working-age population. Consequently, employment and work productivity of individuals with diabetes are important issues for patients, families, employers, and policy makers. In this study, we examine the effect of diabetes on labor market outcomes of employed U.S. adults aged 51-61 using longitudinal data from the Health and Retirement Study (HRS).Several studies have found negative associations between diabetes and employment outcomes (6 -10). The magnitude of the effect of diabetes on employment varies from 4 to 22 percentage points. Diabetes can affect employment in a number of ways. First, diabetes complications may prevent working entirely or increase absenteeism for those who work (11). Second, productivity while at work may also be impaired (12). Third, individuals with diabetes may face employment discrimination. In some cases, especially because of the risk of hypogl...

Long-term detrimental consequences of the onset of type 1 diabetes on annual earnings—evidence from annual registry data in 1990–2005

“…Previous studies from Canada and the USA have indicated differences in earnings, but did not consider type 1 diabetes in particular, nor did they control for duration of diabetes [1][2][3][4][5][6][7][8][9][10][11][12]. In this study we have established more firmly, first, that the differences in earnings were in fact induced by the onset of diabetes using the before-after design and individual-level longitudinal annual data.…”

“…The scarce literature on consequences of type 1 diabetes on earnings, education and participation in the labour market may be explained by the difficulties in obtaining data to confirm a causal relationship. A few published studies have described labour-market outcomes for persons with diabetes of varying duration, relying on cross-sectional data and on self-reporting of diabetes in surveys [1][2][3][4][5][6][7][8][9][10][11][12]. Cross-sectional data may show associations, but are not sufficient for identifying causal relationships.…”

Quantifying the Incremental and Aggregate Cost of Missed Workdays in Adults with Diabetes

“…Unless concerted efforts are undertaken, the economic burden of diabetes will continue to rise by contributing to work loss through absenteeism and health-related work limitations in the workplace. 5 In addition, our findings suggest that disparities of missed workdays based on gender will assist policy makers to consider further efforts to improve women's health, thereby reducing the economic burden to women associated with missed workdays due to injury/illness. Key strategies to reduce missed workdays in people with diabetes include improving the clinical care of diabetes, increasing medication adherence, reducing complications and treating comorbid mental illnesses such as depression.…”

“…5,9,26 The economic burden associated with diabetes is likely to increase as diabetes becomes more prevalent. 5 With rising prevalence of diabetes in the US, cost of missed workdays will continue to rise, and quantifying the incremental and aggregate cost of missed workdays is believed to be important to employers, to estimate potential cost savings of minimizing job absenteeism, along with interventions to reduce diabetes. Unless concerted efforts are undertaken, the economic burden of diabetes will continue to rise by contributing to work loss through absenteeism and health-related work limitations in the workplace.…”

“…3 The prevalence among individuals aged 20 years or older has been increasing, which suggests that diabetes has become an important risk factor for the American workforce. 3,5 Non-Hispanic Blacks (NHB), Hispanic, American Indians, and some Asian Americans are at particularly high risk for type 2 diabetes and its complications. 1,3,6 Individuals with diabetes have been shown to have substantially higher rates of missed work, disability and probability of being early retired than those without diabetes.…”