Heart disease, arthritis, diabetes raise risk of leaving workforce

IWH study of chronic conditions common in older age finds strong associations with people being out of labour force, particularly when conditions are paired

Despite a growing effort on the part of policy-makers and employers to keep older workers in the labour market, health problems remain a big reason many of them leave their jobs.

According to a new study by the Institute for Work & Health (IWH), people with heart disease, arthritis and other types of chronic conditions associated with older age are less likely to be working than those without these conditions. For example, people with heart disease are three times more likely not to be working than those without the condition.

What’s more, people with more than one chronic condition are even more likely to be not working. For those with both heart disease and diabetes, in particular, the risk of not being in the labour market is at least eight times as high as it is for those with neither condition.

Some of these conditions in combination have a synergistic effect, says IWH Scientist Dr. Peter Smith, lead researcher for the study.

The study’s results imply that policies set up to try to keep older workers in the workplace should address the barriers faced by people with chronic conditions, says Smith.

We’ve seen governments doing things such as repealing mandatory retirement and pushing up the retirement age to keep people in the labour market, he says. But there hasn’t been a lot of thinking about how to create work environments that enable people with chronic conditions to stay in the labour market.

A lot of people do want to stay at work for both social and financial reasons, he adds. So we need to think about workplaces and work practices, and how they need to change to keep these people in the labour market for as long as they can.

The study, published online in July 2013 by Ageing and Society (doi:10.1017/s0144686x13000457), draws on three cycles of Statistics Canada’s Canadian Community Heath Survey between 2000 and 2005. It has a total sample of 129,000 people who were either working or not working due to health reasons.

The study examines seven chronic conditions that are most prevalent among older adults. These are hypertension, heart disease, diabetes, arthritis, back problems, migraines and thyroid conditions. It finds each of these has an impact on workforce participation—but to varying extents.

Of the seven, heart disease has the strongest link with not being in the workforce, and thyroid conditions the weakest. Having heart disease puts people at about three times the risk of not working when compared with those without the condition.

The risk of not working for those with diabetes, arthritis or back pain is about twice as high as it is for people who don’t have these conditions. However, as arthritis is the most common of the conditions, it is linked to the greatest number of people not being at work.

Three pairs of conditions examined

The researchers also looked at the effects of these conditions when in pairs. People with heart disease and diabetes are over eight times more likely to not be in the labour market compared to people without either condition. People with arthritis and heart disease are seven times more likely to be out of the labour market than people with neither condition, and people with both arthritis and back pain are five times more likely than people without these conditions to be out of the labour market.

One of the surprise findings for Smith was the fact that the impact of health conditions did not differ for people with different levels of education.

We expected the effects of chronic conditions to be greater among people with less education who, one might assume, would be more likely to be in working environments with higher physical demands and lower levels of control, says Smith. He adds that further study would be needed to probe for the reasons why those differences were not seen.

Also needed are studies on programs to keep people with chronic conditions at work to understand if they are effective, he adds.

There haven’t been a whole lot of intervention studies in this area, says Smith. For example, simple things like giving workers more autonomy and flexibility through the work day might be effective at allowing people with certain conditions to stay at work.

Source: At Work, Issue 74, Fall 2013: Institute for Work & Health, Toronto

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