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Vijan, S., R.A. Hayward, and Kenneth M. Langa. 2004. "The impact of diabetes on workforce participation: Results from a national household sample." Health Services Research, 39(6): 1653-1669.
Objective. Diabetes is a highly prevalent condition that results in substantial morbidity and premature mortality. We investigated how diabetes-associated mortality, disability, early retirement, and work absenteeism impacts workforce participation. Data Source. We used the Health and Retirement Study (HRS), a national household sample of adults aged 51-61 in 1992, as a data source. Study Design. We conducted cross-sectional analyses on the baseline HRS data, and longitudinal analyses using data from eight years of follow-up. We used two-part regression models to estimate the adjusted impact of diabetes on workforce participation, and then estimated the economic impact of diabetes-related losses in productivity. Principal Findings. Diabetes is a significant predictor of lost productivity. The incremental lost income due to diabetes by 1992 was $60.0 billion over an average diabetes duration of 9.7 years. From 1992 to 2000, diabetes was responsible for $4.4 billion in lost income due to early retirement, $0.5 billion due to increased sick days, $31.7 billion due to disability, and $22.0 billion in lost income due to premature mortality, for a total of $58.6 billion dollars in lost productivity, or $7.3 billion per year. Conclusions. In the U.S. population of adults born between 1931 and 1941, diabetes is associated with a profound negative impact on economic productivity. By 1992, an estimated $60 billion in lost productivity was associated with diabetes; additional annual losses averaged $7.3 billion over the next eight years, totaling about $120 billion by the year 2000. Given the rising prevalence of diabetes, these costs are likely to increase substantially unless countered by better public health or medical interventions.