The Impact of Diabetes on the Labour Force Participation and Income Poverty of Workers Aged 45–64 Years in Australia

Objective To quantify the poverty status and level of disadvantage experienced by Australians aged 45–64 years who have left the labour force due to diabetes in 2010. Research Design and Methods A purpose-built microsimulation model, Health&WealthMOD2030, was used to estimate the poverty status and level of disadvantage of those aged 45–64 years who prematurely retire from the workforce due to diabetes. A multiple regression model was used to identify significant differences in rates of income poverty and the degree of disadvantage between those out of the labour force due to diabetes and those employed full- or part-time with no diabetes. Results 63.9% of people aged 45–64 years who were out of the labour force due to diabetes were in poverty in 2010. The odds of being in poverty for those with no diabetes and employed full-time (OR of being in poverty 0.02 95%CI: 0.01–0.04) or part-time (OR of being in poverty 0.10 95%CI: 0.05–0.23) are significantly lower than those for persons not in the labour force due to diabetes. Amongst those with diabetes, those who were able to stay in either full- or part-time employment were as much as 97% less likely to be in poverty than those who had to retire early because of the condition. Sensitivity analysis was used to assess impacts of different poverty line thresholds and key socioeconomic predictors of poverty. Conclusions This study has shown that having diabetes and not being in the labour force because of this condition significantly increases the chances of living in poverty. Intervening to prevent or delay the onset of diabetes is likely to improve their living standards.

[1]  Work absenteeism in type 2 diabetes mellitus: results of the prospective Diabetes Intervention Study. , 1993, Diabete & metabolisme.

[2]  J. Pagán,et al.  The impact of diabetes on adult employment and earnings of Mexican Americans: findings from a community based study. , 2002, Health economics.

[3]  David W. Smith,et al.  Productivity and economic burden associated with diabetes. , 2001, American journal of public health.

[4]  J. Sørensen,et al.  The Cost of Diabetes-Related Complications: Registry-Based Analysis of Days Absent from Work , 2013 .

[5]  Alan D. Lopez,et al.  Burden of disease and injury in Australia in the new millennium: measuring health loss from diseases, injuries and risk factors , 2008, The Medical journal of Australia.

[6]  T. Valle,et al.  Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. , 2001, The New England journal of medicine.

[7]  L. Veerman,et al.  The Impact of Diabetes on the Labour Force Participation, Savings and Retirement Income of Workers Aged 45-64 Years in Australia , 2015, PloS one.

[8]  S. Colagiuri,et al.  Using an economic model of diabetes to evaluate prevention and care strategies in Australia. , 2008, Health affairs.

[9]  Wolfgang Rathmann,et al.  Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. , 2004, Diabetes care.

[10]  A. Earnest,et al.  Chronic disease and labour force participation among older Australians , 2008, The Medical journal of Australia.

[11]  Y. Ng,et al.  Productivity losses associated with diabetes in the US. , 2001, Diabetes care.

[12]  P. Saunders Poverty in Australia Sensitivity Analysis and Recent Trends , 2008 .

[13]  R. Walld,et al.  Impact of diabetes on employment and income in Manitoba, Canada. , 2001, Diabetes care.

[14]  A. Yassin,et al.  Disability and Its Economic Impact Among Adults With Diabetes , 2002, Journal of occupational and environmental medicine.

[15]  T. Vos,et al.  The impact of diabetes prevention on labour force participation and income of older Australians: an economic study , 2012, BMC Public Health.

[16]  J. Lindström,et al.  Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study , 2006, The Lancet.

[17]  Nicola J Cooper,et al.  Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis , 2007, BMJ : British Medical Journal.

[18]  B. Howard,et al.  Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance: The Da Qing IGT and Diabetes Study , 1997, Diabetes Care.

[19]  Shayne Neumann The intergenerational report , 2010 .

[20]  M. Gulliford,et al.  Diabetes‐related inequalities in health status and financial barriers to health care access in a population‐based study , 2004, Diabetic medicine : a journal of the British Diabetic Association.

[21]  Aldi J. M. Hagenaars,et al.  Poverty Statistics in the Late 1980s: Research Based on Micro-data , 1994 .

[22]  G A Colditz,et al.  The economic costs of non-insulin-dependent diabetes mellitus. , 1989, JAMA.

[23]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002 .

[24]  R. Shrestha,et al.  Economic impacts of illness in older workers: quantifying the impact of illness on income, tax revenue and government spending , 2011, BMC public health.

[25]  N. Ray,et al.  Economic Consequences of Diabetes Mellitus in the U.S. in 1997 , 1998, Diabetes Care.

[26]  R. Shrestha,et al.  The financial vulnerability of individuals with diabetes , 2010 .

[27]  R. Shrestha,et al.  Modelling the cost of ill health in Health&WealthMOD (Version II): lost labour force participation, income and taxation, and the impact of disease prevention , 2010 .

[28]  S. Oster,et al.  The Definition and Measurement of Poverty , 2019 .

[29]  A. Mushlin,et al.  Reductions in individual work productivity associated with type 2 diabetes mellitus , 2012, PharmacoEconomics.

[30]  Clemens L. J. Siermann,et al.  Statistics in Focus: Population and social conditions. Income poverty in theEuropean Union: Children,gender and poverty gaps. 2000.12 , 2000 .

[31]  Susanne Rässler,et al.  Statistical Matching: "A Frequentist Theory, Practical Applications, And Alternative Bayesian Approaches" , 2002 .

[32]  P. Deb,et al.  Work disability and diabetes. , 1999, Diabetes care.

[33]  K. Vos,et al.  Equivalence Scale Sensitivity of Poverty Statistics for the Member States of the European Community , 1997 .

[34]  M. Pladevall,et al.  The impact of diabetes on employment and work productivity. , 2005, Diabetes care.

[35]  A. Karter,et al.  Self-monitoring of blood glucose: language and financial barriers in a managed care population with diabetes. , 2000, Diabetes care.

[36]  K. Langa,et al.  The impact of diabetes on workforce participation: results from a national household sample. , 2004, Health services research.

[37]  P. Saunders,et al.  Monitoring Trends in Poverty and Income Distribution: Data, Methodology and Measurement , 2006 .

[38]  S. Bergin,et al.  Diabetes foot disease: the Cinderella of Australian diabetes management? , 2012, Journal of Foot and Ankle Research.

[39]  Nicola J Cooper,et al.  Different strategies for screening and prevention of type 2 diabetes in adults: cost effectiveness analysis , 2008, BMJ : British Medical Journal.