Connect
MJA
MJA

Lost productive life years caused by chronic conditions in Australians aged 45–64 years, 2010–2030

Deborah J Schofield, Rupendra N Shrestha, Michelle Cunich, Robert Tanton, Simon Kelly, Megan E Passey and Lennert J Veerman
Med J Aust 2015; 203 (6): 260. || doi: 10.5694/mja15.00132

Summary

Objectives: To estimate (1) productive life years (PLYs) lost because of chronic conditions in Australians aged 45–64 years from 2010 to 2030, and (2) the impact of this loss on gross domestic product (GDP) over the same period.

Design, setting and participants: A microsimulation model, Health&WealthMOD2030, was used to project lost PLYs caused by chronic conditions from 2010 to 2030. The base population consisted of respondents aged 45–64 years to the Australian Bureau of Statistics Survey of Disability, Ageing and Carers 2003 and 2009. The national impact of lost PLYs was assessed with Treasury’s GDP equation.

Main outcome measures: Lost PLYs due to chronic disease at 2010, 2015, 2020, 2025 and 2030 (ie, whole life years lost because of chronic disease); the national impact of lost PLYs at the same time points (GDP loss caused by PLYs); the effects of population growth, labour force trends and chronic disease trends on lost PLYs and GDP at each time point.

Results: Using Health&WealthMOD2030, we estimated a loss of 347 000 PLYs in 2010; this was projected to increase to 459 000 in 2030 (32.28% increase over 20 years). The leading chronic conditions associated with premature exits from the labour force were back problems, arthritis and mental and behavioural problems. The percentage increase in the number of PLYs lost by those aged 45–64 years was greater than that of population growth for this age group (32.28% v 27.80%). The strongest driver of the increase in lost PLYs was population growth (accounting for 89.18% of the increase), followed by chronic condition trends (8.28%).

Conclusion: Our study estimates an increase of 112 000 lost PLYs caused by chronic illness in older workers in Australia between 2010 and 2030, with the most rapid growth projected to occur in men aged 55–59 years and in women aged 60–64 years. The national impact of this lost labour force participation on GDP was estimated to be $37.79 billion in 2010, increasing to $63.73 billion in 2030.

Please login with your free MJA account to view this article in full

  • Deborah J Schofield1
  • Rupendra N Shrestha1
  • Michelle Cunich1
  • Robert Tanton2
  • Simon Kelly2
  • Megan E Passey3
  • Lennert J Veerman4

  • 1 University of Sydney, Sydney, NSW
  • 2 University of Canberra, Canberra, ACT
  • 3 University of Sydney, Lismore, NSW
  • 4 University of Queensland, Brisbane, QLD


Acknowledgements: 

The development of the microsimulation model used in this research, Healthboyuan;amp;WealthMOD2030, is funded by the Australian Research Council (under grant LP100100158); Pfizer Australia is a partner to the grant. Megan Passey is supported by fellowships from the National Health and Medical Research Council, the Cancer Institute NSW and the Sydney Medical School Foundation.

Competing interests:

We are financially independent of the funding sources, and the funding sources (including Pfizer Australia) played no part in the research design, the analysis, formulation or interpretation of the results, the decision to publish the research findings, or in any other aspect of the research process.

  • 1. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2163-2196.
  • 2. Schofield DJ, Shrestha RN, Passey ME, et al. Chronic disease and labour force participation among older Australians. Med J Aust 2008; 189: 447-450. <MJA full text>
  • 3. Organisation for Economic Co-operation and Development. Sickness, disability and work: breaking the barriers. Paris: OECD Publishing, 2010. http://ec.europa.eu/health/mental_health/eu_compass/reports_studies/disability_synthesis_2010_en.pdf (accessed Jul 2015).
  • 4. Australian Bureau of Statistics. Labour force, Australia, June 2014. Canberra: ABS, 2014. (ABS Cat. No. 6202.0.) http://www.ausstats.abs.gov.au/ausstats/meisubs.nsf/0/4766D879F89E6574CA257D100013F55B/$File/62020_jun%202014.pdf (accessed Jul 2015).
  • 5. Swan A, The Treasury. Australia to 2050: future challenges. Canberra: Commonwealth of Australia, 2010. http://archive.treasury.gov.au/igr/igr2010/report/pdf/IGR_2010.pdf (accessed Jul 2015).
  • 6. World Health Organization. Facing the facts: the impact of chronic disease in high income countries. Geneva: World Health Organization, 2005. http://www.who.int/chp/chronic_disease_report/media/info_sheet_hi_income.pdf (accessed Jul 2015).
  • 7. Cooke M. Policy changes and the labour force participation of older workers: evidence from six countries. Can J Aging 2006; 25: 387-400.
  • 8. Yelin EH, Trupin LS, Sebesta DS. Transitions in employment, morbidity, and disability among persons ages 51–61 with musculoskeletal and non-musculoskeletal conditions in the US, 1992–1994. Arthritis Rheum 1999; 42: 769-779.
  • 9. Begley CE, Annegers JF, Swann AC, et al. The lifetime cost of bipolar disorder in the US: an estimate for new cases in 1998. Pharmacoeconomics 2001; 19: 483-495.
  • 10. Moore R, Mao Y, Zhang J, Clarke K. Economic burden of illness in Canada, 1993. Ottawa: Canadian Public Health Association, 1997. http://publications.gc.ca/collections/collection_2013/aspc-phac/H21-136-1993-eng.pdf (accessed Jul 2015).
  • 11. Schofield DJ, Shrestha RN, Percival R, et al. The personal and national costs of early retirement because of spinal disorders: impacts on income, taxes, and government support payments. Spine J 2012; 12: 1111-1118.
  • 12. Schofield DJ, Shrestha RN, Percival R, et al. The personal and national costs of lost labour force participation due to arthritis: an economic study. BMC Public Health 2013; 13: 1-10.
  • 13. Schofield DJ, Shrestha RN, Percival R, et al. Quantifying the effect of early retirement on the wealth of individuals with depression or other mental illness. Br J Psychiatry 2011; 198: 123-128.
  • 14. Schofield DJ, Cunich M, Shrestha RN, et al. The impact of diabetes on the labour force participation and income poverty of workers aged 45–64 years in Australia. PLOS One 2014; 9: e89360.
  • 15. Schofield D, Shrestha R, Percival R, et al. The personal and national costs of CVD: impacts on income, taxes, government support payments and GDP due to lost labour force participation. Int J Cardiol 2013; 166: 68-71.
  • 16. Schofield D, Shrestha R, Kelly S, et al. A microsimulation model of the long term economic impacts of disease on the labour force participation of Australians aged 45–64 years: what are the costs to individuals and government and the opportunities for effective interventions? Int J Microsim 2014; 7: 94-118.
  • 17. Australian Bureau of Statistics. Information paper. Basic confidentialised unit record file: survey of disability, ageing and carers 2003 (reissue). (ABS Cat. No. Catalogue no. 4430.0.00.001.) Canberra: ABS, 2004. http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/0/0B656F42F01EC683CA25704500769F3C/$File/4430000001_2003%20%28reissue%29.pdf (accessed Jul 2015).
  • 18. Australian Bureau of Statistics. Disability, ageing and carers, Australia: summary of findings. 2009. Canberra: ABS, 2012. (ABS Cat. No. 4430.0.) http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/0/9C2B94626F0FAC62CA2577FA0011C431/$File/44300_2009.pdf (accessed Jul 2015).
  • 19. Keegan M, Kelly S. APPSIM — Dynamic microsimulation modelling of social security and taxation. Canberra: National Centre for Social and Economic Modelling, University of Canberra, 2009. http://pandora.nla.gov.au/pan/70542/20100331-0000/www.canberra.edu.au/No.14.pdf (accessed Jul 2015).
  • 20. Begg SJ, Vos T, Barker B, et al. Burden of disease and injury in Australia in the new millennium: measuring health loss from diseases, injuries and risk factors. Med J Aust 2008; 188: 36-40. <MJA full text>
  • 21. Costello P, The Treasury. Intergenerational report 2007. Canberra: Commonwealth of Australia, 2007. http://archive.treasury.gov.au/igr/igr2007/report/PDF/IGR_2007_final_report.pdf (accessed Jul 2015).
  • 22. Kelly SJ, Percival R, Schofield DJ, et al. The impact of illness on retirement finances. Econ Rec 2012; 88: 576-584.
  • 23. Schofield DJ, Callander EJ, Shrestha RN, et al. Premature retirement due to ill health and poverty: a cross-sectional study of older workers. BMJ Open 2013; 3: e002683.
  • 24. Wannamethee G, Shaper AG. Self-assessment of health status and mortality in middle-aged British men. Int J Epidemiol 1991; 20: 239-245.
  • 25. Swan W. Budget speech 2011-12. Canberra: Australian Government, 2011. http://www.budget.gov.au/2011-12/content/speech/html/speech.htm (accessed Jul 2015).

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

access_time 12:10, 30 September 2015
Sharna Goulding

Climate change and diabetes? The killer of lost productive life years

The World Health Organisation stated the direct and indirect effects of climate change will impose on the health status of the globe (1). Lost productive life years caused by chronic conditions in Australia aged 45-64 years, 2010-2030 estimates 112 000 lost productive life years is caused by chronic illnesses in this age bracket (2). However climate changes influence could exacerbate this estimate, costing the Australian government over 63.73 billion in lost labour force. Diabetes is a disease that is growing immensely with it predicted to rise to half a billion by 2030 which will impoverish families, account for a majority of the lost productive years and overwhelm health services (3). People with diabetes are more susceptible to heat and high humidity with studies showing more hospital admissions, illness and higher rates of mortality in extreme weather events (4). In Australia heatwaves have caused more deaths in the past 100 years than any other natural disaster and are becoming more intense, longer and are occurring more frequently. The number of hot days has doubled in the last 50 years as a consequence of climate change, which has caused more mortality and morbidity in people with diabetes (4,5).
Climate change and diabetes share the same pathways of rapid urbanisation, aging population and the global food system (3). Climate change and diabetes are the outcome of resource overconsumption and as one continues to increase so will the other, which will have a great economic burden from the loss of productive life years.

1. Kjellstrom T. Climate change exposures, chronic diseases and mental health in urban populations – a threat to health security, particularly for the poor and disadvantaged. Technical report. Kobe: World Health Organisation Kobe Centre. 2009.

2. Schofield DJ, Shrestha RN, Cunich M, Tanton R, Kelly S, Passey ME, et al. Lost productive life years caused by chronic conditions in Australians aged 45-64 years, 2010-2030. Med J Aust. 2015;203(6):260.

3. Dain K, Hadley L. Diabetes and climate change--two interconnected global challenges. Diabetes Res Clin Pract. 2012;97(2):337-9

4.Hansen AL, Bi P, Ryan P, Nitschke M, Pisaniello D, Tucker G. The effect of heat waves on hospital admissions for renal disease in a temperate city of Australia. Int J Epidemiol. 2008;37(6):1359-65.

5. Hughes L, Steffen W. Heatwaves: Hotter, Longer, More Often [Internet]. Climate Council of Australia [cited 2015 Sep 17]. Available from:
http://www.climatecouncil.org.au/uploads/9901f6614a2cac7b2b888f55b4dff9cc.pdf

Competing Interests: No relevant disclosures

Miss Sharna Goulding
Monash University

Responses are now closed for this article.