Cardiovascular disease subtypes, physical disability and workforce participation: A cross-sectional study of 163,562 middle-aged Australians

Abstract

Background Workforce participation is reduced among people with cardiovascular disease (CVD). However, detailed quantitative evidence on this is limited. We examined the relationship of CVD to workforce participation in older working-age people, by CVD subtype, within population subgroups and considering the role of physical disability. Methods Questionnaire data (2006–2009) for participants aged 45–64 years (n = 163,562) from the population-based 45 and Up Study (n = 267,153) were linked to hospitalisation data through the Centre for Health Record Linkage. Prior CVD was from self-report or hospitalisation. Modified Poisson regression estimated adjusted prevalence ratios (PRs) for non-participation in the workforce in people with versus without CVD, adjusting for sociodemographic factors. Results There were 19,161 participants with CVD and 144,401 without. Compared to people without CVD, workforce non-participation was greater for those with CVD (40.0% vs 23.5%, PR = 1.36, 95%CI = 1.33–1.39). The outcome varied by CVD subtype: myocardial infarction (PR = 1.46, 95%CI = 1.36–1.55); cerebrovascular disease (PR = 1.92, 95%CI = 1.80–2.06); heart failure (PR = 1.83, 95%CI = 1.68–1.98) and peripheral vascular disease (PR = 1.76, 95%CI = 1.65–1.88). Workforce non-participation in those with CVD versus those without was at least 21% higher in all population subgroups examined, with PRs ranging from 1.75 (95%CI = 1.65–1.85) in people aged 50–55 years to 1.21 (95%CI = 1.19–1.24) among those aged 60–64. Compared to people with neither CVD nor physical functioning limitations, those with physical functional limitations were around three times as likely to be out of the workforce regardless of CVD diagnosis; participants with CVD but without physical functional limitations were 13% more likely to be out of the workforce (PR = 1.13, 95%CI = 1.07–1.20). Conclusions While many people with CVD participate in the workforce, participation is substantially lower, especially for people with cerebrovascular disease, than for people without CVD, highlighting priority areas for research and support, particularly for people experiencing physical functioning limitations.

Loneliness and physical function impairment: Perceived health status as an effect modifier in community-dwelling older adults in Ghana

“…These psychiatric and borderline personality syndromes can impel severe functional impairment ( Hengartner et al, 2014 , Juurlink et al, 2018 ). Second, loneliness may worsen the underlying health conditions and vulnerabilities via health deteriorating lifestyles or cardiometabolic endpoints which are known risk factors of PFI ( Bin Sayeed et al, 2021 ). Third, previous studies suggest that lonely people perceive social relationship deficits and are less likely to engage and participate socially ( Tam-Seto et al, 2016 ).…”

Midlife cardiovascular health factors as predictors of retirement age, work-loss years, and years spent in retirement among older businessmen

“…Cardiovascular disease (CVD) is a leading cause of disability pension and premature exit from the workforce, significantly affecting work ability and labour force participation 2 , 5 . Despite its impact, limited research has focused on studying CVD risk factors or composite CVD risk estimates in populations without pre-existing CVD.…”

“…The sample was subject to selective survival and loss to follow-up, leaving out participants who had poorer general and CVD health in midlife, thus potentially undermining our results regarding retirement age and survival in retirement. Given that CVD is one of the leading causes of premature exit from the workforce 2 , 5 , we believe that participants at high risk of CVD but who did not survive to retirement age may have also been more likely to retire early due to CVD-related health problems. The study population consisted of Caucasian men from higher socioeconomic groups 10 , which provides internal validity but significantly limits generalizability to other socioeconomic groups, women, or individuals with different retirement policies.…”

“…Cardiovascular disease (CVD), a leading cause of premature mortality worldwide 1 , is associated with poorer workforce participation 2 among older employees by increasing the risk of transitioning into disability pension 3 , 4 and exiting the labour force early 5 . It bears high costs to societies, amounting to a quarter of health-related productivity losses in the European Union, with estimates of 54 billion in the year 2019 6 .…”

Projecting the incidence and costs of major cardiovascular and kidney complications of type 2 diabetes with widespread SGLT2i and GLP-1 RA use: a cost-effectiveness analysis

“…The effect of diabetes on workforce participation was drawn from a study of Australian National Health Surveys [ 35 ]. For CVD health states, workforce non-participation was calculated by multiplying the workforce non-participation rate by the prevalence ratio of non-participation from a large Australian cross-sectional study (1.46 for MI, 1.92 for stroke and 1.83 for HF [ 36 ]). We assumed that 50% of people of working age with ESKD were employed [ 37 , 38 ].…”