The importance of illness duration, age at diagnosis and the year of diagnosis for labour participation chances of people with chronic illness: results of a nationwide panel-study in the Netherlands

Abstract

BackgroundCompared to participation rates among general populations, participation of people with chronic illness in the labour market lags behind. This is undesirable, both from the perspective of individuals’ well-being as from a macro-economic perspective for western countries where concerns exist about labour supply and sustainability of social security in the near future. To help develop successful policy measures to prevent early drop-out and support reintegration, we aimed to gain insight into the role of three age related characteristics that may relate to labour participation chances of people with chronic illness: the duration of their illness, how old they were when the chronic disease was diagnosed and the historical year in which the diagnosis was established.MethodsWe analyzed data of one (first) measurement of several cohorts of people diagnosed with a somatic chronic disease, who (had) participated in the Dutch ‘National Panel of people with Chronic illness or Disability’ since 1998 (N = 4634 in total). Multi-level logistic regression analyses were conducted to estimate random effects of the age at diagnosis and the year of diagnosis and fixed effects of illness duration on labour participation, while correcting for the effects of socio-demographic and disease characteristics and socio-economic indicators.ResultsA significant part of the variation in labour participation among people with chronic illness relates to the age they had when they were diagnosed. Furthermore, a longer illness duration is significantly associated with a lower chance of being economically active. This is more the case for men than for women. Labour participation of cancer survivors depends on the phase of the illness they find themselves in. No evidence was found that the year in which the diagnosis was established matters for employment chances later in life.ConclusionAge at diagnosis and illness duration relate to chronically ill people’s chances to participate in the labour market, but how and how strong they relate to labour participation depend on gender and the type of chronic disease at stake. Prospective studies are needed to assess illness trajectories of specific diagnostic groups along with the development of their school and work careers.

Increase in Unemployment over the 2000’s: Comparison between People Living with HIV and the French General Population

“…This higher gap is in line with previous studies showing that the postdiagnosis years are critical in terms of the person’s employment situation[14,21,30]. Contrary to people with other chronic diseases, where a longer duration of illness is associated with a higher risk of work exits[41], HIV-individuals are at higher risk for being unemployed at the beginning of their illness, even though physical limitations due to HIV infection are likely to still be limited, with the exception of individuals who have already reached an advanced stage of HIV disease at the time of diagnosis.…”

Developments in patient activation of people with chronic illness and the impact of changes in self-reported health: results of a nationwide longitudinal study in The Netherlands

“…For the purpose of this study, we used data from people diagnosed with one (or more) chronic disease(s) who were participating in the National Panel of people with Chronic illness or Disability (NPCD), a nationwide prospective panel-study in The Netherlands [16,17]. NPCD was set up in 2005 to provide information about the experiences and consequences of living with chronic illness or disability from the patient's perspective.…”

Cancer survivors' activation to self‐management and its relationship with participation in paid work and work‐related problems

“…Studies have shown that many cancer survivors do return to work . However, the labour participation rate (ie, the proportion of the working‐age population actually participating in the labour market) is lower among cancer survivors than among the general population, and compared with healthy controls, they are more likely to be unemployed . Cancer survivors who are employed usually work less hours than they did before their diagnosis .…”