In:
PLOS Medicine, Public Library of Science (PLoS), Vol. 18, No. 11 ( 2021-11-30), p. e1003848-
Abstract:
Reducing disease can maintain personal individual income and improve societal economic productivity. However, estimates of income loss for multiple diseases simultaneously with thorough adjustment for confounding are lacking, to our knowledge. We estimate individual-level income loss for 40 conditions simultaneously by phase of diagnosis, and the total income loss at the population level (a function of how common the disease is and the individual-level income loss if one has the disease). Methods and findings We used linked health tax data for New Zealand as a high-income country case study, from 2006 to 2007 to 2015 to 2016 for 25- to 64-year-olds (22.5 million person-years). Fixed effects regression was used to estimate within-individual income loss by disease, and cause-deletion methods to estimate economic productivity loss at the population level. Income loss in the year of diagnosis was highest for dementia for both men (US$8,882; 95% CI $6,709 to $11,056) and women ($7,103; $5,499 to $8,707). Mental illness also had high income losses in the year of diagnosis (average of about $5,300 per year for males and $4,100 per year for females, for 4 subcategories of: depression and anxiety; alcohol related; schizophrenia; and other). Similar patterns were evident for prevalent years of diagnosis. For the last year of life, cancers tended to have the highest income losses, (e.g., colorectal cancer males: $17,786, 95% CI $15,555 to $20,018; females: $14,192, $12,357 to $16,026). The combined annual income loss from all diseases among 25- to 64-year-olds was US$2.72 billion or 4.3% of total income. Diseases contributing more than 4% of total disease-related income loss were mental illness (30.0%), cardiovascular disease (15.6%), musculoskeletal (13.7%), endocrine (8.9%), gastrointestinal (7.4%), neurological (6.5%), and cancer (4.5%). The limitations of this study include residual biases that may overestimate the effect of disease on income loss, such as unmeasured time-varying confounding (e.g., divorce leading to both depression and income loss) and reverse causation (e.g., income loss leading to depression). Conversely, there may also be offsetting underestimation biases, such as income loss in the prodromal phase before diagnosis that is misclassified to “healthy” person time. Conclusions In this longitudinal study, we found that income loss varies considerably by disease. Nevertheless, mental illness, cardiovascular, and musculoskeletal diseases stand out as likely major causes of economic productivity loss, suggesting that they should be prioritised in prevention programmes.
Type of Medium:
Online Resource
ISSN:
1549-1676
DOI:
10.1371/journal.pmed.1003848
DOI:
10.1371/journal.pmed.1003848.g001
DOI:
10.1371/journal.pmed.1003848.g002
DOI:
10.1371/journal.pmed.1003848.g003
DOI:
10.1371/journal.pmed.1003848.t001
DOI:
10.1371/journal.pmed.1003848.t002
DOI:
10.1371/journal.pmed.1003848.s001
DOI:
10.1371/journal.pmed.1003848.s002
DOI:
10.1371/journal.pmed.1003848.s003
DOI:
10.1371/journal.pmed.1003848.s004
DOI:
10.1371/journal.pmed.1003848.s005
DOI:
10.1371/journal.pmed.1003848.s006
DOI:
10.1371/journal.pmed.1003848.s007
DOI:
10.1371/journal.pmed.1003848.s008
DOI:
10.1371/journal.pmed.1003848.s009
DOI:
10.1371/journal.pmed.1003848.s010
DOI:
10.1371/journal.pmed.1003848.s011
DOI:
10.1371/journal.pmed.1003848.s012
DOI:
10.1371/journal.pmed.1003848.s013
DOI:
10.1371/journal.pmed.1003848.s014
DOI:
10.1371/journal.pmed.1003848.s015
DOI:
10.1371/journal.pmed.1003848.r001
DOI:
10.1371/journal.pmed.1003848.r002
DOI:
10.1371/journal.pmed.1003848.r003
DOI:
10.1371/journal.pmed.1003848.r004
DOI:
10.1371/journal.pmed.1003848.r005
DOI:
10.1371/journal.pmed.1003848.r006
DOI:
10.1371/journal.pmed.1003848.r007
DOI:
10.1371/journal.pmed.1003848.r008
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2164823-2
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