Probability of Employment Lower in Patients With Arthritis

Patients with arthritis who wish to remain employed in routine work may benefit from policy interventions, specifically ones targeted at those working in smaller, private firms, according to a study published in Social Science and Medicine.¹ Future studies should focus on the cost-effectiveness of these interventions.

“There are various types of arthritis, and some are more common in particular age groups,” investigators emphasized. “But all forms of arthritis can make life difficult for people because of the pain, swelling, or stiffness in a joint or joints, and because of difficulties in getting about. This can affect people’s ability to do their job, to find work they enjoy, to pursue their preferred career paths and to achieve their ambitions.”

The effects of labor market outcomes and the types of affected people were analyzed in the study. Data from 3 population-representative household panel surveys (British Household Panel Survey [BHPS], English Longitudinal Study of Ageing [ELSA], and the UK Household Longitudinal Study [UKHLS]) were collected between 2001 and 2019. Propensity score matched 18,014 adult adults with arthritis, aged 18 to 80, living in the United Kingdom (UK) with a control cohort without arthritis. Multilevel regression modeling was used to examine the relationship between arthritis and employment, and earnings and work hours conditional on employment. Heterogeneity was determined by age, education, gender, employer type, and NS-SEC job classification.

A 3-percentage point reduction in employment probability was observed in patients with arthritis. The size of the effect varied over the life course of the patients, with the largest amount reported in female patients, those without a degree, and those in routine or intermediate occupations when compared with those in professional occupations, or working for small, private companies, as opposed to large, private companies and non-private employers.

Arthritis diagnosis was associated with an 11-percentage point reduction in the probability of employment for female participants aged 50 years without a degree. However, men in the same age group without a degree only reported a 5-percentage point reduction. Employed men with arthritis earned less than those without arthritis, although others, including women with a degree and men without a degree, reported similar earnings regardless of arthritis status. Patients in professional occupations with an arthritis diagnosis also earned less, particularly for females over the age of 40, with further indications that earnings were driven by reduced work hours.

The study was strengthened by the large sample size, allowing investigators to analyze individual-level heterogeneity. The long follow-up period also enabled investigators to compare to previous investigators, thus mitigating the risk of recall bias. However, arthritis was self-reported and may include other musculoskeletal conditions that could be inaccurately deemed as arthritis. Further, the datasets utilized did not allow for investigators to evaluate the severity or type of arthritis, which may have impacted the results of arthritis on labor market outcomes.

“Our study has provided evidence that arthritis has an effect on labour market outcomes, with the condition leading to a lower probability of being employed, and lower earnings for those who are employed,” investigators concluded. “We have also shown that different groups are affected more than others.”

Reference:

Rajah, N., et al. (2023) How does arthritis affect employment? Longitudinal evidence on 18,000 British adults with arthritis compared to matched controls. Social Science & Medicine Part C Medical Economics. doi.org/10.1016/j.socscimed.2022.115606.