Negative employment consequences of arthritis are known but not fully understood. Examining transitions in and out of work can provide valuable information.
OBJECTIVE:
To examine associations of arthritis with employment during the Great Recession and predictors of employment transitions.
METHODS:
Data were for 3,277 adults ages 30–62 years with and without arthritis from the 2007 National Health Interview Survey followed in the Medical Expenditure Panel Survey 2008-2009. Employment (working vs. not working) was ascertained at baseline and five follow-ups. We estimated Kaplan Meier survival curves with 95% confidence intervals (CI) separately for time to stopping work (working at baseline) and starting work (not working at baseline) using Cox proportional hazards regression models with hazard ratios (HR).
RESULTS:
Arthritis was significantly associated with greater risk of stopping work (HR = 1.7, 95% CI = 1.3–2.2; adjusted HR= 1.5, 95% CI = 1.1–2.0) and significantly associated with 40% lower chance of starting work (HR = 0.6, 95% CI = 0.4–0.8), which reversed on adjustment (HR = 1.5, 95% CI = 1.0–2.2). Employment predictors were mixed by outcome.
CONCLUSIONS:
During the Great Recession, adults with arthritis stopped work at higher rates and started work at lower rates than those without arthritis.
Bureau of Labor Statistics. BLS Spotlight on Statistics: The Recession of 2007-2009. Bureau of Labor Statistics, 2012.
2.
GoodmanCJ. ManceSM. Employment loss and the 2007-09 recession: An overview. Monthly Labor Review.2011:1-12.
3.
KayeHS. The Impact of the 2007-2009 Recession on Workers with Disabilities.Bureau of Labor Statistics, 2010.
4.
TheisKA,
MossS. Employment participation and work disability by arthritis status: Repeated cross-sectional studies, 2002-2013, National Health Interview Survey. In Review.
5.
AllaireSJ, AlHereshR, KeysorJJ.Effect of arthritis and other rheumatic conditions on employment. Work.2013:45:417-20.
6.
AllaireS, WolfeF, NiuJ, LaValleyM, MichaudK.Work disability and its economic effect on 55-64 year-old adults with rheumatoid arthritis. Arthritis and Rheumatism.2005;53(4):603-8.
7.
MancusoCA, PagetSA, CharlsonME.Adaptations made by rheumatoid arthritis patients tocontinue working: A pilot study of workplace challenges and successful adaptations. Arthritis Care Res.2000;13:89-99.
8.
RobinsonHS, WaltersK.Patterns of work–rheumatoid arthritis. International Journal of Rehabilitation Medicine.1979;1:121-5.
9.
YelinEH, HenkeCJ, EpsteinWV.Work disability among persons with musculoskeletal conditions. Arthritis and Rheumatism.1986:29:1322-33.
10.
YelinE, TonnerC, TrupinL, PanopalisP, YazdanyJ, JulianL, et al. Work loss and work entry among persons with systemic lupus erythematosus: Comparisons with a national matched sample. Arthritis and Rheumatism.2009:61(2):247-58.
11.
YelinE.Work disabilty in rheumatic diseases. Curr Opin Rheumatol.2007:19:91-6.
12.
WilkieR, PhillipsonC, HayE, PranskyG.Frequency and predictors of premature work loss in primary care consulters for osteoarthritis: Prospective cohort-study. Rheumatology.2014;53:459-64.
13.
TheisKA, WilkieR, BusijaL, ElsworthG, OsborneR.What do we really know about arthritis impact on employment from prospective studies?Arthritis and Rheumatism.2010;62:S869.
14.
TheisKA, MurphyL, HootmanJM, HelmickCG, YelinE.Prevalence and correlates of arthritis-attributable work limitation in the U.S. population among persons ages 18-64:2002 National Health Interview Survey Data. Arthritis Rheum.2007;57(3):355-63.
15.
Agency for Healthcare Research and Quality. MEPS HC-130: Panel 13 Longitudinal Data File.Rockville, MD: AHRQ. 2011.
16.
National Center for Health Statistics. Data file documentation. National Health Interview Survey. 2009 (machine readable data file and documentation). Hyattsville (MD): National Center for Health Statistics, Centers for Disease Control and Prevention, 2009.
Agency for Healthcare Research and Quality. Respondent Payment Experiment with MEPS Panel 13. U.S. Depart- ment of Health & Human Services, 2010 October 6. 2010 Accessed May 4. 2017. Report No.
19.
KesslerRC, AndrewsG, ColpeLJ, HiripiE, MroczekDK, NormandSL, et al. Short Screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med.2002;32(6):959-76.
20.
TheisKA, MurphyL, HootmanJM, WilkieR.Social participation restriction among U.S. adults with arthritis: A population-based study usnig the International Classification of Functioning, Disabilty, and Health (ICF). Arthritis Care Res.2013:65(7).
21.
SAS Institute Inc. SAS/STAT® 9.3 User's Guide.Cary, NC: SAS Institute Inc.; 2011.
22.
CohenSB.An estimation methodology to permit longitudinal cohort analyses based on the National Health Interview Survery and Medical Expenditure Panel Survey. Agency for Healthcare Research and Quality, October 2010.
23.
SchenkerN, GentlemanJ.On Judging the significance of differences by examing the overlap between confidence intervals. The American Statistician.2001:55(3): 182-6.
24.
Institute RT. SUDAAN Language Manual, Volumes 1 and 2. Release 11. Research Triangle Park, NC: Research Triangle Institute; 2012.
25.
BerglundPA.An overview of survival analysis using complex sample data.Ann Arbor, MI: Institute for Social Research. 2011.
26.
De RoosAJ, CallahanL.Differences by sex in correlates of work status in rheumatoid arthritis patients. Arthritis Care Res.1999; 12(6):381-91.
27.
KapteinSA, GignacMAM, BadleyE.Differences in the workforce experiences of women and men with arthritis disability: A population health perspective. Arthritis Care Res.2009;61(5):605-13.
28.
YelinEH.Musculoskeletal conditions and employment. Arthritis Care Res.1995;8(4):311-7.
29.
HollandP, NylénL, ThielenK, van der WeiKA, ChenW, BarrB, et al.. How do macro-level contexts and policies affect the employment chances of chronically ill and disabled people? Part II: The impact of active and passive labor market policies. International Journal of Health Services.2011;41 (3):415-30.
30.
HollandP, BurströmB, WhiteheadM, DiderichsenF, DahlE, BarrB, et al.. How to macro-level contexts and poli- cies affect the employment changes of chronically ill and disabled people? Part I: The impact of recession and deindustrialization. International Journal of Health Services.2011;41(3):395-413.
31.
SigursteinsdottirH, RafnsdottirGL, JonsdottirGA.Changes in occupational mental and physical health symptoms during the economic recession. Work.2017;56:603-15.
32.
Job Accommodation Network. Workplace accommodations: Low cost, High impact.Morgantown, WV: U.S. Department of Labor’s Office of Disability Employment Policy, 2013.
33.
SundarV.Operationlizing workplace accommodations for individuals with disabilities. Work.2017;56:135-55.
34.
SiggeirsdottirK, BrynjolfsdottirRD, HaraldssonSO, VidarS, GudmundssonEG, BrynjolfssonJH, et al.. Determinants of outcome of vocational rehabilitation. Work.2016;55:577-83.
35.
GewurtzRE, LanganS, ShandD.Hiring people with disabilities: A scoping review. Work.2016;54:135-8.
36.
KayeHS, JansLH, JonesEC.Why Don’t Employers Hire and Retain Workers with Disabilities? J Occup Rehabil.2011;21:526-36.
37.
Bureau of Labor Statistics. Women in the Labor Force: A Databook.Wasington, D.C.: U.S. Bureau of Labor Statistics, 2014May 2014. Report No.
38.
BarbourKE, HelmickCG, BoringM, BradyTJ.Vital Signs: Prevalence of Doctor-Diagnosed Arthritis and Arthritis- Attributable Activity Limitation–United States, 2013-2015.MMWR. 2017;66:246-53.
39.
CrimminsEM, KimJK, Sole-AuroA.Gender differences in health: Results from SHARE, ELSA, and HRS. Eur J Public Health.2010;21(1):81-91.
SacksJ, HaroldL, HelmickCG, GurwitzJ, EmaniS, YoodR.Validation of a surveillance case definition for arthritis. J Rheumatol.2005;32:340-7.
42.
SaundersSL, NedelecB.What work means to people with work disability: A scoping review. J Occup Rehabil.2014;24:100-10.
43.
GrønningK, RødevandE, SteinsbekkA.Paid work is associated with improved health-related quality of life in patients with rheumatoid arthritis. Clin Rheumatol.2010;29(1317-1322).
44.
GullifordJ, ShannonD, TaskilaT, WilkinsD, TodM, BevanS.Sick of being unemployed: The health issues of out out of work men and how support services are failing to address them.Lancaster, England: The Work Foundation Part of Lancaster University, 2014Contract No.: ISBN: 978-1-906121-15-0.
