Work-loss years among people diagnosed with diabetes: a reappraisal from a life course perspective

Mikaela B Von Bonsdorff,Minna Salonen,Monika E Von Bonsdorff,Tuija M Mikkola,Hannu Kautiainen,Maija Haanpää,Johan G Eriksson

doi:10.1007/s00592-018-1119-x

Abstract

AimsEarly exit from the workforce has been proposed to be one of the unfavorable consequences of diabetes. We examined whether early exit from the workforce differed between persons who were and were not diagnosed with diabetes during their work career.MethodsThe cohort included 12,726 individuals of the Helsinki Birth Cohort Study, born between 1934 and 1944. Using data from nationwide registers, the cohort was followed up from early adulthood until they transitioned into retirement or died. Work-loss years were estimated using the restricted mean work years method.ResultsDuring a follow-up of 382,328 person-years for men and 349 894 for women, 36.8% transitioned into old age pension and 63.2% exited workforce early. Among men, 40.5% of those with and 32.8% of those without diabetes transitioned into old age pension (p=0.003). The corresponding numbers for women were 48.6% and 40.4% (p = 0.013), respectively. Mean age at exit from the workforce was 60.1 (95% confidence interval [CI], 59.6 to 60.7) years among men with diabetes and 57.6 (95% CI, 57.2 to 58.0) years among men without diabetes (p = 0.016). Among women, corresponding ages were 61.4 (95% CI, 60.8 to 61.9) years for those with diabetes and 59.5 (95% CI, 59.3 to 59.7) years for those without diabetes (p < 0.001). The difference in mean restricted work-loss years according to diabetes was 2.5 (95% CI 0.5 to 4.6) for men and 1.9 (95% CI 1.0 to 2.8) for women.ConclusionAmong individuals followed up throughout their work career, those with a diabetes diagnosis exited the workforce approximately two years later compared to those without diabetes.

Highlights

Governments’ long-term economic projections for public expenditure on pensions are strongly reliant on effective retirement ages and the assumption that people will exit the workforce at an older age in the future [1]
The rest (63.2%) retired early or died prematurely—28.8% transitioned into disability pension, 14.0% into unemployment pension, 12.8% into part-time pension and 7.6% had died before transitioning into any form of retirement
The difference in the mean restricted work years according to diabetes status was 2.5 for men and 1.9 for women in favor of those who had a record of diabetes during their work career

Summary

Introduction

Governments’ long-term economic projections for public expenditure on pensions are strongly reliant on effective retirement ages and the assumption that people will exit the workforce at an older age in the future [1]. The employment rates of people aged 55–64 years have been rising during recent decades in the USA [2] and in the OECD countries, in the latter ones from 52 to 57% on average [3]. This is partly due to pension reforms in several countries. For example in Finland, in the year 2011 almost one-third of the working aged people had transitioned into disability pension already at an average age of 52 years [4].

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Conclusion