Academic Unit of Health Economics, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, UK; Centre for Longitudinal Studies, University College London, UK.
Academic Unit of Health Economics, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, UK.
Soc Sci Med. 2023 Mar;321:115606. doi: 10.1016/j.socscimed.2022.115606. Epub 2023 Jan 30.
One in ten working age people in the UK live with arthritis or a similar condition affecting their joints. This impacts their quality of life, including through their work. But little is known about how arthritis affects labour market outcomes and the types of people most likely to be affected.
Data from three population-representative household panel surveys (BHPS, ELSA, UKHLS) collected in 2001-2019 was harmonised. Propensity score matching was used to match 18,014 UK adults aged 18-80 who have arthritis with comparable adults without arthritis. The relationship between arthritis and employment, and earnings and work hours conditional on employment, were assessed using multilevel regression modelling. Heterogeneity in these relationships were assessed by age, gender, degree-level education status, NS-SEC job classification and employer type.
On average, arthritis was associated with a 3 percentage point reduction in the probability of employment. The effect size varied over people's life course and was larger amongst females, people without a degree, and those in routine or intermediate occupations (when compared to those in professional occupations) or working for small private companies (when compared to large private companies and non-private employers). Our models predict, for instance, that arthritis is associated with an 11 percentage point reduction in the probability of employment among 50-year-old women without a degree. This contrasts with a 5 percentage point reduction among 50-year-old men without a degree. If employed, men with a degree earned less if they had arthritis, whereas others (including women with a degree and men without a degree) had similar earnings regardless of their arthritis status. Those in professional occupations with arthritis also earnt less, especially if they were women aged over 40, with indications that this was driven by reduced work hours.
Policy interventions to support people with arthritis who wish to remain in work might be designed with people in routine work in mind, and targeted at those working in smaller private firms. More research on the cost-effectiveness of those interventions is needed.
在英国，十分之一的工作年龄段人群患有关节炎或类似的关节疾病。这会影响他们的生活质量，包括工作。但是，人们对关节炎如何影响劳动力市场结果以及最有可能受影响的人群类型知之甚少。
对 2001 年至 2019 年期间收集的三项具有代表性的家庭面板调查（BHPS、ELSA、UKHLS）的数据进行了协调。使用倾向评分匹配将 18014 名年龄在 18 至 80 岁之间患有关节炎的英国成年人与没有关节炎的可比成年人进行匹配。使用多层次回归模型评估关节炎与就业以及就业条件下的收入和工作时间之间的关系。通过年龄、性别、学位教育程度、NS-SEC 工作分类和雇主类型评估这些关系的异质性。
平均而言，关节炎导致就业概率降低 3 个百分点。效应大小因人们的生命周期而异，在女性、没有学位的人以及常规或中级职业（与专业职业相比）或为小型私营公司工作的人（与大型私营公司和非私营雇主相比）中更大。例如，我们的模型预测，在没有学位的 50 岁女性中，关节炎与就业概率降低 11 个百分点有关。相比之下，没有学位的 50 岁男性则降低 5 个百分点。如果有工作，有学位的男性如果患有关节炎，收入就会减少，而其他人（包括有学位的女性和没有学位的男性）无论关节炎状况如何，收入都相同。患有关节炎的专业人士的收入也较低，尤其是年龄在 40 岁以上的女性，有迹象表明这是由于工作时间减少所致。
为希望继续工作的关节炎患者提供支持的政策干预措施可能会针对常规工作人群，并针对在较小的私营公司工作的人群。需要对这些干预措施的成本效益进行更多研究。
