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Published on: April 19, 2019
Cardiovascular disease subtypes, physical disability and workforce participation: A cross-sectional study of 163,562
Muhammad Shahdaat Bin Sayeed1, Grace Joshy1, Ellie Paige1
1National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.
Insights
Cardiovascular disease (CVD) significantly reduces workforce participation, especially for those with cerebrovascular disease. Physical functioning limitations further exacerbate this issue, highlighting needs for targeted support.
Area of Science:
- Public Health
- Epidemiology
- Health Economics
Background:
- Workforce participation is notably lower among individuals with cardiovascular disease (CVD).
- Quantitative evidence on the extent of this reduction, particularly by CVD subtype and across different demographics, is limited.
- Understanding these disparities is crucial for developing targeted interventions and support systems.
Purpose of the Study:
- To quantitatively assess the relationship between cardiovascular disease (CVD) and workforce participation in older working-age adults.
- To examine variations in workforce participation based on CVD subtype, population subgroups, and the presence of physical disability.
- To provide evidence for identifying priority areas for research and support.
Main Methods:
- Utilized questionnaire data from the population-based 45 and Up Study (n=163,562) linked to hospitalization records.
- Analyzed participants aged 45-64 years, identifying prior CVD through self-report or hospitalization records.
- Employed modified Poisson regression to estimate adjusted prevalence ratios (PRs) for workforce non-participation in individuals with and without CVD.
Main Results:
- Individuals with CVD had significantly higher workforce non-participation rates (40.0%) compared to those without CVD (23.5%, PR=1.36).
- Workforce non-participation varied by CVD subtype, with cerebrovascular disease showing the highest PR (1.92).
- Physical functional limitations were a stronger predictor of non-participation (PR≈3) than CVD alone, though CVD without limitations still increased non-participation (PR=1.13).
Conclusions:
- Workforce participation is substantially lower for individuals with CVD compared to the general population.
- Cerebrovascular disease, heart failure, and peripheral vascular disease are associated with particularly high rates of workforce non-participation.
- Addressing physical functioning limitations is critical for supporting workforce participation among individuals with CVD.
Background:
Workforce participation is reduced among people with cardiovascular disease (CVD). However, detailed quantitative evidence on this is limited. We examined the relationship of CVD to workforce participation in older working-age people, by CVD subtype, within population subgroups and considering the role of physical disability.
Methods:
Questionnaire data (2006-2009) for participants aged 45-64 years (n = 163,562) from the population-based 45 and Up Study (n = 267,153) were linked to hospitalisation data through the Centre for Health Record Linkage. Prior CVD was from self-report or hospitalisation. Modified Poisson regression estimated adjusted prevalence ratios (PRs) for non-participation in the workforce in people with versus without CVD, adjusting for sociodemographic factors.
Results:
There were 19,161 participants with CVD and 144,401 without. Compared to people without CVD, workforce non-participation was greater for those with CVD (40.0% vs 23.5%, PR = 1.36, 95%CI = 1.33-1.39). The outcome varied by CVD subtype: myocardial infarction (PR = 1.46, 95%CI = 1.36-1.55); cerebrovascular disease (PR = 1.92, 95%CI = 1.80-2.06); heart failure (PR = 1.83, 95%CI = 1.68-1.98) and peripheral vascular disease (PR = 1.76, 95%CI = 1.65-1.88). Workforce non-participation in those with CVD versus those without was at least 21% higher in all population subgroups examined, with PRs ranging from 1.75 (95%CI = 1.65-1.85) in people aged 50-55 years to 1.21 (95%CI = 1.19-1.24) among those aged 60-64. Compared to people with neither CVD nor physical functioning limitations, those with physical functional limitations were around three times as likely to be out of the workforce regardless of CVD diagnosis; participants with CVD but without physical functional limitations were 13% more likely to be out of the workforce (PR = 1.13, 95%CI = 1.07-1.20).
Conclusions:
While many people with CVD participate in the workforce, participation is substantially lower, especially for people with cerebrovascular disease, than for people without CVD, highlighting priority areas for research and support, particularly for people experiencing physical functioning limitations.
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