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Earnings during adulthood in patients with childhood-onset inflammatory bowel disease: a nationwide population-based
Petter Malmborg1,2,3, Åsa H Everhov2,3, Jonas Söderling3
1Sachs' Children and Youth Hospital, Stockholm, Sweden.
Insights
Childhood-onset inflammatory bowel disease (IBD) is linked to modest reductions in early adult earnings. Severe childhood IBD, including surgery or hospitalization, significantly impacts later income.
Area of Science:
- Pediatric Gastroenterology
- Health Economics
- Longitudinal Cohort Studies
Background:
- Childhood-onset inflammatory bowel disease (IBD) presents a severe phenotype with increased morbidity.
- Previous research indicates lower academic achievement in children with IBD compared to peers.
Purpose of the Study:
- To investigate the association between childhood-onset IBD and subsequent professional career trajectories and earnings.
- To quantify the long-term economic impact of IBD diagnosed in individuals under 18 years of age.
Main Methods:
- A cohort of 5404 individuals diagnosed with childhood-onset IBD (ulcerative colitis or Crohn's disease) was identified in the Swedish National Patient Register (1990-2014).
- Patients were matched with 51,295 general population controls.
- Earnings data from 1992-2017 were analyzed using the longitudinal integration database for health insurance and labour market studies, with earnings adjusted for inflation.
Main Results:
- Individuals with childhood-onset IBD experienced significantly lower annual taxable earnings between ages 20 and 30.
- At age 30, the adjusted median annual income difference (AMAID) was -5.4%.
- Patients with more severe childhood IBD (requiring surgery or inpatient treatment) showed a substantially larger income gap (AMAID at age 30: -16.3%).
Conclusions:
- The overall impact of childhood-onset IBD on early adult earnings is modest.
- However, a significantly larger negative income gap is observed in individuals with more severe disease during childhood.
- These findings highlight the importance of recognizing the long-term economic consequences associated with severe pediatric IBD.
Background:
IBD with onset during childhood seems to represent a severe disease phenotype with increased morbidity. We have previously demonstrated that children with IBD have significantly lower final grades in compulsory school compared to healthy peers.
Aim:
To evaluate the association of childhood-onset IBD with a later professional career and subsequent earnings METHODS: We identified 5404 individuals diagnosed with childhood-onset (<18 years) IBD between 1990 and 2014 (2818 with ulcerative colitis and 2328 with Crohn's disease) in the Swedish National Patient Register. Patients were matched with 10 general population reference individuals by sex, birth year, and place of residence (n = 51,295). Data on earnings during 1992-2017 were obtained through the longitudinal integration database for health insurance and labour market studies. Earnings were converted into Euros (inflation-adjusted to 2019). The differences in earnings between patients and general population reference individuals were calculated through quantile regression.
Results:
Patients with childhood-onset IBD had significantly lower annual taxable earnings from ages 20 to 30 (adjusted median annual income difference (AMAID) at age 30: -5.4% [95% CI -9.1% to -1.8%]). In particular, annual taxable earnings through early adult age were lower in patients who, during childhood, had had surgery or long-term inpatient treatment for IBD (AMAID at age 30: -16.3% [95% CI -24.7% to -7.9%]).
Conclusions:
Overall, the negative influence of disease on earnings in early adult age was modest for patients with childhood-onset IBD. The markedly larger negative income gap from ages 20 to 30 in patients with more severe IBD during childhood should be recognised.
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