Association between cardiovascular disease and productive market and non-market activities in Australia

Chronic diseases such as cardiovascular diseases (CVD) are a leading cause of death and disability worldwide. In addition, its negative impact on productive market activities (PMA) has also been established. Our study aims to investigate the association between CVD and PMA and productive non-market activities (PNMA), examine whether these associations differ across demographic and socioeconomic subgroups, and compare the patterns of association across different types of CVD.

A longitudinal analysis utilising data from the Household, Income and Labour Dynamics in Australia (HILDA), applying a correlated random effects (CRE) model.

We utilised the data on 13,969 individuals from the HILDA study from waves 9, 13, 17, and 21. A CRE model was applied to account for both within-group (time-varying) and between-group (time-invariant) variations. Sensitivity analysis was performed by developing various models that progressively adjusted for control variables and a dynamic model by including a lagged term of the dependent variable.

The CRE model reveals that individuals who, on average, have CVD with medication across the survey waves exhibit a 14.72-h reduction in PMA per week (p < 0.01) compared to those without CVD, controlling for all other variables. Individuals with CVD partially compensate for the loss of PMA by increasing PNMA. The highest reduction was observed in PMA for men (-15.55 h) with CVD and taking medications. For individuals under 65, the statistically significant associations with PMA and PNMA, as well as total activities, remain largely consistent with the overall results. Hypertension shows the strongest negative association with PMA, particularly for men (-17.42 h) and women (-13.23 h, p < 0.01), followed by heart disease (-11.89 h, p < 0.01 for men).

CVD is significantly associated with reduced productivity, with the most substantial losses observed among individuals taking medication. The association is particularly pronounced for PMA. This underscores the need for workplace policies that support individuals with chronic conditions.