Chronic diseases robbing middle-aged of productivity, finds study

The study is the first one that looks at the link between economic productivity of the middle-aged and elderly, and the chronic diseases they suffer from

Nearly 23 per cent middle-aged people with chronic non-communicable diseases (NCDs) in India have no other way but to curtail their paid work due to illnesses while 7 per cent have to stop working, says the country’s first-ever population-based study that estimates how such chronic diseases impact economic productivity.

The proportion of people between 45 and 64 years who had stopped or curtailed their work was the highest (21 per cent) among victims of stroke, followed by neurological or psychiatric disorders (18 per cent) and chronic heart disease (13 per cent).

In addition, more than 10 per cent of the middle-aged population who took one of the two decisions suffered either from chronic lung disease or cancer.

The study by researchers from the International Institute for Population Sciences (IIPS), Mumbai, is the first one that looks at the link between economic productivity of the middle-aged and elderly, and the chronic diseases they suffer from.

Though a large number of studies estimated high out-of-pocket payment and financial catastrophe due to healthcare costs in India, there are no nationally representative studies on productivity loss due to health problems, even though chronic diseases are growing in the world’s second-most populous nation, largely affecting the middle-aged and elderly population; many of them are in the working age.

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For the assessment, the IIPS team used two impact groups — people who had to curtail their work and people who had to stop working. They used data from another study that looks at the aging behaviour of more than 70,000 Indians over the years.

“The results suggest that 7 per cent of older adults ever stopped working and 23 per cent had limited work due to health-related issues. This is the first ever population-based study that estimated the prevalence of ever-stopped work and limiting paid work among middle aged and elderly in India,” the researchers reported in the journal BMC Public Health.

Explaining why stroke topped the list of reasons behind stopping of the work, the researchers said many stroke survivors experienced post-stroke spasticity resulting in inability to perform daily activities, further necessitating their management and treatment. This exerts a considerable economic burden due to treatment cost and lost productive days.

The researchers showed that among a sample of people aged between 45 and 60 years who had stopped work for a year or longer, 58 per cent did so because of health issues followed by childcare (24 per cent). Those with lower levels of income and education demonstrated lesser chances of stopping or limiting work.

As the burden of non-communicable diseases is on the rise in India, studies in the past have shown that the share of middle-aged and elderly population (45+) has increased from 18.9 per cent in 2001 to 25.1 per cent in 2020, while median age of onset of NCDs is declining from 57 years in 2004 to 53 years by 2018.

“Evidences from this study on chronic diseases and productivity loss in India is new and staggering, with a demand for policy attention,” they reported.