Lower workforce participation is associated with more severe persisting breathlessness

Clark, Joseph; Chang, Sungwon; Kinchin, Irina; Ferreira, Diana; Kochovska, Slavica; Morgan, Deidre; Poulos, Leanne M; Johnson, Miriam J.; Ekström, Magnus; Currow, David C.

Abstract

Background: Not being able to work has negative health, social and financial consequences. Persisting breathlessness is prevalent in working-aged people. Is it associated with lower workforce participation? This study, using the South Australian Health Omnibus, aimed to explore associations between paid workforce participation and persisting breathlessness intensity, and economic impacts on income in people of working age. Methods: This cross-sectional study conducted face-to-face interviews with a random sample of adults in South Australia (n = 8916). Questions included key demographic data, workforce participation and the presence and intensity of persisting breathlessness. Data from working-aged respondents (20–65years of age) were standardised to the census for regression analyses. Work was coded to paid full- or part-time work or ‘other’. Persisting breathlessness (more than three of the last six months) used the modified Medical Research Council breathlessness scale (aggregated to 0, 1, 2–4). Opportunity cost valuations compared annual income foregone by persisting breathlessness severity. Results: Of people interviewed, 6,608 were working-aged (49.9% male; 67.5% had post-secondary qualifications; 70.9% were in paid full- or part-time work; and 1.7% had mMRC score 2–4). Workforce participation dropped in working aged people with increasing breathlessness: mMRC 0, 70.6%; mMRC 1, 51.7%; mMRC 2–4, 20.3%. In the regression model, people with the most severe breathlessness were much less likely to work (OR 0.14; 95% CI 0.09, 0.22). Annual income foregone by people with persisting breathlessness was AU$10.7 billion (AU$9.1b for full-time and AU$1.6b for part-time work; range AU$5.9b, AU$49.7b). Conclusion: Worsening persisting breathlessness is associated with lower workforce participation with direct financial consequences, greatest for older males.

Citation

Clark, J., Chang, S., Kinchin, I., Ferreira, D., Kochovska, S., Morgan, D., Poulos, L. M., Johnson, M. J., Ekström, M., & Currow, D. C. (2022). Lower workforce participation is associated with more severe persisting breathlessness. BMC Pulmonary Medicine, 22(1), Article 93. https://doi.org/10.1186/s12890-022-01861-y

• Journal Article Type: Article
• Acceptance Date: Dec 14, 2021
• Online Publication Date: Mar 18, 2022
• Publication Date: Dec 1, 2022
• Deposit Date: Dec 15, 2021
• Publicly Available Date: Mar 22, 2022
• Journal: BMC Pulmonary Medicine
• Electronic ISSN: 1471-2466
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 1
• Article Number: 93
• DOI: https://doi.org/10.1186/s12890-022-01861-y
• Keywords: Persisting breathlessness; Cross-sectional population survey; Workforce participation; Income foregone
• Public URL: https://hull-repository.worktribe.com/output/3899241