PhysioUpdate 8th March 2022

People with osteoarthritis routinely find their 'healthy working lives' are cut short as they age

Age-associated conditions such as osteoarthritis pose a barriers to people remaining healthy and in work for longer, according to a study published earlier this month in Scientific Reports. Led by Marty Lynch from Keele University’s school of medicine, the study sought to understand the impact of osteoarthritis on health working life expectancy (HWLE) – the average amount of time that people can expect to remain healthy and in work.

People’s working lives and retirement ages are being extended in response to an ageing population, but this study found that osteoarthritis, a common musculoskeletal condition in adults aged 50 and over, is associated with a significant reduction on healthy working lives.

Policies should encourage 'good work 

The researchers compared HWLE in people with and without osteoarthritis from ages 50 and 65, both on a national level and in the local region of North Staffordshire. To do this, they looked at mortality and survey data for people from aged 50 and 65 obtained from the English Longitudinal Study of Ageing (ELSA), and from three time points of the North Staffordshire Osteoarthritis Project (NorStOP).

They found that osteoarthritis was linked to significantly reduced HWLE across all age groups; at age 50 the average number of years that people with osteoarthritis could be healthy and in work is over a third less than for those age 50 without osteoarthritis. The level of reduction was similar at national and local level, but the number of years that people were healthy and in work was considerably less in North Staffordshire than the national estimate.

In a release published on Keele University's website, lead author Dr Lynch said: ‘These results indicate the extent of the difference in healthy working life for people with a common health condition compared to those who do not have long term conditions and that local and regional differences for health and job opportunities can have a major impact on working lives.’

Co-author Ross Wilkie noted: ‘Whilst the study highlights the reduced healthy working life expectancy for people with osteoarthritis, the differences between areas and occupation types suggests that there is potential for this to increase.'

Dr Wilkie added: 'Policies to encourage “good work” and health promotion in workers, and approaches to facilitating working practice can have a positive impact on maintaining health and work participation when people have health conditions.’

Source: https://www.keele.ac.uk/about/news/2022/february/new-research-arthritis/lower-healthy-working-life-expectancy.php

What does the paper say?

Early identification (perhaps via presenteeism) and intervention could extend healthy working lives not just for workers with musculoskeletal conditions but also for those with other physical and mental health conditions [Marty Lynch et al.]

Implications for policy and research: a summary

‘As the prevalence of osteoarthritis among workers increases (through population and workforce ageing, deferred retirement age, and increasing obesity and physical inactivity), the association between osteoarthritis and lower HWLE may make extensions to working life difficult for many people with this common musculoskeletal condition. However, findings such as longer healthy working lives for self-employed people caution against an interpretation of inevitability.

‘An important implication for research is therefore the need to understand – in the general population and in particular among those with osteoarthritis – how biopsychosocial factors drive work participation and work outcomes such as absenteeism (work absence e.g. for health reasons) and presenteeism (reduced productivity while at work due to illness or for other reasons).

‘Achieving extended working lives policies may require changing perceptions around work disability as a likely consequence of osteoarthritis and other musculoskeletal disorders. Further work is needed to determine the extent that interference of symptomatic osteoarthritis with everyday activities (such as work and social engagement) may be lessened with supportive workplaces and a higher degree of individual control of work responsibilities and arrangements.

The article adds: ‘Proactive population/public health and primary care approaches targeting maintenance of workers’ health could prevent health conditions such as osteoarthritis impacting on work participation. Early identification (perhaps via presenteeism) and intervention could extend healthy working lives not just for workers with musculoskeletal conditions but also for those with other physical and mental health conditions.’

Conclusion

‘Evidence from two large longitudinal studies analysed in this study show that people with osteoarthritis are expected to spend fewer years healthy and in work from age 50 compared to people without osteoarthritis. The population subgroup identified by sex, osteoarthritis and occupation type that was best placed to work extended working lives were self-employed men without osteoarthritis – who were expected to be healthy and in work for just over 13 years from age 50.

The article adds: ‘Tackling HWLE inequalities and improving work outcomes for people with osteoarthritis will lead to overall improvements in average HWLE at the national level, which will require an understanding of the links between lower HWLE and key (modifiable and non-modifiable) factors that are potential drivers of health, wellbeing, and work participation.’

To see the full version of the article, titled Healthy working life expectancy at age 50 for people with and without osteoarthritis in local and national English populations, visit: https://www.nature.com/articles/s41598-022-06490-3

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