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CVD event survivors experience decreases in employment, earnings
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Survivors of CV and cerebrovascular events, particularly strokes, experienced a substantial loss in employment and earnings for at least 3 years, according to findings published in the Canadian Medical Association Journal.
Researchers sought to assess the effect of acute MI, cardiac arrest and stroke on work and earnings among working-age people.
“Health events may start a cascade where new disability causes earnings losses, which may contribute to cost-related nonadherence to medication, which contributes to worsened and even new health problems,” Allan Garland, MD, professor in the departments of medicine and community health sciences at the University of Manitoba, Winnipeg, and colleagues wrote.
Previously, Cardiology Today reported the association between income volatility and increased risks for CVD and all-cause mortality in an assessment conducted by researchers from the University of Miami Miller School of Medicine.
Garland and colleagues compared data from the Canadian Hospitalization and Taxation Database from 2005 to 2013 of exposed patients who were admitted to the hospital with acute MI, cardiac arrest and stroke with controls not admitted to the hospital for similar events.
The participants were aged 40 to 61 years, worked 2 years before their events and survived 3 years after the event. They were matched to controls in 11 variables. The primary outcome was working status 3 years after the event.
Researchers identified that patients with stroke in the exposed cohort (n = 4,395) had the greatest reduction in employment (19.8 percentage points; 95% CI, 18.5-23.5) and annual earnings ($13,278; 95% CI, 12,301-14,225) compared with matched controls.
Patients with cardiac arrest (n = 1,043) also had a lower reduction in employment (12.9 percentage points; 95% CI, 10.4-15.3) and annual earnings ($11,143; 95% CI, 8,962-13,324) after 3 years vs. controls.
Compared with controls, exposed patients with acute MI (n = 19,129) had the lowest decrease in percentage of workers employed (5 percentage points; 95% CI, 4.5-5.5) and annual earnings ($3,834; 95% CI, 3,346-4,323) following the event.
According to Garland and colleagues, the effects of income loss were greater for patients with comorbid diseases, lower baseline earnings, longer hospital stays or mechanical ventilation.
Being able to identify subgroups at high risks for substantial employment and earnings losses may assist in targeting interventions, policies and legislation to promote a return to work, they wrote.
“Our findings add individual-level details to the current understanding of the economic consequences of cardiovascular and cerebrovascular disease,” Garland and colleagues wrote. “The loss of earnings attributable to these health events represent some of the total costs of caring for such conditions.” – by Earl Holland Jr.
Disclosures: The authors report no relevant financial disclosures.
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