795 - Musculoskeletal Conditions Are the Most Common Causes of Work Limitation in U.S. Adults

Sunday, November 6, 2011: 2:30 PM
W194a (McCormick Place West)
Kristina A. Theis1, Charles G. Helmick1 and Jennifer M. Hootman2, 1Centers for Disease Control and Prevention, Atlanta, GA, 2Centers for Disease Control and Prevention, Kennesaw, GA
Presentation Number: 795

Background/Purpose: People with work limitations are less likely to be employed, contribute to payroll taxes, or add to national productivity than those without work limitations, and chronic diseases are among the major causes of work limitation.  However, there are existing interventions that can decrease, delay, or mitigate work limitations that may be especially effective if targeted to appropriate populations.  We estimated the most common causes of work limitation among U.S. adults overall and among those with 7 common chronic diseases.

 

Method: The data source was the 2009 National Health Interview Survey, an annual survey designed to be nationally representative of civilian, non-institutionalized U.S. adults (age ≥18 years) conducted by in-person interview (n = 27,731; response rate = 65%).  Work limitation was identified by self-report of being “unable to work” or “limited in work.”  Respondents with limitations were shown a flashcard of 18 health conditions plus an “other” category and asked to identify all health problems causing their difficulties. All respondents were separately asked about the presence of 7 chronic conditions.  Arthritis was identified by “Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?”  The same question wording was used for hypertension, stroke, asthma, cancer, diabetes, and heart conditions (coronary heart disease, angina, heart attack, and any other kind of heart condition or disease).  Diagnoses were not mutually exclusive.  Weighted proportions and 95% confidence intervals (CI) were calculated, accounting for the complex sample design (SAS 9.2).

 

Result: Overall, 28.4 million (12.5%, 95% CI = 12.0-13.1) U.S. adults reported work limitation.  The most commonly reported causes of work limitation were back/neck problems (25.8%, 95% CI = 24.0-27.6) and arthritis/rheumatism (19.4%, 95% CI = 17.7-21.2), followed by depression/anxiety/emotional problems (15.1%, 95% CI = 13.6-16.6), heart problems (14.6%, 95% CI = 13.2-16.0), and musculoskeletal/connective tissue problems (13.1%, 95% CI = 11.6-14.7).  Among those with 7 common chronic diseases and work limitation, arthritis/rheumatism and/or back/neck problems were among the top 3 causes for each (Table). 

 

Table. Most Common Causes of Work Limitation by Chronic Condition, weighted prevalence estimates and proportions with 95% confidence intervals (CI), NHIS, 2009

Chronic condition

Causes of work limitation

Prevalence (in 1,000s)

Proportion in % (95% CI)

Hypertension

Back/neck problems

4,077

26.4 (24.0-28.7)

 

Arthritis/rheumatism

3,892

25.2 (22.7-27.7)

 

Hypertension

3,295

21.3 (19.0-23.6)

Stroke

Stroke

1,146

39.3 (34.6-44.0)

 

Heart problems

742

25.4 (22.3-28.5)

 

Arthritis/rheumatism

690

23.7 (19.9-27.4)

Asthma

Lung/breath problems

2,130

33.5 (29.9-37.0)

 

Back/neck problems

1,753

27.6 (24.0-31.1)

 

Arthritis/rheumatism

1,398

22.0 (18.9-25.0)

Cancer

Cancer

1,193

26.5 (23.1-29.8)

 

Back/neck problems

1,108

24.6 (21.1-28.1)

 

Arthritis/rheumatism

1,099

24.4 (20.7-28.0)

Diabetes

Diabetes

3,446

51.8 (48.0-55.6)

 

Arthritis/rheumatism

1,745

26.2 (22.6-29.9)

 

Back/neck problems

1,653

24.9 (21.3-28.4)

Heart conditions

Heart problems

184

41.9 (38.8-45.1)

 

Arthritis/rheumatism

2,171

23.5 (20.7-26.3)

 

Back/neck problems

2,152

23.3 (20.5-26.1)

Arthritis

Arthritis/rheumatism

5,175

33.5 (30.7-36.3)

 

Back/neck problems

4,997

32.4 (29.8-34.9)

 

Musculoskeletal/connective tissue problems

2,300

19.4 (17.3-21.6)

 

Conclusion: In addition to being the most common causes of work limitation overall, arthritis/rheumatism and/or back/neck problems were among the top 3 causes of work limitation regardless of chronic condition, suggesting that addressing work limitation caused by musculoskeletal conditions is important no matter what other chronic conditions are present.  Evidence-based public health interventions (e.g., the Chronic Disease Self-Management Program) and vocational rehabilitation may delay or reverse disability among adults with chronic conditions experiencing work limitations.

 


Keywords: comorbidity, disability, job loss and quality of life

Disclosure: K. A. Theis, None; C. G. Helmick, None; J. M. Hootman, None.