How long do people with rheumatic and musculoskeletal diseases stay healthy and in work across Europe? Analysis of data from SHARE and ELSA.

Abstract

This study aims to estimate the extent of the reduction in healthy working life expectancy (HWLE), from age 50, for people with rheumatic and musculoskeletal diseases (RMDs) in 19 countries across Europe and highlight the need to target extending working lives through interventions and policy. Data were from 2 longitudinal studies (Survey of Health, Ageing and Retirement in Europe [2004-2022], English Longitudinal Study of Ageing [2002-2023]) that collect information in people aged 50 years and over. 'Healthy' and 'working' were defined as no limiting long-standing illness and employment/self-employment, respectively. RMDs were identified from self-report of ever having received a doctor diagnosis of arthritis or rheumatism. Age-adjusted discrete time 3-state models were fitted using IMaCh software, a maximum likelihood modelling programme using interpolation of Markov Chains, to estimate HWLE from transition probabilities between each healthy and working state based on RMD status (overall, by sex, education, and physical activity), stratified by 19 countries. In 6 countries, HWLE in the population with RMDs was around 50% or less than for the population without RMDs. The lowest HWLE for populations with RMDs was in Austria 2.60 (1.49, 3.71) years which was 42.9% of HWLE for the population without RMDs. HWLE was lower in populations with RMDs with lower than upper secondary education in all countries and in populations with RMDs categorised as physically inactive in 16 countries. The differences observed in HWLE demonstrate the substantial societal burden associated with RMDs. However, differences by country, sex, education and physical activity indicate that there are opportunities for interventions and policies to increase HWLE.