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Arthritis is a very debilitating disease and likely impacts labor
force participation, either forcing people to retire early due to
the pain or physical restriction of arthritis, reducing the hours
they can work or changing to a lower-paid job, said lead author
Emily Callander, a research fellow at the University of Sydney.
“For those who are already in retirement it may be that the costs of
treatment or costs of accessing aids or career services have
required them to draw down some of their assets, which would lower
the income they derive from their assets,” Callander told Reuters
Health by email.
The researchers studied more than 4,000 Australian adults between
2007 and 2012.
At the start of the study, the participants were not in poverty and
did not have arthritis. By 2009, 300 of the participants had
developed arthritis, half of whom were men. Over the study, 18
percent of women and 16 percent of men fell into poverty based on
income, and the proportion in poverty increased with age.
Women who developed arthritis were 51 percent more likely to fall
into income poverty than nonarthritic women. For men, arthritis
increased the risk by 22 percent.
Women were also more likely to fall into poverty by a definition
encompassing income, health and education attainment, or
“multidimensional poverty,” according to the results in Arthritis
and Rheumatology.
“It is known that people with lower incomes are more likely to
develop arthritis, but this is the first study to show the inverse
relationship – that arthritis could also lead to income poverty,”
Callander said.
Women are more likely than men to have severe arthritis, which may
make it harder for them to work, but that dimension was not included
in this study, she noted.
“In our analysis we did take into consideration other factors, such
as age, being married or in a de facto relationship as opposed to
being single, being a home owner as opposed to renting or having a
mortgage, and whether the person lived in a major city, an inner
regional area or a rural area,” she said. “However, even after
considering all these other factors, being diagnosed with arthritis
still leads to an increased risk of poverty.”
But the study did not account for other health issues, including
obesity, which increases the risk for arthritis and is more common
among people with lower socioeconomic status, said Dr. Gillian
Hawker, chair of Medicine at the University of Toronto, who was not
involved in the research.
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“Poverty is associated with poor diet and less opportunity for
physical activity which increases the risk for obesity and in turn
for osteoarthritis,” Hawker told Reuters Health by email.
We should first address the common risk factors, particularly
obesity, and ensure that all people with arthritis have access to
surgical and non-surgical treatment, she said.
Preventing arthritis would reduce the health burden as well as the
economic burden, but as the population ages in many countries,
arthritis will continue to become more common, so it will also be
important to help those with the condition remain in the workforce,
Callander said.
“We know, for example, that workplace modifications may help people
remain in employment, so encouraging employees and employers to look
at these options would be a great start,” she said.
“One of the most important considerations should be that any
arthritis interventions – be it treatment or prevention – should be
equally effective in both low and high income patients, this will
ensure that our health interventions do not widen inequality gaps,”
she said. “Furthermore, when treating arthritis patients, health
professionals should be aware of this greater risk of income
poverty, and consider a patient’s ability to pay for any out of
pocket costs when determining considering treatment options and
devising treatment plans.”
SOURCE: http://bit.ly/1USRI6C Arthritis and Rheumatology, online
September 8, 2015.
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