Original Article
Prevalence and causes of work disability among working-age U.S. adults, 2011–2013, NHIS

https://doi.org/10.1016/j.dhjo.2017.04.010Get rights and content

Abstract

Background

Chronic conditions are among the major causes of work disability (WD), which is associated with lower employment, less economic activity, and greater dependence on social programs, while limiting access to the benefits of employment participation.

Objective/Hypothesis

We estimated the overall prevalence of WD among working-age (18–64 years) U.S. adults and the most common causes of WD overall and by sex. Next, we estimated the prevalence and most common causes of WD among adults with 12 common chronic conditions by sex and age. We hypothesized that musculoskeletal conditions would be among the most common causes of WD overall and for individuals with other diagnosed chronic conditions.

Methods

Data were obtained from years 2011, 2012, and 2013 of the National Health Interview Survey. WD was defined by a “yes” response to one or both of: “Does a physical, mental, or emotional problem NOW keep you from working at a job or business?” and “Are you limited in the kind OR amount of work you can do because of a physical, mental or emotional problem?”

Results

Overall, 20.1 million adults (10.4% (95% CI = 10.1–10.8) of the working-age population) reported WD. The top three most commonly reported causes of WD were back/neck problems 30.3% (95% CI = 29.1–31.5), depression/anxiety/emotional problems 21.0% (19.9–22.0), and arthritis/rheumatism 18.6 (17.6–19.6). Musculoskeletal conditions were among the three most common causes of WD overall and by age- and sex-specific respondents across diagnosed chronic conditions.

Conclusions

Quantifying the prevalence and causes of work disability by age and sex can help prioritize interventions.

Section snippets

Methods

Data were obtained from years 2011, 2012, and 2013 of the National Health Interview Survey (NHIS), an ongoing in-person survey nationally representative of the civilian, non-institutionalized U.S. population, linking the Person File to the Sample Adult Core for each year (n = 33,014; 34,525; and 34,557; response rate = 66.3%, 61.2%, and 61.2%, respectively). For the purposes of this study, work disability was defined by a “yes” response to one or both of: “Does a physical, mental, or emotional

Results

Part 1 (overall prevalence and causes): Overall, 20.1 million adults (10.4% (95% CI = 10.1–10.8) of the working-age population) reported work disability. Prevalence of work disability was lowest in younger adults (4.6% in 18–24 year olds) and highest in the oldest working-age adults (19.7% in 55–64 year olds) (Fig. 1). Prevalence of self-reported work disability was virtually identical among men and women in each age group.

The top three most commonly reported causes of work disability overall

Discussion

Work disability is common, reported by 1-in-10 working-age adults. Among those with studied chronic conditions, both men and women consistently reported MSK conditions among the top three most common causes of work disability across age groups. Iezzoni et al. recently established that disability among U.S. adults, by seven different measures including work disability, rose significantly between 1998 and 2011,25 and Martin and Schoeni demonstrated increases in sensory, physical function,

Conclusions

In conclusion, work disability is common, reported by 1-in-10 working-age adults. Both men and women consistently reported MSK conditions among the top three most common causes of work disability across age groups and despite various diagnosed chronic conditions. Efforts to reduce work disability should consider MSK conditions among all working-age U.S. adults.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Financial disclosures

No authors have any financial disclosures regarding this manuscript. There were no external funders for this work.

Acknowledgements

We wish to thank Miriam Cisternas for assistance with programming and data quality checks.

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