11/7/07 6:45 AM

Chronic Illness Packs Punch; Depression Tops List

By Kathy Gurchiek

Chronic disease has a more than $1 trillion impact on the U.S. economy annually in lost productivity, according to a study that the Milken Institute released Oct. 2, 2007, and it “could balloon to nearly $6 trillion by the middle of the century.”

The report, An Unhealthy America: The Economic Burden of Chronic Disease, points to seven chronic diseases—cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions and mental illness—as having a $1.3 trillion annual impact on the economy, with $1.1 trillion of that in lost productivity.

Another report, from the American Hospital Association (AHA), found that depression, sadness and mental illness, as a group, is the most prevalent chronic health problem among U.S. workers.

U.S. workers with depression/sadness/mental illness took an average of about 25 more sick days than others in 2003, according to the AHA’s TrendWatch report released in October 2007.

The report uses the most recent data available from the Centers for Disease Control and Prevention that is consistent with all the chronic diseases the AHA looked at, AHA spokesman Matt Fenwick told SHRM Online.

The prevalence of chronic health problems among employed Americans is rising, the AHA found, and it comes with a significant financial cost to employers.

In 2003, chronic illness resulted in $48 billion in wages paid for time not worked attributable to employee illness, and $27 billion in reduced productivity attributable to illness, the AHA report says.

The 10 most common chronic conditions among U.S. workers in 2003, and the average number of annual workdays lost per person with the illness, according to the AHA, were:

• Depression/sadness/mental illness, 25.6 days.

• Cancer, 16.9 days.

• Respiratory disorders, 14.7 days.

• Asthma, 12 days.

• Migraines/headaches, 10.7 days.

• Allergies, 8.2 days.

• Heart disease, 6.8 days.

• Arthritis, 5.9 days.

• Diabetes, 2.0 days.

• Hypertension, 0.9 days.

Together, asthma, diabetes and hypertension “account for significant losses in workdays for individual states and the nation’s economy—on average an estimated 1,221 days of work absences per 1,000 employed Americans” annually, according to the study.

Asthma took the worst toll on California, resulting in 15,840 days absent per year, with an annual dollar impact of $2.9 million, according to the AHA. Texas had the second-highest asthma-related absences per year (8,190 days).

California and Texas also were hardest hit by lost workdays per year attributable to diabetes (1,711 and 1,271 days, respectively) and hypertension (2,761 and 1,775 days, respectively).

The AHA’s TrendWatch includes a state-by-state analysis conducted by report partner Avalere Health LLC. The Milken Institute’s state-by-state and disease data can be found at www.chronicdiseaseimpact.com.

Preventive Steps

Much of the economic impact is avoidable by investing in good health, Milken and the AHA contend.

“The good news is that with moderate improvements in prevention and early intervention such as reducing the rate of obesity, the savings to the economy would be enormous,” said Ross DeVol, director of health economics and regional economics at the Milken Institute, in a press release.

DeVol is the principal author of the Milken report, which was supported by a grant from the Pharmaceutical Research and Manufacturers of America.

The AHA points to the benefits of employers taking proactive steps.

Citing data from the National Institutes of Health, the AHA notes that nearly 180,000 women will be diagnosed with breast cancer in 2007 and more than 40,000 women are expected to die from the disease.

However, routine mammograms might reduce breast cancer deaths “by as much as 30 percent” because screening can lead to earlier detection, improving survival rates, the AHA says in its report.

“Employer-sponsored, on-site mammograms help overcome barriers to screening, such as cost and inconvenience by allowing women to be screened without taking time off from work,” the AHA report says.

Eli Lilly and Co., for example, offers eligible employees free mammograms, as well as gynecological exams, colonoscopy screenings, flu shots and immunizations for employees on business travel.

On-site mammograms can result in fewer lost workdays—33.9 days for those screened vs. 74.5 days for others, according to one study—and a savings of $18,526 in treatment costs for those whose cancer was detected via screening vs. $35,031 in treatment costs for others, according to the AHA report.

Some chronic conditions aren’t as deadly but still take a toll on employee health and the employer’s bottom line.

Workers suffering from migraine headaches, for example, cost employers nearly $13 billion per year in lost workdays and reduced productivity, with $8 billion “directly attributable to absenteeism alone,” the AHA reports.

Employer-sponsored wellness plans can play a part in turning around the problem of chronic illness among employees, the AHA suggests.

Such programs can take a variety of forms—access to fitness centers, health risk assessments, disease management, healthy cafeteria programs, employee assistance programs—and result in an average savings of $5.93 for every $1 the employer spends, the AHA found.

It attributed those savings, in general, “to lower medical costs, reduced absenteeism and presenteeism, fewer workers’ compensation and shorter-term disability claims, and increased productivity.”

Kathy Gurchiek is associate editor for HR News. She can be reached at kgurchiek@shrm.org.

Related Articles:

NIMH: Employer-Sponsored Depression Programs Work, HR News, Oct. 12, 2007

Managing Disability Time Off Costs: Wellness, Prevention and Data Integration, SHRM Online Compensation & Benefits Focus Area, June 2007

Chronic Pain Takes Increasing Toll on U.S. Productivity, HR News, March 9, 2007

For the latest HR-related business and government news, go daily to www.shrm.org/hrnews.