Productivity Losses Associated With Diabetes in the U.S.

  1. Ying Chu Ng, PHD,
  2. Philip Jacobs, PHD and
  3. J.A. Johnson, PHD
  1. From Hong Kong Baptist University (Y.C.N.), Hong Kong, China; and the University of Alberta and Institute of Health Economics (P.J., J.A.J.), Alberta, Canada.
  1. Address correspondence and reprint requests to Philip Jacobs, ACHORD GROUP, Institute of Health Economics, #1200, 10405 Jasper Ave., Edmonton, Alberta, T5J 3N4 Canada. E-mail: pjacobs{at} .


OBJECTIVE— The objective of this study was to estimate the cost of productivity losses in the U.S. attributable to diabetes, with regard to specific demographic and disease-related characteristics in the U.S.

RESEARCH DESIGN AND METHODS— We used the 1989 National Health Interview Survey, a random survey of individuals in the U.S. that included a diabetes supplement. Data on individuals were obtained for labor force participation, hours of work, demographic and occupational characteristics, self-reported health status, and several variables that indicated the presence, duration, and severity (complications) of diabetes. Using multivariate regression analyses, we estimated the association of independent variables (e.g., demographics, health, and diabetes status) with labor force participation, hours of work lost, and the economic value of lost work attributable to diabetes and its complications and duration.

RESULTS— In general, the presence of diabetes and complications were found to be related to workforce participation variables. The magnitude of the lost-productivity costs depended on personal characteristics and on the presence and status of diabetes. In general, the loss of yearly earnings amounted to about a one-third reduction in earnings and ranged from $3,700 to $8,700 per annum.

CONCLUSIONS— Diabetes has a considerable net effect on earnings, and the complications and duration of diabetes have compound effects. Our findings have implications for the cost-effectiveness of diabetes control; the presence of complicating factors is the single most important predictive factor in lost productivity costs attributable to diabetes, and thus the avoidance or retardation of complications will have an impact on indirect health-related costs.


  • Abbreviations: HRS, Health and Retirement Survey; NHIS, National Health Interview Survey.

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted November 1, 2000.
    • Received July 10, 2000.
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