Cardiac events, stroke lead to loss of work, reduced income in survivors of working age

People who have experienced a heart attack (myocardial infarction), stroke or cardiac arrest are significantly less likely to be working than healthy people, and if they are working, on average have lower incomes, found a study published in CMAJ (Canadian Medical Association Journal).

Cardiovascular disease and stroke are the most common causes of death worldwide, resulting in hospitalization, disability and loss of income. For example, one-third of heart attacks, 25% of strokes and 40% of cardiac arrests occur in people of working age under age 65.

The current study evaluates the effect of these conditions on the labour market and compares outcomes of people aged 40 to 61 years who were working before their event with controls who had not experienced a stroke or cardiac event. To rule out any temporary labour market effects due to health issues, the researchers looked at employment three years after the initial event.

"Three years after admission to hospital for any of these health events, people who survived were less likely than the matched participants to be working and had greater losses in annual earnings," says Dr. Allan Garland, Professor of Medicine and Community Health Sciences Co-Head, Section of Critical Care Medicine, University of Manitoba and physician, Health Sciences Centre Winnipeg. "The loss in earnings was substantial, with reductions ranging from 8% to 31%. Even if people were able to work, their incomes in the third year after the event were 5% to 20% less than before."

The effects for stroke were the highest, with 31% decrease compared with 23% for cardiac arrest and 8% for acute myocardial infarction.

"Unemployment and lost earning owing to common health events have broad societal relevance, with consequences for patients, families and governments, such as bankruptcy, worsening health and lost productivity," says Dr. Garland.

Being employed is associated with well-being and life satisfaction. The researchers hope that the study will help in developing interventions and policies to support people to return to work, although more research is needed.