Preventing heart disease could keep more people employed and save billions for the economy

Preventing 10 years of coronary heart disease would save nearly USD $15 billion in gross domestic product (GDP) by keeping people gainfully employed. That's the finding of a study published today in the European Journal of Preventive Cardiology.

The findings come on World Heart Day, during which employers are urged to invest in the heart health of their staff and governments are asked to adopt policies and regulations which foster better heart health, including sugar taxes, smoking bans and reducing air pollution.

"Economic evaluations of disease typically focus on the cost for healthcare systems," said study author Ms. Feby Savira, a Ph.D. student at Monash University, Melbourne, Australia. "Our study examined how much money could be saved by preventing heart disease, thereby enabling people to remain in work."

Coronary heart disease accounts for a third of all deaths in people over 35. People with coronary heart disease have more days of unplanned absence from work (called "absenteeism") and are less productive while at work (known as "presenteeism") compared to the general population. Those with the disease are also more likely to retire early.

The researchers estimated the economic impact of stopping future cases of coronary heart disease in Australia over the next 10 years (2020-2029). Preventing all future cases would save nearly A$22 billion (or USD $15 billion) in GDP due to reductions in coronary heart disease-related deaths, and increased productivity. This is equivalent to almost A$75,000 (USD $51,000) for every case avoided.

"Even preventing just 10% of future coronary heart disease cases (equivalent to 2,860 new cases per year over 10 years) could result in A$2 billion (USD $1.5 billion) in monetary gains from improved productivity alone," said Ms. Savira. "Our study demonstrates the strong financial incentive for the prevention of coronary heart disease to improve health and productivity among the working-age population."

Early retirement due to coronary heart disease accounted for most of the estimated loss in productivity (65.4%) followed by presenteeism (i.e. at work but not fully functioning; 20.3%), absenteeism (8.4%), and premature death (5.9%). Men contributed 62% to the total loss of productivity due to coronary heart disease.

The authors argue that policy makers should view spending to prevent heart disease as an investment—for example by banning industrial fats and making it easier to walk or cycle to work.

Ms. Savira said: "These findings demonstrate the profound impact of coronary heart disease on individuals, employers and society. Employers can establish healthy workplaces, for example by providing group exercise classes, and healthy food and beverage options. There is plenty each of us can do to protect our health and livelihood: it is estimated that 80% of cardiovascular disease could be stopped by eliminating bad habits such as poor-quality diet, physical inactivity, and smoking."

To conduct the study, the researchers used a metric called the productivity-adjusted life year (PALY), which adjusts years lived for reduced productivity due to disease/ill health. A model was constructed for the total Australian working-age population (15-69 years) over 10 years, separated by coronary heart disease status. The researchers predicted more than 290,000 new coronary heart disease cases over the next 10 years. If these cases were prevented, over 4,000 deaths could be averted, resulting in more than 8,000 years of life saved and 104,000 PALYs gained.