The personal and national costs of lost labour force participation due to arthritis: an economic study

Arthritis is a common and costly health condition internationally. The direct medical costs of arthritis are significant, with the condition being the fourth most common reason for seeking general practitioner medical care. Treatment of arthritis in Australia cost around $4 billion (AU) in health system expenditure in 2004–05, the fourth largest cause of health expenditure in the country. However, this figure covers only the direct medical costs, and the indirect costs, are considered to be larger. Within Australia arthritis has been listed as a ‘National Health Priority Area’, and affects 15% of the population. By 2020 the prevalence of the condition is estimated to increase, with arthritis potentially affecting 35% of the Australian population. Arthritis can cause significant activity limitation, and is responsible for around 13% of the disability reported in Australia. Due to its impact on functional ability, arthritis is associated with decreased labour force participation rates. Within Australia the impact of arthritis on labour force participation among people in the pre-retirement age group of 45 to 64 years is significant – with people suffering from arthritis being 3 times more likely to be out of the labour force than those with no chronic health condition.Authors: Deborah J Schofield, Rupendra N Shrestha, Richard Percival, Megan E Passey, Emily J Callander and Simon J Kell

Job-Related Attitudes and Burnout Amongst Medical Physicists in the United States

In the last forty-five years, burnout has evolved from a psychological fad to a validated syndrome included in both the 10th and 11th editions of the International Classification of Diseases by the World Health Organization. Numerous studies have been conducted to determine the prevalence and toll of burnout within the health care sector including within the field of oncology. However, the impact of this syndrome on medical physicists has been largely unevaluated. This dissertation study aims to fill the gap in the literature by examining job-related attitudes and burnout amongst medical physicists in the United States. Themulti-dimensional theory of burnout provided the theoretical underpinnings of this cross-sectional correlational study. The survey instrument utilized in this dissertation study consisted of two questionnaires, theMaslach Burnout Inventory and an organizational survey tool based on version one of the Agency for Healthcare Research and Quality Survey on Patient Safety Culture. The Maslach Burnout Inventory was used to quantify the burnout burden amongst medical physicists in the United States. Additionally, the relationship between the emotional exhaustion domain and work hours, error reports, and organizational and safety features amongst therapeutic medical physicists was also determined

Replacing the projected retiring baby boomer nursing cohort 2001 – 2026

<p>Abstract</p> <p>Background</p> <p>The nursing population in Australia is ageing. However, there is little information on the rate and timing of nursing retirement.</p> <p>Methods</p> <p>Specifically designed health workforce extracts from the Australian Bureau of Statistics (ABS) censuses from 1986 to 2001 are used to estimate the rate of nursing retirement. The 2001 nursing data are then "aged" and retirement of the nursing workforce projected through to 2026. ABS population projections are used to examine the future age structure of the population and the growth and age distribution of the pool of labour from which future nurses will be drawn.</p> <p>Results</p> <p>Attrition rates for nurses aged 45 and over are projected to be significantly higher between the base year of 2006 and 2026, than they were between 1986 and 2001 (p < 0.001).</p> <p>Between 2006 and 2026 the growth in the labour force aged 20 to 64 is projected to slow from 7.5 per cent every five years to about 2 per cent, and over half of that growth will be in the 50 to 64 year age group. Over this period Australia is projected to lose almost 60 per cent of the current nursing workforce to retirement, an average of 14 per cent of the nursing workforce every five years and a total of about 90,000 nurses.</p> <p>Conclusion</p> <p>The next 20 years will see a large number of nursing vacancies due to retirement, with ageing already impacting on the structure of the nursing workforce. Retirement income policies are likely to be a key driver in the retirement rate of nurses, with some recent changes in Australia having some potential to slow retirement of nurses before the age of 60 years. However, if current trends continue, Australia can expect to have substantially fewer nurses than it needs in 2026.</p

Psychological distress increases the risk of falling into poverty amongst older Australians: the overlooked costs-of-illness

Background: This paper aimed to identify whether high psychological distress is associated with an increased risk of income and multidimensional poverty amongst older adults in Australia. Methods: We undertook longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using modified Poisson regression models to estimate the relative risk of falling into income poverty and multidimensional poverty between 2010 and 2012 for males and females, adjusting for age, employment status, place of residence, marital status and housing tenure; and Population Attributable Risk methodology to estimate the proportion of poverty directly attributable to psychological distress, measured by the Kessler 10 scale. Results: For males, having high psychological distress increased the risk of falling into income poverty by 1.68 (95% CI: 1.02 to 2.75) and the risk of falling into multidimensional poverty by 3.40 (95% CI: 1.91 to 6.04). For females, there was no significant difference in the risk of falling into income poverty between those with high and low psychological distress (p = 0.1008), however having high psychological distress increased the risk of falling into multidimensional poverty by 2.15 (95% CI: 1.30 to 3.55). Between 2009 and 2012, 8.0% of income poverty cases for people aged 65 and over (95% CI: 7.8% to 8.4%), and 19.5% of multidimensional poverty cases for people aged 65 and over (95% CI: 19.2% to 19.9%) can be attributed to high psychological distress. Conclusions: The elevated risk of falling into income and multidimensional poverty has been an overlooked cost of poor mental health

Projecting the impacts of illness on labour force participation: An application of Health&WealthMOD

Health&WealthMOD is the first Australian microsimulation model designed to determine the economic impacts of disease on older workers, aged 45 to 65 years. Chronic health conditions are known to be associated with early retirement. This paper describes an application of Health&WealthMOD to estimate the impact of this association on projected labour force participation to 2020 given the ageing population and long-term trend in chronic conditions. Due to ageing and disease trends, the number of people with chronic conditions in the 45-64 years age group was expected to rise to about 4.8 million by 2020, an increase of 82% from the 2003 population of the same age group. About 904,000 persons in the 45-64 age group were projected to be out of the labour force due to ill health in 2020, when only the ageing and population growth were considered. When trends in illness were captured, the figure was increased to about 1.2 million persons. This demonstrates that health is a major driver of labour force participation and retirement and that economic policies alone, with no consideration of health interventions to treat or prevent chronic illness, will only have a limited impact on labour force participation. Thus, it is important that the government focuses on both health policies and economic policies in order to make sure that there will be an adequate supply of labour force in future.impacts of illness, labour force, participation, Health&WealthMOD

Copepod summer grazing and fecal pellet production along theWestern Antarctic Peninsula

Copepods are important grazers on phytoplankton and contributors to carbon export, but their role is poorly understood in theWestern Antarctic Peninsula (WAP), a region of high productivity and rapid climate warming. We conducted grazing and egestion experiments with large, dominant copepods each January from 2012 to 2014. We found higher gut evacuation rates (k), initial gut pigment and ingestion rates (I) for Calanus propinquus and Rhincalanus gigas compared with Calanoides acutus. Since k and I linearly increased with chlorophyll a for most species, ingestion rates were 4-70 times greater in more productive coastal regions than offshore, slope waters. Copepods have a low grazing impact on phytoplankton biomass (\u3c 1%) and productivity (1%, up to 11%) compared with the dominant WAP macro-and microzooplankton. Egestion rates were high (0.8-37.3 mu gC ind.(-1) day(-1)); however, similar to 58% of fecal pellets are retained in the upper water column. Daily carbon rations of similar to 1% indicated feeding on other carbon sources (protozoans and metazoans) to meet metabolic demands. However, during a coastal phytoplankton bloom, daily C rations increased to up to 13%, indicating increased reliance on phytoplankton. Future changes in theWAP plankton community may affect food web carbon flow and export

Case Studies - Health&WealthMOD: a microsimulation model of the economic impacts of diseases on older workers

The Australian Government is seeking to encourage older workers to remain in the labour force longer to overcome future labour shortages and ensure adequate taxation revenue to fund the needs of an ageing population. Longer labour force participation also has benefits to individuals in terms of available income and capacity to save for a better standard of living in retirement. While the Government recognises that not all older workers are able to participate in the labour force, there is little information on what health conditions keep people from working, or what the costs are to the government or the individual. This case study outlines how a new micro simulation model, Health&WealthMOD, is being designed to fill this information gap by estimating the economic impacts of illness. The general approach adopted is outlined, following which two early applications of the model are presented. The model is used to explore the determinants of the duration spent in retirement and to generate projections of retirement due to illness to 2020.health; disability; wealth; retirement period

Modelling the cost of ill health in Health&WealthMOD (Version II): lost labour force participation, income and taxation, and the impact of disease prevention

This paper provides a detailed description of the construction of Health&WealthMOD (Version II). It is Australia’s only microsimulation model of health and illness and their impacts on labour force participation, income, wealth and government revenue and expenditure. In this paper, we describe Health&WealthMOD (Version II) and its architecture, the application of the model, and some of the results it has produced.Health&WealthMOD, cost of ill health, lost labour force participation, income, taxation, disease prevention

Keep on keeping on: predicting who will be able to work until they are 70 years old

[Extract] The Federal Government announced in its 2015 budget that, in addition to increasing the age of eligibility for the Age Pension to 67 years by 2023, it plans to further increase the age of eligibility to 70 years by 2035[1]. The economic drivers for this policy were emphasised twelve months earlier in the National Commission of Audit Report (2014): Once the impacts of an ageing population and expected lower growth prospects in the longer term are taken into account a growing fiscal gap will emerge at all levels of government across Australia if current expenditure and revenue policies remain unchanged.… Today we have five people working for every one retired person, by 2050 we will only have 2.7[2]. Justification for increasing the age of eligibility for the Age Pension has centred on increasing longevity and related costs of pension payments and health and aged care. Treasury’s 2015 Intergenerational Report (IGR) highlighted this point, stating: “A greater proportion of the population will be aged 65 and over. The number of Australians in this age group is projected to more than double by 2054-55 compared with today” and thus the Government has also implemented policies to increase the labour force participation of older Australians[3]. However, the capacity of people to work until the age of 70 not only depends on the availability of incentives and employment opportunities but their health capacity to do so. Although the Australian population is living longer, there is evidence that they are not a healthier population (Productivity Commission report on An Ageing Australia, 2014)[4]. We estimated there are 512,700 people aged 65-69 years who will be in the labour force. Of these, 500,600 are projected to be able to keep working until the age of 70 (312,600 in full-time and 188,000 in part-time) and 97,700 who will not be able to work due to their ill-health. We also estimated the effects (and ranking) of the individual’s main chronic condition on their probability of participating in the workforce, where arthritis, back problems and other diseases of the musculoskeletal system were the top three conditions that would keep most people out of the labour force. The fundamental role of health in enabling labour force participation has, and will continue to be, a key concern for policymakers. For example, the Council of Australian Governments’ (COAG) current agenda for human capital and mature-age employment states that: “The foundation of the nation’s human capital is the health of its people. A strong economy requires a healthy current and future workforce”[5]. The current project provides much needed information about how many people will have the health capacity to work beyond the age of 65

Zooplankton diel vertical migration during Antarctic summer

Zooplankton diel vertical migration (DVM) during summer in the polar oceans is presumed to be dampened due to near continuous daylight. We analyzed zooplankton diel vertical distribution patterns in a wide range of taxa along the Western Antarctic Peninsula (WAP) to assess if DVM occurs, and if so, what environmental controls modulate DVM in the austral summer. Zooplankton were collected during January and February in paired day-night, depth-stratified tows through the mesopelagic zone along the WAP from 2009-2017, as well as in day and night epipelagic net tows from 1993-2017. The copepod Metridia gerlachei, salp Salpa thompsoni, pteropod Limacina helicina antarctica, and ostracods consistently conducted DVM between the mesopelagic and epipelagic zones. Migration distance for M. gerlachei and ostracods decreased as photoperiod increased from 17 to 22 h daylight. The copepods Calanoides acutus and Rhincalanus gigas, as well as euphausiids Thysanoessa macrura and Euphausia crystallorophias, conducted shallow (mostly within the epipelagic zone) DVMs into the upper 50 m at night. Rhincalanus gigas, T. macrura, and L. h. antarctica DVM behavior was modulated by chlorophyll a concentration, mixed layer depth, and depth of the subsurface chlorophyll a maximum, respectively. Carnivorous and detritivorous taxa – including the calanoid copepod Paraeuchaeta antarctica, ostracods, chaetognaths, and Tomopteris spp. polychaetes – as well as seasonally migrating copepods, were most abundant in the mesopelagic zone regardless of the diel cycle. Paraeuchaeta antarctica underwent reverse DVM within the top 100 m. The impacts of Antarctic zooplankton summer DVM and the resident mesopelagic assemblage on carbon export should be better quantified