Household income losses associated with ischaemic heart disease for US employees

Objective: To estimate the cost of lost work days due to ischaemic heart di sease (IHD), and the cost of this reduced productivity using reduction in h ousehold income. Design and setting: Using 2 years of nationally representative observationa l data, this study examined the effect on household income of IHD. This eff ect was estimated after accounting for unemployment, days lost to illness a nd other effects of illness on the income of workers aged 18 to 64 years. Main outcome measures and results: Previous measures of indirect costs of d isease have typically not included the loss in productivity due to suboptim al work performance. Among workers in this age group, IHD was associated wi th a reduction of $US3013 in annual household income; this reduction was in dependent of occupational class, age, size of household and educational lev el. Such a reduction may be because of reduced on-the-job performance, empl oyer perception of this, or unrelated lifestyle choices. It represents an e stimated $US6.05 billion annual loss in productivity in 1992 dollars (or $U S6.45 billion in 1996 dollars). Conclusions: Estimates of the indirect costs of chronic disease that do not account fully for the lost income of employees may significantly underesti mate the benefits to employers and society of treatment and prevention.