Findings from a West Virginia University research team suggest a possible link between leaving the workforce prematurely because of disabilities from non-life-threatening, work-related conditions and the development of serious health problems, even death.
The team, led by Dr. Christopher Martin, suggests the link has less to do with the disabling conditions and more to do with the social determinants of health from employment loss. “It’s a medical study with social implications,” Martin said.
Researchers looked at two of the most common conditions causing disabilities in people on workers’ compensation. The most recent study focused on carpal tunnel syndrome and was published in the Journal of Occupational Environmental Medicine. The previous study included data on low back pain.
“What we found was your overall risk of death was about 40% higher if you were disabled from those conditions than if you had the same diagnosis but were not disabled,” said Martin, program director of the WVU Occupational Medicine Residency Program and professor in the WVU School of Public Health and WVU School of Medicine. “Similarly, we saw specific increases in deaths from cancer and heart disease of a comparable magnitude. The highest relative increases were in suicides and overdose deaths.”
The research also shows an increase in deaths became greater the longer the people remained on disability.
“These conditions that people are being disabled from should not, in and of themselves, increase death rates,” Martin said. “However, when people leave work and their lives are not good, when they don’t see that they have a future, when they don’t see they have any opportunities, that’s the pattern of death that you see being elevated. Appalachia is ground zero for a lot of those problems.”
Martin decided to conduct the research after seeing what he called “a marked decline” in the overall health of several of his patients when they incurred work-related disability and transitioned out of their jobs.
“They often told me they weren’t leaving home and they became physically inactive,” Martin said. “They had weight gain and associated disorders such as diabetes.”
That’s when Martin saw the social determinants of health pattern emerge.
“Our identity is closely linked to the jobs we do and our feelings of self-worth are closely tied to work,” Martin said. “When you transition out of that and there’s no reason to go anywhere in the morning, you don’t see a bright future. You might start to wonder what your point is on this planet.”
Martin said the study brings to light the need for more awareness about the health implications associated with not working.
“When physicians are making decisions about whether or not someone should be working, we need to weigh the competing risks,” Martin said. “Even for non-health care people and policymakers, when we don’t mention the hazards of not working, we’re providing an incomplete picture.”
The study was funded by the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. Other researchers involved included SueAnn Woods, associate professor and doctoral capstone coordinator in the School of Medicine’s Division of Occupational Therapy; Dr. Chuanfang Jin, associate professor and associate program director in the School of Public Health’s Occupational Medicine and Occupational and Environmental Health Sciences; and Stephen Bertke and Dr. Lynne Pinkerton, NIOSH.
Martin has plans for a more refined review that includes other variables such as body mass index and tobacco use, and a separate study with the WVU Regional Research Institute focusing on workforce participation — the percentage of the population that is either working or actively looking for work — and health status.
“Until we have more West Virginians thinking their future is bright and they have lots of opportunities, we’re never going to get ahead of our public health problems,” Martin said. “That’s not something a physician can solve.”
MEDIA CONTACT: Linda Skidmore
Health Research Writer
WVU Research Communications
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