Issue 36 / 21 September 2015

CHRONIC illness, particularly in older workers, is a threat to productivity that could strip billions of dollars from the national economy over the next 15 years, according to new MJA research.
Researchers have forecast that an increasing burden of chronic illness in workers aged 45‒64 years would result in an additional 112 000 lost productive life years (PLYs) between 2010 and 2030. (1)
Using a microsimulation model, they estimated that the national impact of this lost workforce participation on gross domestic product would grow from $37.79 billion in 2010 to $63.73 billion in 2030. Back problems would be responsible for the greatest number of PLYs lost, followed by arthritis, then behavioural and mental disorders.
Professor Rosemary Calder, director of the Australian Health Policy Collaboration at Victoria University, told MJA InSight that despite many attempts to address prevention over the past 30 years “none have stuck”.
“We are still focused on responses to illness rather than to the interventions that are preventive”, she said.
Professor Calder welcomed the researchers’ emphasis on the economic impact of chronic conditions.
“This isn’t just the burden on individuals … it’s a question of what it does to our economy. It’s a national responsibility and therefore it needs to be a national investment.”
She said her organisation was working with a broad collaboration of chronic illness experts to identify the policy changes needed to “drive prevention as a critical central element of health care”, including a review of the targets and indicators in the WHO global action plan to prevent and control non-communicable diseases. (2), (3)
Professor James Dunbar, of Deakin University’s Health Service Implementation Research Unit, said the MJA research findings were a “call to action”, describing Australia’s investment in the prevention of chronic disease as “woeful”.
“It is high time we implemented what we know and can do to reduce cardiovascular disease, improve the screening programs for the three cancers [breast, cervical and bowel] and eliminate asthma deaths”, Professor Dunbar told MJA InSight.
“We should also reduce the gap in life expectancy for people with chronic and enduring mental health problems and do more to reduce the suicide rate.”
Health Minister Sussan Ley told MJA InSight that the federal government was committed to finding better ways to prevent common chronic diseases and to care for people with chronic and complex conditions.
Ms Ley said the recently released Primary Health Care Advisory Group discussion paper, which resulted from consultations with more than 2000 groups and individuals, modelled better outcomes for people living with chronic and complex health conditions. (4)
“The discussion paper will inform the government’s development of a healthier Medicare to better support people with complex and chronic diseases to ensure they receive the right care, in the right place at the right time”, Ms Ley said.
A Health Department spokesperson added that high-level policy initiatives were under way, including the National Strategic Framework for Chronic Conditions, to prioritise the national response to chronic diseases and identify the most appropriate ways to improve prevention, identification and management these diseases. “This work will provide the opportunity to consider a number of quality of life style issues, including workforce participation for those with chronic conditions”, the spokesperson said. (5)
Professor Andrew Wilson, director of the University of Sydney’s Menzies Centre for Health Policy and the Australian Prevention Partnership Centre, said chronic diseases and associated chronic conditions were the “biggest health problem” facing Australia.
“We know we can prevent a lot of that chronic disease,” he said. “Even if we just applied what we know now, we could get substantial reductions in future chronic disease rates.”
Professor Wilson said the MJA research highlighted the fact that prevention had benefits beyond health care cost savings.
However, he was cautious about the reliability of long-term forecasting, saying a lot could happen in 15 years, such as the substantial improvements in disability-free life expectancy that occurred between 1998 and 2012. (6)
“There is some good news as well as the caution that if we don’t do anything about this, there could be substantial loss of productivity”, Professor Wilson said.
(Photo: Marcin Balcerzak / shutterstock)

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