Diabetes associated with early labor-force exit: a comparison of sixteen high-income countries

Health Aff (Millwood). 2014 Jan;33(1):110-5. doi: 10.1377/hlthaff.2013.0518.


The economic burden of diabetes and the effects of the disease on the labor force are of substantial importance to policy makers. We examined the impact of diabetes on leaving the labor force across sixteen countries, using data about 66,542 participants in the Survey of Health, Ageing and Retirement in Europe; the US Health and Retirement Survey; or the English Longitudinal Study of Ageing. After matching people with diabetes to those without the disease in terms of age, sex, and years of education, we used Cox proportional hazards analyses to estimate the effect of diabetes on time of leaving the labor force. Across the sixteen countries, people diagnosed with diabetes had a 30 percent increase in the rate of labor-force exit, compared to people without the disease. The costs associated with earlier labor-force exit are likely to be substantial. These findings further support the value of greater public- and private-sector investment in preventing and managing diabetes.

Keywords: Epidemiology; Public Health; Workforce Issues.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cost of Illness
  • Costs and Cost Analysis
  • Cross-Cultural Comparison*
  • Cross-Sectional Studies
  • Diabetes Mellitus / economics*
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / prevention & control
  • Europe
  • Female
  • Humans
  • Life Expectancy
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pensions / statistics & numerical data
  • Proportional Hazards Models
  • Retirement / economics*
  • Retirement / statistics & numerical data*
  • Socioeconomic Factors