An Unhealthy America: The Economic Burden of ... - Milken Institute

An Unhealthy AmericaMilken InstituteThe indirect impacts are estimated on the basis of wage rates and output (GDP). To do this we multiply the number of lostworkdays by disease and wages per employee (GDP per employee). All through this section, we refer to wage-based impactevaluated at the average wage rates per employee. We take a similar approach when presenting results in terms of output.To estimate individual (EPRC) presenteeism, we rely on a 2004 study by Goetzel et al., 65 reporting disease-specific costs(in addition to treatment costs) related to absenteeism and presenteeism. In the following table, we provide absenteeismand presenteeism costs, as reported by the study. These are costs derived on an employee basis, meaning they arespread out across a firm’s entire work force.Costs Related to Absenteeism and PresenteeismCosts Related to Absenteeism and Presenteeism - US$ Per Employee, AnnualPer Employee, AnnualChronic Disease Expenditures Absenteeism PRC* Expenditures/PRCPresenteeismDisease Cancer (Billions) 4.5(Millions)(Thousands) 75.7Cancer Asthma 48.1 2.1 10.6 72.2 4.5Breast Respiratory Cancer Infections 5.5 27.5 1.1 33.3 4.8Colon Diabetes Cancer 3.9 19.2 0.3 158.8 11.5Lung Hypertension Cancer 6.3 46.7 0.4 246.7 17.1Prostate Heart Disease Cancer 4.3 19.2 1.0 70.5 4.1Other Cancers 28.0 7.7 3.6Emotional Disturbances 33.4 246.0Pulmonary Conditions 45.2 49.2 0.9Source: Journal of Occupational and Environmental Medicine, 2004Diabetes 27.1 13.7 2.0Hypertension 32.5 36.8 0.9Heart Disease 64.7 19.2 3.4We use disease-specific Stroke ratios of presenteeism to absenteeism 13.6 (from the 2.4 Goetzel study) and 5.6 our estimates from individuallost workdays to derive Mental indirect Disorders impacts due to individual 45.8presenteeism. 30.3 1.5Total 277.0 162.2 1.7Methodology for CaregiversPRC: Population Reporting ConditionTo determine the impact of caregiver lost workdays, we use estimates from two studies, the first conducted in 2004 byNational Alliance for Caregiving and AARP, 67 the second by Metlife in 2006. 68 The former measured the total number ofU.S. caregivers and determined the total to be 44.4 million (39 percent male, 61 percent female). Of those, 60 percent ofthe men and 41 percent of women are employed full time. The Metlife study concludes that 10 percent of male caregiversmiss, on average, nine workdays a year. Among female caregivers, 18 percent miss an average of 24.75 workdays. We usethese statistics to derive lost workdays at the national level.65. Goetzel et al. “Health, Absence, Disability, and Presenteeism Cost Estimates of Certain Physical and Mental HealthConditions Affecting U.S. Employers.” Journal of Occupational and Environmental Medicine. Vol 46. 2004.66. For example, the ratio of presenteeism to absenteeism from Goetzel et al. for cancer was almost 17 times. We multipliedthat ratio with our estimate of impact of an individual’s lost workdays for cancer ($6.1 billion) to obtain individual’spresenteeism for cancer (i.e., 17 x 6.1 = $103.7 billion).67. National Alliance for Caregiving (NAC) and AARP. “Caregiving in the U.S.” 2004.68. Metlife Mature Market Institute, National Alliance for Caregiving, 2006. “The Metlife Caregiving Cost Study: ProductivityLosses to U.S. Business.” See: http://www.caregiving.org/data/Caregiver%20Cost% 20Study.pdf.[ 128 ]