Allan Garland, MD,  MA  Professor of Medicine & Community Health Sciences Co-Head, Section of Critical Care Medicine University of Manitoba

Heart Attacks and Stroke Cause Blows to Financial Health Interview with:

Allan Garland, MD,  MA  Professor of Medicine & Community Health Sciences Co-Head, Section of Critical Care Medicine University of Manitoba

Dr. Garland

Allan GarlandMD,  MA 
Professor of Medicine & Community
Health Sciences
Co-Head, Section of Critical Care Medicine
University of Manitoba What is the background for this study?

Response: Heart attacks, strokes and cardiac arrest are common acute health events.  Most studies of serious acute health events look at outcomes such as death and how long is spent in the hospital.  But for working age people, the ability to work and earn income are very important outcomes that have rarely been studied.

We set out to carefully measure, across Canada, how much heart attacks, strokes and cardiac arrests affect the ability of working age people to work and earn. What are the main findings? 

Response: Compared to working age people with similar characteristics who did not experience any of the three acute health events, individuals who did experience them and were alive at least three years later were less likely to be working, and whether they were working or not, they had lower average earnings.

Out of 100 such people, 5 to 20 fewer were still working.  Their average annual earnings were $3800-13,300 less, which represented drops of 8-31% of their pre-event earnings.  These effects were largest for stroke survivors, smallest for heart attack survivors, and in between for survivors of cardiac arrest.  These losses of the ability to work and earn were greater for people who had lower income before the events, had more chronic medical disorders, and needed more or longer hospital care for their acute health events. What should readers take away from your report?

Response: Unemployment and lost earnings from common acute health events have broad consequences across society. For those who are affected, the financial effects of such health events extend as far as causing bankruptcy.  Earnings losses can start a sequence of events that further worsens health.  The costs of lost productivity among workers who survive such acute health events are also borne by employers and governments.  Also, our identification of groups who are more likely to experience larger effects on their ability to work and earn may assist in targeting interventions, policies and legislation to promote return to work. What recommendations do you have for future research as a result of this work?

Response: Although earnings are the great majority of total income for most Canadians, they do not represent the entire picture; future studies should evaluate other sources of household earnings, investment income, disability and other insurance payments, and other financial supports.  Also, because these effects differ by health event and possibly by country, much work remains to form a more complete understanding of the economic effects of acute illnesses.

None of the authors have any conflicts or interest or other disclosures to make.


Effects of cardiovascular and cerebrovascular health events on work and earnings: a population-based retrospective cohort study

Allan GarlandSung-Hee JeonMichael StepnerMichelle RotermannRandy FransooHannah WunschDamon C. ScalesTheodore J. Iwashyna and Claudia Sanmartin

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Jan 7, 2019 @ 4:22 pm

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