Financial impact of diabetes on the American economy

Sick days, disability, early retirement, and premature death of diabetic Americans born between 1931 and 1941 cost the country almost $133.5 billion by the year 2000, according to a new estimate by researchers with the University of Michigan (U-M) and the Department of Veterans Affairs (VA).

This analysis is the first to identify the staggering financial impact of diabetes on the economy using a single, consistent source of data -- the Health and Retirement Study (HRS), a national longitudinal study funded by the National Institute on Aging (NIA), part of the National Institutes of Health.

"This study is a stark reminder of the huge financial burden diabetes places on patients, their families, and society," Health and Human Services Secretary Tommy G. Thompson said. "Diabetes remains a serious and growing health threat, but there are simple steps we can all take, such as eating wisely and staying active, that can reduce the toll that diabetes takes on our lives."

"Understanding the economic impact of diabetes allows a more complete understanding of the cost-effectiveness of diabetes treatment programs and may provide a rationale for employers to begin to address workplace programs to improve health," according to the study by Sandeep Vijan, M.D., M.S., and colleagues.* The study, published in the December 2004 issue of Health Services Research, was funded by the Social Security Administration. Additional support for the researchers came from the NIA, the VA, and the Alzheimer's Association.

For the study, Vijan and U-M co-authors Rodney A. Hayward, M.D., and Kenneth M. Langa, M.D., Ph.D., looked at diabetes-associated mortality, disability, early retirement, and work absenteeism among a national household sample of older adults interviewed over an 8-year period as part of the HRS. Since 1992, HRS has conducted interviews every 2 years with a nationally representative sample of 22,000 Americans age 50 and older to assess major trends in health and economic well-being.

Between 1992 and 2000, the average person with diabetes lost $2,800 in wages due to early retirement, $630 due to sick days, and $22,100 due to disability. When these results were extended to all people with diabetes born between 1931 and 1941 -- 2.3 million people -- the total economic losses were $58.6 billion. The study also found that $60 billion in productivity losses occurred prior to 1992 in this group, suggesting a total productivity loss due to diabetes of nearly $120 billion.

Researchers excluded people who were already disabled at the start of the study due to diabetes. When the cost of the already disabled was added, the economic toll of the disease mounted to $133.5 billion over the entire lifetime of this group.

Since the analysis was limited to a narrow age group -- Americans born between 1931 and 1941 -- the total cost of lost productivity due to diabetes for all ages is much greater, the researchers note.

"This study makes excellent use of the longitudinal design of the HRS, one of the few studies that measures both health and economic factors in the same study, to demonstrate the huge negative economic impact that diabetes has on our society beyond the personal costs of illness and premature death," said Richard M. Suzman, Ph.D., NIA Associate Director for the Behavioral and Social Research Program. Other studies funded by NIA have shown that diabetes multiplies the cost of treating other diseases, he said.

The researchers note that improving health behaviors can prevent diabetes, and improving treatment can prevent many diabetes complications that are responsible for the huge losses in productivity. NIH and the Centers for Disease Control and Prevention (CDC), for instance, have joined forces on the National Diabetes Education Program, a federally funded program that includes over 200 partners at the federal, state, and local levels, working together to reduce the morbidity and mortality associated with diabetes (http://www.ndep.nih.gov/).

About 18.2 million Americans are estimated to have diabetes. With the aging of the population and the dramatic increase in obesity and sedentary lifestyles even among the young, the prevalence of diabetes is increasing at an epidemic rate. The CDC recently estimated that if current trends continue, one in three people born today will develop the disease. People with diabetes tend to be male, African American or Hispanic, and less educated, according to the new study.