Economic burden of disease by industrial sector & gender: Differences in quality-adjusted life years and associated costs

Introduction: The health and well-being of any workforce is shaped by exposures in and out of the workplace as well as predetermined sociodemographic circumstances. It is therefore expected that the burden of disease will vary considerably by industry sector. A comprehensive measure of the burden of disease is quality-adjusted life years (QALYs) – a standardized metric comprising both changing mortality and morbidity associated with healthcare interventions, lifestyle choices, job choice, or other characteristics. Objective: Estimate and compare differences in QALYs by gender and across the 8 National Occupational Research Agenda (NORA) industry sectors. Methods: Data from the 1997 – 2010 National Health Interview Survey (NHIS) were used to estimate QALYs for all workers by NORA sector. Differences in QALYs were calculated and translated into economic values using upper- and lower-bound estimates of societal willingness-to-pay per QALY. Results: Among NORA sectors, Wholesale and Retail Trade workers had the highest average QALYs remaining (36.0 years), while Mining was most disadvantaged with 31.7 QALYs remaining. Significant gender differences were also noted with male workers having an average of 4.34 fewer QALYs remaining than women. These gender- and industry-specific differences in health-adjusted life expectancy represent an average economic loss between $550,217-$1.044 million. Conclusion: Results provide a novel perspective on differences in health and longevity among workers and possibly other subgroups, which is helpful for designing workplace benefits and targeted health promotion efforts.