Measuring the Burden of Work Disability: A Review of Methods, Measurement Issues and Evidence

This chapter describes issues and measures related to the burden of work disability. The burden encompasses working age adults whose engagement in the labour force is temporarily or permanently compromised due to a health condition. The burden includes both direct costs (i.e. health care, wage replacement benefits and rehabilitation services from various public and private insurance providers) and indirect costs (i.e. labour productivity and output losses). The full extent of the burden of disability can and does encompass non-financial and sometimes intangible outcomes such as individual role functioning outside of the paid-labour force and health-related quality of life. We touch on these matters, but focus on work disability burdens. A number of studies have investigated the financial impact of specific health conditions such as low back pain, depression, arthritis, and diabetes, but fewer studies have considered the financial impact of all health conditions. The few that have, find the costs to be substantial even though they have only been able to measure a part of the full burden. Given the magnitude of the costs to society, the issue of work disability and its prevention clearly warrants attention by policymakers, employers, labour representatives, and society at large.