How Long Do People With Arthritis Stay Healthy and in Work? Analysis of Data From the Health and Retirement Study

Objective To estimate healthy working life expectancy (HWLE; the average number of years that adults from age 50 years can expect to be healthy and in paid work) in the United States for people with arthritis overall and by sex, education, ethnicity, region, and obesity status. Methods Longitudinal survey data (14 waves of the Health and Retirement Study) for adults aged ≥50 years were used. “Healthy” and “working” were defined as no limiting long-standing illness and employment/self-employment, respectively. Age-adjusted, continuous-time, five-state models were fitted using Interpolated Markov Chains ( IMaCh) software, a maximum likelihood modeling program using interpolation of Markov Chains, to estimate hazards of transitions out of the healthy and working state based on arthritis status (and the covariates sex, ethnicity, region, education, and obesity status). Results Weighted values are for 37,062 participants across 14 waves. HWLE at age 50 years for people with arthritis was almost half that for those without arthritis (6.18 years [95% confidence interval (CI) 6.06–6.30 years] vs 11.71 years [95% CI 11.56–11.86 years]). Those with both obesity and arthritis had the smallest HWLE values at age 50 years. Conclusion The extent of reduction in a healthy and working state highlights the societal impact of arthritis. Variation in the amount of time in a healthy and working state by sociodemographic factors suggests that there are approaches that can increase HWLE. Further exploration of workplace factors and employment opportunities may lead to strategies to reduce the impact of arthritis on healthy working lives.