Reduced Healthy Working Life Expectancy with Arthritis Save

Key Takeaways

• Arthritis can be disabling enough to prevent people from working, but the factors influencing employability in this population have not been well studied.
• This study used data from the long-running Health and Retirement Study to estimate "healthy working life expectancy" (HWLE) for people with arthritis, including major subgroups.
• HWLE was found to be markedly diminished for people with arthritis, and especially so for arthritis patients not finishing high school, those with obesity, and Black individuals.
• People with arthritis face a dramatically shortened working life compared with other individuals, researchers found, putting numbers to a familiar phenomenon that hadn't previously been quantified.

Using the long-running, U.S.-based Health and Retirement Study (HRS), which enrolls people age 50 and older, as the data source, Ross Wilkie, PhD, of Keele University in Staffordshire, England, and colleagues estimated that those reporting an arthritis diagnosis could expect just 6.18 more years of being able to work without physical limitations, compared with 11.71 years for those without arthritis.

This gap was even bigger for certain subgroups: people with obesity, those not finishing high school, Black individuals, and women, the researchers reported in ACR Open Rheumatology.

"Variation in the amount of time in a healthy and working state by sociodemographic factors suggests that there are approaches that can increase HWLE [healthy working life expectancy]," they wrote. Except for obesity, however, the factors identified in the study as associated with shortened HWLE would be difficult if not impossible to modify once arthritis has developed, and the investigators didn't suggest specific interventions targeting them.

Wilkie and colleagues did note that employers could do a lot to accommodate workers with arthritis, but mainly the authors called for more research on ways to improve patients' employability. "Research is required to understand -- not just in those with arthritis and obesity but also in the general population -- how health, sociodemographic, workplace, and environmental factors combine to drive being healthy and in work," they explained, including the reasons behind absenteeism and "presenteeism," in which people go to work but are less productive.

The group's estimates were based on the HRS, which surveys a new group of participants every 2 years; data from 1994 to 2020, comprising some 37,000 Americans overall, were analyzed. Two-thirds said they had received a diagnosis of arthritis (the study didn't distinguish among subtypes such osteoarthritis and rheumatoid arthritis). Some 45% were men and 72% were white.

To develop estimates of overall life expectancy and HWLE, the authors used cross-sectional data for participants at ages 50, 55, 60, and 65, establishing the proportions who reported being "healthy" -- that is, free of physical impairments that limit their ability to work -- or otherwise, and who were actively working at each interval. These were also calculated for sociodemographic subgroups defined by sex, geography, education, race-ethnicity, and obesity.

For men overall, HWLE for people without arthritis was estimated to be 12.36 years, compared with 6.10 years for those with arthritis. Corresponding values for women were 11.12 and 6.05 years, respectively. Wilkie and colleagues also divided HWLE into overall life expectancy to get a view of how much remaining life could be spent on the job and feeling good: the results for men were 41% without arthritis and 22% with, and for women, 33% without arthritis and 19% with. 

Lack of a high school diploma was also especially damaging in the context of arthritis. For men, this meant HWLE of 9.86 years for people without arthritis and 2.41 years for those with the condition. Among women, the figures were 7.22 versus 3.72 years, respectively. Wilkie and colleagues commented that diminished HWLE for people without a high school education wasn't a surprise, given that manual labor is often the only employment available for these individuals, and arthritis takes an especially heavy toll on the ability to perform such work.

The study also showed regional differences in HWLE rates, with the Northeast having the highest numbers and the Midwest with the lowest. However, the gaps between estimates for people with arthritis versus without were about the same across regions, except for being a bit smaller in western states (e.g., 3.5 years for men compared with 6-7 years elsewhere).

Black men with arthritis could expect just 3.51 years of healthy working life, versus 6.88 years for white men with arthritis; notably, though, HWLE was also shorter for Black men without arthritis relative to white counterparts, and thus the difference made by arthritis was only 1 year greater for Black men versus white men.

Finally, the study also identified obesity as a negative influence on HWLE, best seen through HWLE's percentage of overall life expectancy. This was 18% for men with obesity and arthritis, as opposed to 24% for the man without obesity and arthritis.

Limitations to the study included its reliance on cross-sectional data obtained from different participants over time, and over a period when treatments have changed, especially for inflammatory arthritis; the data were not adjusted for medications or other therapies participants may have received. Arthritis diagnoses, employment status, limitations on work ability, and other data were self-reported and not objectively confirmed. Subgroups smaller than those noted above could not be meaningfully analyzed because of insufficient numbers.

Source Reference: Wilkie R, et al "How long do people with arthritis stay healthy and in work? Analysis of data from the Health and Retirement Study" ACR Open Rheumatol 2026; DOI: 10.1002/acr2.70142.