title: The labor productivity effects of chronic backache in the United States.
abstract: OBJECTIVE
  Back pain afflicts approximately 31 million Americans, and is the number one cause of activity limitation in young adults. Little is known about the labor productivity costs associated with this chronic disease. Such information could provide useful input to employers considering alternative health benefits plans for managing their employees' health care needs. The goals of this study were to generate employee-level as well as national estimates of the labor productivity losses associated with chronic back ache.
  
  
  METHODS
  Multivariate methods were used to isolate the effects of chronic backache on employment status and disability days. These results were combined with information on earnings to generate labor productivity cost estimates associated with chronic backache. The study used data from the National Medical Care Expenditure Survey (NMES), which provides information on health status, health care utilization and cost, work, disability, and sociodemographic characteristics for a nationally representative sample of the noninstitutionalized civilian population of the United States in 1987.
  
  
  RESULTS
  Average annual productivity losses per worker due to chronic backache were $1,230 for male workers, measured in 1996 dollars, and $773 per female worker. These figures translated into aggregate annual productivity losses from chronic backache of approximately $28 billion in the United States.
  
  
  CONCLUSIONS
  The labor productivity losses from chronic backache differed by gender and other sociodemographic characteristics. The aggregate labor productivity losses associated with chronic backache were quite large and comparable to estimates of the direct medical costs associated with treating this chronic illness.
authors.affiliation: Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520, USA. John.Rizzo@Yale.edu
authors.forename: J A
authors.initials: JA
authors.lastname: Rizzo
authors.forename: T A
authors.initials: TA
authors.lastname: Abbott
authors.forename: M L
authors.initials: ML
authors.lastname: Berger
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000191:economics* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004526:Efficiency; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000191:economics* / Q000453:epidemiology; D018582:Sick Leave / Q000191:economics*; D014481:United States / Q000453:epidemiology