Productivity Losses Due to Diabetes in Urban Rural China

Hongying Hao; Stephen Nicholas; Lizheng Xu; Anli Leng; Jingjie Sun; Zhiyan Han

doi:10.3390/ijerph19105873

Productivity Losses Due to Diabetes in Urban Rural China

Int J Environ Res Public Health. 2022 May 12;19(10):5873. doi: 10.3390/ijerph19105873.

Authors

Hongying Hao^{1

2

3}, Stephen Nicholas^{4

5

6

7}, Lizheng Xu^{8

9}, Anli Leng¹⁰, Jingjie Sun¹¹, Zhiyan Han¹²

Affiliations

¹ Graduate School, Shandong First Medical University & Shandong Academy of Medical Sciences, 6699 Qingdao Road, Jinan 250013, China.
² Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
³ NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China.
⁴ Australian National Institute of Management and Commerce, 1 Central Avenue Australian Technology Park, Eveleigh, NSW 2015, Australia.
⁵ Guangdong Institute for International Strategies, Guangdong University of Foreign Studies, 2 Baiyun North Avenue, Guangzhou 510420, China.
⁶ School of Economics and School of Management, Tianjin Normal University, No. 339 Binshui West Avenue, Tianjin 300387, China.
⁷ Newcastle Business School, University of Newcastle, Newcastle, NSW 2308, Australia.
⁸ School of Medical Science, The University of New South Wales, Kensington, NSW 2052, Australia.
⁹ The George Institute for Global Health, Newtown, NSW 2042, Australia.
¹⁰ School of Political Science and Public Administration, Institute of Governance, Shandong University, 72 Binhai Road, Qingdao 266237, China.
¹¹ Shandong Health Commission Medical Management Service Center, Jinan 250012, China.
¹² School of Health Care Security, Shandong First Medical University & Shandong Academy of Medical Sciences, 6699 Qingdao Road, Jinan 250013, China.

Abstract

Background: Productivity losses due to diabetes are increasing in China, but research about the impact of diabetes on productivity in urban and rural areas requires further in-depth study. This article provides the first estimate of the cost of productivity losses attributed to diabetes in individuals 20-69 years old in urban and rural areas of China.

Methods: The human capital approach is employed to measure the productivity losses attributed to absenteeism, presenteeism, labor force dropout, and premature deaths due to diabetes of the 20-69-year-old population of males and females in urban and rural areas of China. Based on the life table modelling, we calculate the years of potential life lost and working years of life lost of people with diabetes.

Results: In 2017, we estimated that there were 100.46 million people with diabetes, with the total cost of productivity losses being USD 613.60 billion, comprising USD 326.40 billion from labor force dropout, USD 186.34 billion from premature death, USD 97.71 billion from absenteeism, and USD 27.04 billion from presenteeism. Productivity loss was greater in urban (USD 490.79 billion) than rural areas (USD 122.81 billion), with urban presenteeism (USD 2.54 billion) greater than rural presenteeism (USD 608.55 million); urban absenteeism (USD 79.10 billion) greater than rural absenteeism (USD 18.61 billion); urban labor force dropout (USD 261.24 billion) greater than rural labor force dropout (USD 65.15 billion); and urban premature death (USD 147.90 billion) greater than rural premature death (USD 38.44 billion).

Conclusions: Diabetes has a large and significant negative impact on productivity in urban and rural China. Productivity loss is significantly higher in urban versus rural regions. Further investment is required in the prevention, diagnosis, and control of diabetes in under-resourced health services in rural locations as well as in urban areas, where most diabetes cases reside. Specifically, targeted and effective diabetes prevention and management actions are urgently required.

Keywords: diabetes; premature deaths; productivity losses.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Absenteeism
Adult
Aged
China / epidemiology
Diabetes Mellitus* / epidemiology
Efficiency*
Female
Humans
Male
Middle Aged
Rural Population
Young Adult

Grants and funding

This research was funded by Development and Revision of “Shandong Province’s Implementation Opinions on Deepening the Reform of the Medical Security System” grant number 332535.