Thank you for sitting, Europe! It costs €240 billion a year
The tentative and delicate green shoots of economic recovery are just about visible across some EU Member States. But a major driver of sustainable economic growth and recovery across the EU will be the speed with which these Member States can mobilise and deploy highly skilled, resilient and healthy workforces and rely on them to help deliver productivity growth and increased competitiveness. One challenge is that ageing workforces across the EU are also more likely to be constrained by a growing burden of chronic conditions which threatens work ability, productivity, social inclusion and labour market participation. Chief among these chronic conditions are musculoskeletal disorders (MSDs).
MSDs have such a profound and widespread impact on the productivity of ordinary workers that some now argue that sitting is the new smoking. Painful sitting positions in the office – often hunched over a keyboard – and repetitive movements with our arms and hands may lead to the development of a musculoskeletal disorder (MSD) such as Repetitive Strain Injury or lower back pain, and even put some workers at increased risk of experiencing periods of depression or anxiety. The data tell us that this is not a trivial problem. There are more than 100 million Europeans living with chronic musculoskeletal pain and in excess of 44 million have an MSD caused by their work. A worker with an MSD will often take several days off work, or perhaps come to work only to be less productive and worsen their condition. After being off sick for six weeks this worker is more likely to switch to disability benefits rather than return to work. In fact, MSDs have been confirmed as the primary cause of sickness absence and years lived with disability in Europe by numerous studies, including the Global Burden of Disease and our own Fit for Work research.
By 2030, half of the working-age population will be living with a chronic condition.
Currently, the European economy is losing around €240 billion to MSDs, which is about 2% of GDP according to the European Commission’s estimations. As the workforce ages and the retirement age is extended, the situation is set to worsen. By 2030, half of the working-age population of some EU countries will be living with a chronic condition which will challenge their ability to work. If workers with MSDs take longer periods of sickness absence from work or leave the labour force entirely, this can have costly implications for healthcare, welfare, employers and individuals. Yet many of these costs can be avoided with well-coordinated and early interventions.
The worst option is to wait until workers develop an MSD or until the condition has become so painful or chronic that little can be done to help them regain their previous mobility or function. Since 2007, The Work Foundation, through the Fit for Work Europe Coalition, has been advocating healthcare and workplace interventions for MSDs which support job retention and return to work. An innovative care model, Early Intervention, founded by Dr Juan Angel Jover and tested in Spain for two years demonstrated promising results. Sickness absence and permanent job loss related to MSDs were reduced by 39% and 50%, respectively. In addition, care costs for people enrolled in the Early Intervention programme were significantly lower, whilst the cost-benefit analysis showed that almost £10 was recouped for every £1 invested in the programme. Portugal, the UK, Latvia and Lithuania are now developing their own versions of the programme and tailoring its mechanics to their local requirements.
A unified EU Plan focusing on MSDs in the working age population could encourage and actively support all Member States to adopt an Early Intervention programme, but the Commission, the Parliament and the Council have been increasingly reluctant to engage on disease-specific initiatives. The Council launched the “Reflection process on chronic diseases” in December 2010 and invited Member States to join the debate around two areas – “health promotion and disease prevention”, “chronic disease management and exchange of good practice”. The final report was released in October last year and the Joint Action on Chronic Diseases was established to lead the action for health promotion and prevention. The chronic disease management issues should have been addressed in the form of the Council Conclusions under the Lithuanian Presidency, but they were put aside for future presidencies.
Commissioner Borg’s speech on “Efficient and Sustainable Health Care Systems in Europe 2020” in December last year and the announcement of the first ever Summit on Chronic Conditions organised by DG SANCO prompted hope that 2014 could be an opportunity for more ambitious policies against chronic conditions. The summit represents a double premiere since it is also the first time MSDs were given a place on the agenda alongside other major non-communicable diseases like cancer, diabetes, cardiovascular and respiratory diseases. The Fit for Work Europe speaker, Dr Juan Jover, and the Early Intervention model met with a warm and supportive audience on the first day of the summit. Despite the profile given to MSDs by the Summit, it remains to be seen whether the EU take a more joined-up approach to the management of chronic conditions – especially those which threaten labour productivity – and coordinate its work across the health, employment/welfare and finance functions to follow through the policy recommendations and best practices shared at this summit.
Professor Stephen Bevan, Founding President of Fit for Work Europe and Director of the Centre for Workforce Effectiveness at The Work Foundation, Lancaster University.