Racially Charged Police Enforcement Has Cost the U.S. Economy $53 Billion to $220 Billion in Lost Productivity

There is a major difference in the drug arrest rate and incarceration rates between Black and White individuals. However, the drug use rate across the two groups is similar (and has been over time). This study estimates the lost productivity over time of people arrested on drug charges because they are Black. Ceteris Paribus, if those using the drugs were White, instead of Black, at the point of arrest and incarceration, what would have been their additional productivity levels over their lives? In this study I estimate this lost productivity to be $53 billion to $220 billion from 1980–2018 (in 2019-dollars), suggesting that the Lucas wedge is substantial for racial drug arrests.

Development and testing of the aerial porter exoskeleton

Back pain is one of the largest drivers of workplace injury and lost productivity in industries around the world. Back injuries were one of the leading reasons in resulting in days away from work at 38.5% across all occupations, increasing for manual laborers to 43%. While the cause of the back pain can vary across occupations, for materiel movers it is often caused from repetitive poor lifting. To reduce the issues, the Aerial Porter Exoskeleton (APEx) was created. The APEx uses a hip-mounted, powered exoskeleton attached to an adjustable vest. An onboard computer calculates the configuration of the user to determine when to activate. Lift form is assisted by using a novel lumbar brace mounted on the sides of the hips. Properly worn, the APEx holds the user upright while providing additional hip torque through a lift. This was tested by having participants complete a lifting test with the exoskeleton worn in the “on” configuration compared with the exoskeleton not worn. The APEx has been shown to deliver 30 Nm of torque in lab testing. The activity recognition algorithm has also been shown to be accurate in 95% of tested conditions. When worn by subjects, testing has shown average peak reductions of 14.9% BPM, 8% in VO2 consumption, and an 8% change in perceived effort favoring the APEx.

Disadvantaged Americans are suffering the brunt of rising pain and physical limitations

Using data from three national surveys of US adults (one cohort and two cross-sectional studies, covering the period from the mid-1990s to the mid-2010s), we quantify the degree to which disparities by socioeconomic status (SES) in self-reported pain and physical limitations widened and explore whether they widened more in midlife than in later life. Unlike most prior studies that use proxy measures of SES (e.g., education), we use a multidimensional measure of SES that enables us to evaluate changes over time in each outcome for fixed percentiles of the population, thereby avoiding the problem of lagged selection bias. Results across multiple datasets demonstrate that socioeconomic disparities in pain and physical limitations consistently widened since the late 1990s, and if anything, widened even more in midlife than in late life (above 75). For those aged 50–74, the SES disparities in most outcomes widened by more than 50% and in some cases, the SES gap more than doubled. In contrast, the magnitude of SES widening was much smaller above age 75 and, in the vast majority of cases, not significant. Pain prevalence increased at all levels of SES, but disadvantaged Americans suffered the largest increases. Physical function deteriorated for those with low SES, but there was little change and perhaps improvement among the most advantaged Americans. At the 10th percentile of SES, the predicted percentage with a physical limitation at age 50 increased by 6-10 points between the late-1990s and the 2010s, whereas at the 90th percentile of SES, there was no change in two surveys and in the third survey, the corresponding percentage declined from 31% in 1996–99 to 22% in 2016–18. The worst-off Americans are being left behind in a sea of pain and physical infirmity, which may have dire consequences for their quality of life and for society as a whole (e.g., lost productivity, public costs).

The relationship between headache-attributed disability and lost productivity: 2. Empirical evidence from population-based studies in nine disparate countries

Background Headache disorders are disabling, with major consequences for productivity, yet the literature is silent on the relationship between headache-attributed disability and lost productivity, often erroneously regarding the two as synonymous. We evaluated the relationship empirically, having earlier found that investment in structured headache services would be cost saving, not merely cost-effective, if reductions in headache-attributed disability led to > 20% pro rata recovery of lost productivity. Methods We used individual participant data from Global Campaign population-based studies conducted in China, Ethiopia, India, Nepal, Pakistan and Russia, and from Eurolight in Lithuania, Luxembourg and Spain. We assessed relationships in migraine and probable medication-overuse headache (pMOH), the most disabling common headache disorders. Available symptom data included headache frequency, usual duration and usual intensity. We used frequency and duration to estimate proportion of time in ictal state (pTIS). Disability, in the sense used by the Global Burden of Disease study, was measured as the product of pTIS and disability weight for the ictal state. Impairment was measured as pTIS * intensity. Lost productivity was measured as lost days (absence or < 50% productivity) from paid work and corresponding losses from household work over the preceding 3 months. We used Spearman correlation and linear regression analyses. Results For migraine, in a linear model, we found positive associations with lost paid worktime, significant (p < 0.05) in many countries and highly significant (p < 0.001) in some despite low values of R2 (0–0.16) due to high variance. With lost household worktime and total lost productivity (paid + household), associations were highly significant in almost all countries, although still with low R2 (0.04–0.22). Applying the regression equations for each country to the population mean migraine-attributed disability, we found pro rata recoveries of lost productivity in the range 16–56% (> 20% in all countries but Pakistan). Analysing impairment rather than disability increased variability. For pMOH, with smaller numbers, associations were generally weaker, occasionally negative and mostly not significant. Conclusion Relief of disability through effective treatment of migraine is expected, in most countries, to recover > 20% pro rata of lost productivity, above the threshold for investment in structured headache services to be cost saving.

Occupational health

Occupational health is the ‘promotion and maintenance of the highest degree of physical, mental, and social well-being of workers in all occupations’. Work-related ill-health and injuries cause considerable mortality and morbidity to workers worldwide, and are a major cause of disability, lost productivity, and sickness absence. In the occupational setting, workers may suffer from occupational diseases (those directly caused by workplace hazards); ‘work-related diseases’ (those that are multifactorial in origin with occupational exposures contributing to part of the aetiology); and non-occupational diseases that affect the general population. Primary, secondary, and tertiary preventive measures can be used to reduce the burden of disease at the workplace. Prevention of occupational ill-health requires an understanding of the work processes, the range and extent of exposures to hazards, and the steps that may be available to reduce exposure. It also requires recognition of vulnerable occupational groups such as workers in developing nations, migrant workers, child labour, women workers, and impaired workers. The standard hierarchy of control strategies for reducing exposure to workplace hazards includes elimination, substitution, isolation, engineering measures, administrative procedures, and personal protective equipment. The workplace can be a suitable venue for health promotion activities although this should not be at the expense of elimination and control of exposure to occupational hazards. As occupational health practice has evolved to consideration of health issues beyond the ‘factory gate’, the discipline now has much in common with environmental health and encompasses the philosophy and principles of good public health practice.

Neurological diseases, epidemiology, and public health

This chapter presents information for selected neurological conditions by referring to current or classic research papers. Conditions such as headache especially migraines have substantial public health impact because of the high prevalence, age groups affected, the associated lost economic productivity and the increase in disability-adjusted life years. Multiple sclerosis, a relatively common neurological disease, can affect individuals in young adulthood, decrease their productivity, and ultimately make them dependent on others. Traumatic brain injury occurring in youth or young adulthood can cause years of extra medical care in addition to lost productivity among those who survive the immediate event; in addition, repetitive trauma may cause chronic traumatic encephalopathy leading to dementia in later life. Epilepsy may have onset throughout one’s life course. While most causes are unknown, some may result from trauma or may be caused by specific genes, among other causes. While there are intractable forms of epilepsy, great strides have been made in preventing and managing seizures enabling patients to lead relatively full and normal lives. Neurodegenerative diseases, such as Parkinson’s disease and Alzheimer’s disease, are now acknowledged to begin 10–30 years prior to symptom onset. This will influence how risk factor studies are conducted and interpreted, which may offer earlier diagnostic potential. Effective treatments for the resulting clinical dementias that reduce productivity, functional ability, and independence from older individuals have not yet been realized. Without question, neurological diseases have substantial public health as well as grave personal impact.

Diabetes mellitus

Diabetes is an increasingly common, progressive metabolic disorder that results in a range of distressing symptoms, altered daily functioning, social and psychological impacts on individuals and their families, high healthcare expenditures, lost productivity, and premature mortality. Prevalence and absolute numbers of people with diabetes has grown worldwide, with no country or region spared. In this chapter, we review the data regarding diabetes burdens, describing patterns observed in low- and middle-income countries, and in high-income countries. We describe the major gaps that must be addressed, both in research and in implementation, to better detect, prevent, and treat diabetes. We describe what is known and yet unknown about vulnerable populations and describe efforts to address disparities in diabetes.

The lost productivity cost of absenteeism due to COVID-19 in health care workers in Iran: a case study in the hospitals of Mashhad University of Medical Sciences

Background Human resources management plays an important role in social development and economic growth. Absence from work due to health problems can make obstacles to the growth of economy. This study conducted aimed to estimate the absenteeism costs of COVID-19 among the personnel of hospitals affiliated to Mashhad University of Medical Sciences in Mashhad, Iran. Methods This cross-sectional study was conducted between February 19, 2020, and September 21, 2020. The absenteeism costs were calculated using the human capital approach. Finally, we applied the linear regression to assess the impact of variables on the lost productivity of absenteeism due to COVID-19 among the personnel of hospitals affiliated to Mashhad University of Medical Sciences. Results The results of this study showed that 1958 personnel had COVID-19. The total of absenteeism days in our study were 32,209 days, with an average of 16.44 absenteeism days. Total costs due to absenteeism were estimated to be nearly $1.3 million, with an average of $671.4 per patient. The results of regression model showed that gender (male), age (> 50 years), employment Type (non-permanent) and monthly income had a positive relationship with the absenteeism cost. Also, there are a negative significant relationship between absenteeism cost with job (physicians) and work experience. Conclusions Absenteeism costs of COVID-19 in the hospitals of Mashhad University of Medical Sciences represent a significant economic burden. The findings of our study emphasize the emergency strategies to prevent and control COVID-19 among the healthcare workers. It can decrease the economic impacts of COVID-19 and improve human resources management during the COVID-19 pandemic.

Estimated Cost Effectiveness of Influenza Vaccination for Emergency Medical Services Professionals

Introduction: Because of their frequent contact with compromised patients, vaccination against influenza is recommended for all healthcare workers. Recent studies suggest that vaccination decreases influenza transmission to patients and reduces worker illness and absenteeism. However, few emergency medical services (EMS) agencies provide annual vaccination, and the vaccination rate among EMS personnel remains low. Reticence among EMS agencies to provide influenza vaccination to their employees may be due in part to the unknown fiscal consequences of implementing a vaccination program. In this study, we sought to estimate the cost effectiveness of an employer-provided influenza vaccination program for EMS personnel. Methods: Using data from published reports on influenza vaccination, we developed a cost-effectiveness model of vaccination for a hypothesized EMS system of 100 employees. Model inputs included vaccination costs, vaccination rate, infection rate, costs associated with absenteeism, lost productivity due to working while ill (presenteeism), and medical care for treating illness. To assess the robustness of the model we performed a series of sensitivity analyses on the input variables. Results: The proportion of employees contracting influenza or influenza-like illness (ILI) was estimated at 19% among vaccinated employees compared to 26% among non-vaccinated employees. The costs of the vaccine, consumables, and employee time for vaccination totaled $44.19 per vaccinated employee, with a total system cost of $4,419. Compared to no vaccination, a mandatory vaccination program would save $20,745 in lost productivity and medical costs, or $16,325 in net savings after accounting for vaccination costs. The savings were 3.7 times the cost of the vaccination program and were derived from avoided absenteeism ($7,988), avoided presenteeism productivity losses ($10,303), and avoided medical costs of treating employees with influenza/ILI ($2,454). Through sensitivity analyses the model was verified to be robust across a wide range of input variable assumptions. The net monetary benefits were positive across all ranges of input assumptions, but cost savings were most sensitive to the vaccination uptake rate, ILI rate, and presenteeism productivity losses. Conclusion: This cost-effectiveness analysis suggests that an employer-provided influenza vaccination program is a financially favorable strategy for reducing costs associated with influenza/ILI employee absenteeism, presenteeism, and medical care.