Sheryl Ubelacker, the Canadian Press
Published: January 7, 2019
TORONTO (AP) – Middle-aged Canadians who have had a heart attack, stroke or cardiac arrest are less likely to work three years later, and those who can continue working often experience a significant drop in income, the researchers report.
In a 2005-2013 study published Monday in the Canadian Medical Association Journal, researchers evaluated the long-term effects of cardiovascular events such as a stroke on people's ability to work and any changes in their annual earnings.
One-third of heart attacks, one-fourth of strokes and 40 percent of cardiac arrest – where the heart suddenly stops beating – occur in people under the age of 65 and can result in persistent physical and / or cognitive disabilities.
"For people of working age, one of the most important things is the ability to work and earn," said lead author Dr. Allan Garland, a specialist in internal medicine at the University of Manitoba. "So it's a relevant long-term result."
The study linked Statistics Canada's hospitalization data and anonymous tax returns to compare more than 24,500 Canadians aged 40-61 who suffered a heart attack, stroke or cardiac arrest compared to their peers who did not have one.
Researchers looked at each person's annual job earnings for two years before the cardiovascular event, then compared them to three years of earnings later.
The numbers were then compared to those who were not affected by a heart attack, stroke, or cardiac arrest to determine the relative loss of income of the affected group.
"Three years after admission to the hospital for any of these health events, the people who survived were less likely than the paired participants to work and had greater losses in annual earnings," said Garland.
"The loss of revenue was substantial, with reductions varying from 8% to 31%. Even if people could work, their incomes in the third year after the event were 5% to 20% less than before."
The financial consequences of having a stroke were the most significant, with a 31% drop in purchasing power, against 23% in cardiac arrest and 8% in heart attack.
"And if you look at the effect on average annual incomes, it was $ 14,000 and change – that was 31% of your starting salary. So stroke patients were losing about a third of their income on average ".
That's because strokes, which damage brain cells, can potentially leave a person with a disability, including weakness on one side of the body, speech difficulties or cognitive difficulties.
Such deficits could mean that a factory worker who had a weak leg might no longer be able to perform physical tasks such as lifting or an office worker with an affected hand and arm could be unable to operate a computer, Garland of Winnipeg explained.
For Carole Laurin, a series of strokes at age 42 meant she had to leave her teaching job in Manitoba due to cognitive deficits and residual weakness on her left side that still affects her mobility.
Now 57, living in Ottawa, Laurin said she was lucky because her teacher's long-term pension covered physical, occupational, and neuropsychological therapy.
"I think I'm lucky because many stroke survivors I've met do not have a pension plan through their employer, so they're living off their CPP deficiency," she said. "They're fighting more than I am."
Still, even with her pension, Laurin had a 40% drop in income when she had to give up her career. And there was also the psychological blow.
"It took me two years to mourn the loss of never being able to work again. It was a tremendous loss, I still feel it."
Patrice Lindsay, director of system change and stroke at the Heart and Stroke Foundation, said it is not just the individual who has a cardiovascular event that can suffer financially.
There is also the family of the person – "the spouse who can not return to work because they have to provide more intensive care or the children of older people who have an economic impact if they have to take time off from work to help their parents or to take them to work, "she said.
Lindsay said she is enthusiastic about the University of Manitoba study because it provides measurable evidence on the financial consequences of heart disease and stroke that can be presented to the provinces in defense of change.
"A person of 40 or 45 is not ready to retire, but what we are missing out on in our system now is the widespread availability of targeted targeted professional rehab … which helps get them back to work," she said .
"We have heard many, many times about people having to burn their retirement savings to pay for their rehabilitation, so they can go back to work and have a higher functional level."
Garland said that unemployment and the loss of earning power due to common cardiovascular events have widespread social relevance, with consequences such as worsening patient health, possible bankruptcy and loss of tax revenue for governments.
"I think the goal here must be to understand the magnitude of these problems … and then institute policies to try to help these people get back to work."