Heart at­tack, stroke can harm earn­ing power


Lethbridge Herald - - BUSINESS - Sh­eryl Ubelacker THE CANA­DIAN PRESS — TORONTO

Mid­dle-aged Cana­di­ans who have had a heart at­tack, stroke or car­diac ar­rest are less likely to be work­ing three years later, and those who can keep work­ing of­ten ex­pe­ri­ence a sig­nif­i­cant drop in in­come, re­searchers re­port.

In a 2005-2013 study pub­lished this week in the Cana­dian Med­i­cal As­so­ci­a­tion Jour­nal, re­searchers eval­u­ated the long-term ef­fects of car­dio­vas­cu­lar events such as a stroke on peo­ple’s ca­pac­ity to work and any changes in their an­nual earn­ings.

One-third of heart at­tacks, a quar­ter of strokes and 40 per cent of car­diac ar­rests — in which the heart sud­denly stops beat­ing — oc­cur in work­ing-age peo­ple un­der 65 and can re­sult in lin­ger­ing 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, an in­ter­nal medicine spe­cial­ist at the Uni­ver­sity of Man­i­toba. “So it’s a rel­e­vant long-term out­come.”

The study linked Sta­tis­tics Canada hos­pi­tal­iza­tion data and anonymized tax re­turns to com­pare more than 24,500 Cana­di­ans aged 40 to 61 who had suf­fered a heart at­tack, stroke or car­diac ar­rest against their age­matched peers who had not ex­pe­ri­enced one of those life-threat­en­ing events.

Re­searchers looked at each per­son’s an­nual em­ploy­ment earn­ings for two years prior to the car­dio­vas­cu­lar event, then com­pared them to three years of earn­ings af­ter­wards.

The fig­ures were then com­pared to those for peo­ple who had not been af­fected by a heart at­tack, stroke or car­diac ar­rest to de­ter­mine the af­fected group’s rel­a­tive loss of in­come.

“Three years after ad­mis­sion to hospi­tal for any of these health events, peo­ple who sur­vived were less likely than the matched par­tic­i­pants to be work­ing and had greater losses in an­nual earn­ings,” Gar­land said.

“The loss in earn­ings was sub­stan­tial, with re­duc­tions rang­ing from eight per cent to 31 per cent. Even if peo­ple were able to work, their in­comes in the third year after the event were five per cent to 20 per cent less than be­fore.”

The fi­nan­cial fall­out from suf­fer­ing a stroke was the most sig­nif­i­cant, with a 31-per-cent drop in earn­ing power ver­sus 23 per cent for car­diac ar­rest and eight per cent for heart at­tack.

“And if you looked at the ef­fect on the av­er­age an­nual earn­ings, it was $14,000 and change — which was 31 per cent of their base­line salary. So stroke pa­tients were los­ing about a third on av­er­age of their in­comes.”

That’s be­cause strokes, which dam­age brain cells, can po­ten­tially leave a per­son with a dis­abil­ity, in­clud­ing weak­ness on one side of the body, im­paired speech or cog­ni­tive dif­fi­cul­ties.

Such deficits could mean a fac­tory worker left with a weak leg might no longer be able to per­form phys­i­cal tasks like lift­ing or an of­fice worker with an af­fected hand and arm could be un­able to op­er­ate a com­puter, Gar­land ex­plained from Win­nipeg.

For Ca­role Lau­rin, a se­ries of strokes at age 42 meant she had to leave her Man­i­toba teach­ing job due to cog­ni­tive deficits and resid­ual weak­ness on her left side that still af­fects her mo­bil­ity.

Now 57 and liv­ing in Ot­tawa, Lau­rin said she was for­tu­nate be­cause her teacher’s long-term dis­abil­ity pen­sion cov­ered physio, oc­cu­pa­tional and neu­ropsy­cho­log­i­cal ther­apy.

“I think I’m lucky be­cause a lot of stroke sur­vivors I’ve met don’t have a pen­sion plan through their em­ployer, so they’re liv­ing off their CPP dis­abil­ity,” she said. “They’re strug­gling more than I am.”

Still, even with her pen­sion, Lau­rin ex­pe­ri­enced about a 40-per-cent drop in in­come when she had to give up her ca­reer. And there was also the psy­cho­log­i­cal blow.

“It took me two years to grieve the loss of not ever be­ing able to work again. That was a tremen­dous loss, I still feel it.”

Pa­trice Lind­say, di­rec­tor of sys­tems change and stroke for the Heart and Stroke Foun­da­tion, said it’s not only the in­di­vid­ual who has a car­dio­vas­cu­lar event who can suf­fer fi­nan­cially.

There’s also the per­son’s fam­ily — “the spouse who can’t go back to work be­cause they have to pro­vide more in­tense care or the chil­dren of older peo­ple who have an eco­nomic im­pact if they have to take time off work to go help their par­ents or to take them to med­i­cal ap­point­ments,” she said.

Lind­say said she’s ex­cited about the Uni­ver­sity of Man­i­toba study be­cause it pro­vides mea­sur­able ev­i­dence about the fi­nan­cial con­se­quences of heart dis­ease and stroke that can be pre­sented to the prov­inces in ad­vo­cat­ing for change.

“A 40- or 45-year-old is not ready to re­tire, but what we’re miss­ing in our sys­tem right now is wide­spread avail­abil­ity of spe­cific tar­geted vo­ca­tional re­ha­bil­i­ta­tion ... that helps get them back to work,” she said.

“We’ve heard many, many times about peo­ple hav­ing to burn through their re­tire­ment sav­ings to pay for their re­hab so they can get back to work and have a higher func­tional level.”

Gar­land said unem­ploy­ment and lost earn­ing power due to com­mon car­dio­vas­cu­lar events have broad so­ci­etal rel­e­vance, with con­se­quences such as wors­en­ing health for pa­tients, po­ten­tial bank­ruptcy and loss of tax rev­enue for gov­ern­ments.

“I think that the goal here needs to be to un­der­stand the mag­ni­tude of these prob­lems ... and then in­sti­tute poli­cies to try to help these peo­ple get back to work.”

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