Healthy working life expectancy at age 50 for people with and without osteoarthritis in local and national English populations

Retirement ages are rising in many countries to offset the challenges of population ageing, but osteoarthritis is an age-associated disease that is becoming more prevalent and may limit capacity to work until older ages. We aimed to assess the impact of osteoarthritis on healthy working life expectancy (HWLE) by comparing HWLE for people with and without osteoarthritis from ages 50 and 65 nationally and in a local area in England. Mortality-linked data for adults aged ≥ 50 years were used from six waves (2002–13) of the English Longitudinal Study of Ageing and from three time points of the North Staffordshire Osteoarthritis Project. HWLE was defined as the average number of years expected to be spent healthy (no limiting long-standing illness) and in paid work (employment or self-employment), and was estimated for people with and without osteoarthritis and by sex and occupation type using interpolated Markov chain multi-state modelling. HWLE from age 50 years was a third lower for people with osteoarthritis compared to people without osteoarthritis both nationally (5.68 95% CI [5.29, 6.07] years compared to 10.00 [9.74, 10.26]) and in North Staffordshire (4.31 [3.68, 4.94] years compared to 6.90 [6.57, 7.24]). HWLE from age 65 years for self-employed people with osteoarthritis exceeded HWLE for people without osteoarthritis in manual or non-manual occupations. Osteoarthritis was associated with a significantly shorter HWLE. People with osteoarthritis are likely to have significantly impaired working ability and capacity to work until older ages, especially in regions with poorer health and work outcomes.