Background Systemic lupus erythematosus (SLE) predominantly develops in younger age groups, when many are establishing themselves in the workforce. The development of a chronic, autoimmune condition during this period can have a devastating impact on employment.
Objectives To determine the impact of SLE on employment loss from a large, population-based cohort.
Methods The source of data was from the 2011 annual patient-reported survey of the Georgians Organized Against Lupus (GOAL), an ongoing population-based cohort of patients with validated SLE in Atlanta, Georgia assembled from the Georgia Lupus Registry (GLR). The GLR is supported by the Centers for Disease Control and Prevention and designed to more accurately estimate the incidence and prevalence of SLE. In partnership with the state health department, the GLR was able to access protected health information without patient consent from hospitals (20), rheumatologists (35), nephrologists (10), dermatologists (20), commercial labs, and population databases. The GOAL cohort aims to assess the physical, psychological and socio-economic burden of SLE utilizing validated instruments. GOAL participants were surveyed between August and November of 2011 for this analysis. Employment status at time of SLE diagnosis and survey completion was assessed to define employment loss. Among those employed at SLE diagnosis, logistic regression analysis was used to study the association between socio-demographic factors and employment loss by the time of the 2011 survey. Employment loss was defined as receiving disability benefits (private or Social Security) or being unemployed if younger than 65.
Results 512 SLE patients were surveyed with a mean age of 47.3 (SD 13.4), 14.4 (SD 9.1) years of disease, and 14.2 (SD 2.9) years of education. 93.2% were female, 75.9% were black and 15.9% white. 3 Asians and 16 with unknown race were not included in the multivariate analysis. At the time of SLE diagnosis, 390 (76.2%) were working and 31(6.1%) were unemployed or retired. Among the 390 who were working at diagnosis, 109 (27.9%) were still working at survey completion (median time since diagnosis=12.7 years, IQR 8.5-19.4), while 47 (12.1%) were unemployed and 176 (45.1%) were receiving disability benefits. The median times from SLE diagnosis to employment loss and from employment loss to survey completion were 3.2 years (IQR 0.1-9.8) and 7.1 years (IQR 3.1-13.1), respectively. The remaining 58 were retired, a homemaker, student, unemployed ≥65 of age, or unable to classify.
Conclusions SLE has profound impact on employment. Black race, older age at diagnosis and lower education were associated with job loss. Additional study of factors that impact employment is warranted.
Disclosure of Interest None Declared
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