Productivity losses due to diabetes in urban and rural China

Abstract Objective: To provide the first estimates of the cost of productivity losses attributed to diabetes age 20-69 years old in urban and rural areas of China. Methods: Construct through life table modelling, expectancy life of diabetes sufferers, including the years of potential life lost and working years of life lost. Using the human capital approach, we measured the productivity losses attributed to absenteeism, presenteeism, labor force dropout and premature deaths due to diabetes of the population aged 20-69 years in urban and rural areas in China. Results: In 2017, we estimated that there were 100.46 million diabetes lost hours, with the total cost of productivity losses US$613.60 billion, comprising US$326.40 billion from labor force dropout, US$186.34 billion from premature death, US$97.71 billion from absenteeism, and US$27.04 billion from presenteeism. Productivity loss was greater in urban (US$490.79 billion) than rural areas (US$122.81 billion), with urban presenteeism (US$2.54 billion) greater than rural presenteeism (US$608.55 million); urban absenteeism (US$79.10 billion) greater than rural absenteeism (US$18.61 billion); urban labour force dropout (US$261.24 billion) greater than rural labour force dropout (US$65.15 billion) and urban premature death (US$147.90 billion) greater than rural premature death (US$38.44 billion). Conclusions: Diabetes had a large and significant negatively impact on productivity in urban and rural in China, with a significant gap in the level of diabetes management in urban compared to rural regions. Productivity loss was significantly higher in urban than rural regions. Further investment is required in the prevention, diagnosis and control of diabetes in under-resourced health services in rural locations and also in urban areas, where most diabetes cases reside. Specifically, targeted and effective diabetes prevention and management actions are urgently required.