Labor Economics

Effect of multiple sclerosis on income

Typically, people focus on how severe diseases affect their health.  Clearly, however, poor health also can affect people’s income as well as some disease makes holding a job difficult or impossible.  Even people in good health with serious diseases may lower income if they need to miss work frequently for frequent doctor’s appointments.

In fact, this is what a study by Landfeldt et al. (2017) found when studying patients with multiple sclerosis (MS) in Sweden.   They used data from the Swedish Multiple Sclerosis Registry to measure trends in patient incomes before and after a diagnosis with multiple sclerosis.  They compared these trends with healthy individuals from the Swedish Total Population Register.  MS patients were matched with healthy counterparts on a 1:10 ratio based on individual age, sex, and region. Specifically, the authors fitted:

two linear mixed-effects regression models to the longitudinal data to explore determinants of gross salary among patients with MS by sex. Random effects were specified at the patient level, as well as for each year of follow-up…To control for fixed effects, the models were adjusted for age, university education, marital status, Expanded Disability Status Scale (EDSS) score, comorbidities, and calendar year.

The authors also used a Cox proportional hazard model to measure time until zero income.  Using these approaches, they found that:

…patients with MS had €5,130 less gross salary per year compared with controls, ranging from a loss of €2,430 the first year to €9,010 after 11 years…The proportion of patients and general population controls with zero gross salary was similar at index (16% vs. 16%; P = 0.473), but diverged markedly during follow-up post-index, ranging from 22% in the second year to 45% after 10 years for patients, and from 18% to 32% for controls.

Getting sick causes a ‘double whammy’.  Not only do you have to deal with the physical symptoms of illness, but one’s income also declines just at the time when one could use these additional funds to pay for needed treatments.


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