Background/Purpose: Systemic lupus erythematosus (SLE) predominantly develops in young groups, when many are establishing themselves in the workforce and can have a devastating impact on employment. We studied the impact of sociodemographic factors on work loss in SLE, the general public, and other major chronic conditions. 

Methods: The Georgians Organized Against Lupus (GOAL) cohort is derived predominantly from the population-based Georgia Lupus Registry and collects annually self-reported measures from validated patients with SLE. The Behavioral Risk Factor Surveillance System (BRFSS) survey samples representative individuals from the general population on self-reported health conditions and behaviors. We studied GOAL SLE participants who lived in the Atlanta metropolitan area surveyed between August 2011 and April 2012, and 4 BRFSS samples (general population and self-reported diabetes, asthma, and cardiovascular disease [CVD]) from the same geographic area, surveyed between 2005-10. The effect of sociodemographic factors on being unemployed/disabled at survey completion in SLE and BRFSS participants aged >18 and <65 was analyzed with logistic regression. We reported the adjusted odds ratios (OR) of being unemployed/disabled for each sociodemographic variable within SLE and 4 BRFSS samples.

Results:

	SLE n=630	General n=6339	Diabetes n=473	Asthma n=783	CVD n=244
Age, mean	45	41	49	38	51
Females %	94	52	51	57	49
Whites %	19	59	51	61	46
Blacks %	81	42	49	39	54
Education ≤high school %	35	23	30	28	34
Unemployed/disabled% (95% CI)	47 (43-50)	12 (11-13)	23 (18-28)	19 (14-23)	33 (25-42)
OR (95% CI) of unemployed/disabled1
Age (Per 5 year increase)	1.1 (1.0-1.2)	1.1 (1.1-1.2)	1.1 (1.0-1.3)	1.2 (1.1-1.3)		0.9 (0.7-1.2)
Gender (Male vs Female)	1.2 (0.6-2.4)	1.2 (0.9-1.5)	0.9 (0.5-1.7)	2.0 (1.0-3.9)		1.0 (0.5-2.2)
Race (Black vs White)	2.7 (1.7-4.3)	1.9 (1.4-2.5)	1.0 (0.6-2.0)	1.7 (0.9-3.2)		1.5 (0.7-3.1)
Marital Status (Married vs other2)	0.5 (0.4-0.7)	0.5 (0.4-0.6)	0.4 (0.2-0.7)	0.3 (0.2-0.7)		0.2 (0.1-0.4)
Education (≤High School vs >High School)	2.1 (1.5-3.0)	3.0 (2.3-3.9)	4.0 (2.2-7.3)	2.9 (1.5-5.7)		2.5 (1.1-5.8)

¹ Adjusted by the other sociodemographics

² never married, separated, divorced, widowed

Conclusion: The burden of unemployment/disability was significantly higher in SLE than in other chronic diseases, even when the mean age of SLE and the education level were similar across groups. Less than 1/3 of individuals with diabetes, asthma and CVD were unemployed, as compared to almost 50% of SLE. Black race was associated with unemployment/disability in SLE and the general population, but not in other chronic diseases. Lower education and not being married increased the risk of unemployment/disability in all groups. Important factors, such as disease severity, treatment response, or access to care in black patients with SLE must be further explored in order to reduce the burden of work loss in SLE.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/work-loss-in-systemic-lupus-erythematosus-the-general-public-and-other-chronic-conditions/