Depression, breast cancer and migraines among disease and health conditions impacting productivity

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Depression and cancer, alongside chronic conditions like sleep apnoea and migraines, are among the leading health burdens on the workforce and costing the economy billions of dollars in lost work and lowered productivity, preliminary research from Monash University has revealed.
Health economists have developed a "productivity index" to compare the economic burden of diseases in the hope of creating a more holistic approach to health care and in turn boost productivity.
Katie Thorpe was just 27 when she was diagnosed with breast cancer, balancing her career in digital communications with a "fantastic" flexible employer who gave her time off for treatment, and the ability to regularly work from home.
"During the first year of my intense treatment, I would say it was probably anywhere from four to six months that I had off, including my sick days," she said.
However, Katie faced another curveball, when her company was shut down and she eventually found a new job that required a commute.
"I would go to radiation at 7am in the morning, finish radiation, and then get on the train to go into the city. That was quite a slog," she said.
"In that job, there was not a lot of flexibility around start times and it was in the office by nine, otherwise it compromised my role."
She said finding a new job proved difficult once discussions around her diagnosis began.
"Once I was a good chance at a role I talked to them about … having stage 4 metastatic breast cancer and ... once we entered into those conversations about the flexibility or the concessions that would need to be made: it was crickets after that," she said.
She now does freelance work from home.
"Work is such an important part of my life still, it's obviously a necessity for things like paying my medical bills, being able to make the most of my life as it still remains," she said.
"It can become pretty lonely and very isolated, when you are in the cancer world.
"Having to live in this limbo of continuing to work until I'm not able to, just makes me more determined to want to give back and do that while I can and maintain that sense of connection and giving back to society while I can still be a part of it."
Health economist and epidemiologist Professor Zanfina Ademi said they found disease had a "profound impact" on women returning to work.
"In the first five years after the first [breast cancer] diagnosis, every year women have lost half a year of their productivity," she said.
"That improved in the next five years, so then the productivity went up 73 per cent."
The first-of-its-kind study revealed that of the estimated 10,372 working-age Australian women diagnosed with breast cancer in 2022, they would collectively lose $1.4 billion in salary over the 10-year period after diagnosis.
The research team found the impact on GDP over the same period was $3.2 billion.
Breast Cancer Network Australia (BCNA) CEO Kirsten Pilatti said for those living with metastatic breast cancer, it meant life-long complications.
"[There are] more than 16,000 people just in NSW, Queensland and Victoria alone living with metastatic disease, who will have treatment forever, and so that really does change how they may dip in and out of our economy," she said.
"It represents billions of dollars in economic loss in having women with breast cancer not working in the system."
It's not just breast cancer costing the economy in lost productivity.
Diseases assessed so far through a productivity lens by Monash University showed some of the most burdensome diseases and illnesses, using a novel measure of "productivity adjusted life years" (PALYs).
1.0 means fully productive
• Breast cancer: 0.51 (first five years)
• Acute myeloid leukaemia: 0.52
• Kidney disease: 0.531-0.74
• Depression and/or mental health: 0.660-0.681
• Knee osteoarthritis: 0.67
• Epilepsy: 0.75
• Chronic migraine: 0.84
• Sleep apnoea: 0.84
• Sudden cardiac arrest: 0.86
• Episodic migraine: 0.88
*All single studies using different assumptions
Further to this, a Finnish study co-authored by Professor Ademi, found depression and other mental health issues caused the greatest productivity losses among eight chronic conditions surveyed.
The impact was far more significant in women than men, particularly in the 35-64 age group.
"When we compared across diseases, depressions or other mental health disorders and depression for paid and unpaid work showed it had the greatest impact on productivity loss and the productivity loss was more obvious in women than in men," she said.
Migraines, which affect one in three women, equated to a loss over 10 years of $53,000 per person.
While sleep apnoea, which is most prevalent in men and linked to cardiovascular disease, created a substantial lifetime work productivity burden.
"The cumulative impact on productivity is huge, these diseases are so debilitating," Professor Ademi said.
Researchers say the economic burden of these illnesses isn't just about missing work — it also includes reduced performance on the job and people leaving the workforce entirely.
"If we're talking about a woman who is suffering from endometriosis or problematic periods, then she has terrible stomach cramps, inability to focus and concentrate," Jean Hailes for Women's Health Dr Sarah White said.
"If we're talking about a woman with migraine for example, which disproportionately affects women, we're talking about severe headaches along with vomiting, things like that. So literally, physically cannot turn up to work."
Reproductive health issues like severe menstrual pain, menopause, perimenopause and endometriosis, have an extraordinary impact on productivity, according to research led by Curtin University.
"For this study, we undertook to survey employees across the healthcare workspaces and directly ask about whether or not people were facing each of these conditions and what affects those conditions," Director of the Bankwest Curtin Economics Centre, Professor Alan Duncan, said.
"We found that the aggregate impact in terms of lost productivity exceeded $21 billion per year.
"And that occurs for a number of reasons … absenteeism … and reduced productivity amongst those that remain at work despite those conditions."
For businesses to support people returning to work from an illness, they need to provide the "right care at the right time", Professor Zanfina said, and to ensure that care is not fragmented.
"We need care that supports people to return to work, not just improve their productivity but also their wellbeing," she said.
For breast cancer survivors, BCNA developed resources for workplaces on how to help someone undergoing treatment.
"The gold standard is working closely with the individual," BCNA CEO Ms Pilatti said.
She said by not supporting people with illness to return to work, businesses were losing valuable assets of knowledge, leadership and productivity.