Work participation in chronic kidney disease: action is needed to avoid accumulating health and social disadvantage for patients

Excerpt

Employment is an important aspect of life participation, and is associated with better mental health [1] and socioeconomic well-being. Loss of work may compound disadvantage across the life-course through bidirectional relationships between socioeconomic position (SEP) and health. As shown in Fig. 1, socioeconomic disadvantage drives poor health (e.g. chronic conditions) which drives poor socioeconomic outcomes (e.g. loss of work/income) and further health disadvantage: a vicious cycle [2]. Ability to work and life participation are important outcomes for patients and caregivers living with chronic kidney disease (CKD) [3]. Patients with CKD often face barriers to employment including symptoms, comorbidities, time and logistical burden of treatments (e.g. dialysis), which can be like a full-time job, especially when undertaken at home [3]. Data on employment status (i.e. participation in paid work) indicate increased risks of unemployment among patients with CKD compared to the general population [4, 5]. Less is known about work ability and work functioning, which encompass a person’s ability to do their job, including health-related limitations [6].

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