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The Self-Reported Health and Productivity Burden of Autoimmune Disorders at a Major Self-Insured Employer

Allen, Harris PhD; Bunn, William B. III MD, JD, MPH; Naim, Ahmad B. MD

Journal of Occupational and Environmental Medicine: September 2012 - Volume 54 - Issue 9 - p 1049–1063
doi: 10.1097/JOM.0b013e3182602447
Original Articles

Objectives: Examine the self-reported health and productivity burden of three autoimmune disorders: rheumatoid arthritis, psoriasis, and inflammatory bowel disease.

Methods: A 2009 representative survey of a major employer's US workforce, with two approaches for disease identification: (1) self-report and (2) self-report replicated by claims-based International Classification of Diseases, 9th Revision (ICD-9), codes.

Results: Self-reported prevalence: rheumatoid arthritis, 4.2%; psoriasis, 3.0%; inflammatory bowel disease, 1.2%. Psoriasis and inflammatory bowel disease replicated rheumatoid arthritis' pattern of health and productivity effects though not as strongly. The three autoimmune disorders combined significantly affected health at all severity levels. They also significantly affected productivity at higher severity but not at no symptom/lower severity levels.

Conclusions: When employees with autoimmune disorders with lower severity/no symptoms do not progress to higher severity, their work performance remains on par with healthy employees. Autoimmune disorders' high impact/low prevalence offers much promise for lowering costs through benefit design.

Supplemental Digital Content is Available in the Text.

From the Harris Allen Group, LLC (Dr Allen), Brookline, Mass; Navistar, Inc (Dr Bunn), Lisle, Ill; and Janssen Scientific Affairs, LLC (Dr Naim), Horsham, Penn.

Address correspondence to: Harris Allen, PhD, Harris Allen Group, LLC, 150 Walnut Street Road, #2, Brookline, MA 02445 (

All the authors collaborated on the development of the research paradigm and on the interpretation of the results and conclusions. Dr Allen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Disclosure: No conflicts of interest have been declared for any of the authors.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2012 by the American College of Occupational and Environmental Medicine