Depression and other mental health issues reduce the number of productivity-adjusted life years (PALYs) more than musculoskeletal diseases or cardiovascular diseases, according to a recent joint study by the University of Eastern Finland, the Finnish Social Insurance Institution (Kela), and Monash University in Australia. The study was the first to examine the loss of PALYs due to chronic conditions at the population level in Finland. The results were published in Value in Health, a highly regarded journal in health economics.

PALY is a new metric developed at Monash University that allows for the examination of the burden of diseases from the perspective of work and functional capacity. It represents a year in full work and functional capacity in relation to the demands of both work and home life.

According to the newly published study, depression and other mental health issues lead to an annual loss of 99,570 PALYs at work and 256,086 PALYs in home and volunteer work among Finns aged 18–79 years. The significant impact of depression and mental health issues was particularly evident among women aged 18–34 years.

Due to musculoskeletal diseases, 67,945 PALYs are lost annually at work and 198,544 in leisure time. Cardiovascular diseases result in a loss of 55,329 and 143,453 PALYs annually. Other diseases examined in the study included asthma, diabetes, gastrointestinal diseases, migraine and other chronic headaches, and thyroid diseases.

In Finland, mental health disorders have, according to Kela, long been the most common reason for sick leave among those aged 16–34, and since 2017, they have also become the most common reason for sick leave for those aged 35–49. An increase is also seen among those aged 50–67, although musculoskeletal diseases remain the most common reason for this age group.

“Young adults’ depression and mental health issues are clearly reflected in the number of lost PALYs. The increase in depression and mental health issues may indicate, for example, better diagnosis of these diseases and reduced stigma, but it can also be attributed to the increased burden of working life and the pressure caused by social media,” says Senior Researcher Piia Lavikainen from the University of Eastern Finland.

The study was based on a sample of 2,187 respondents from 2022, representing the Finnish adult population, stratified by age, gender and hospital district. The sample population was asked about their illnesses and perceived work and functional capacity. The survey data were extrapolated to cover the entire Finnish adult population using Statistics Finland’s population data. PALYs were estimated based on population numbers by gender and age group, and based on the prevalence of chronic conditions, and the work and functional capacity impairment they cause.

“The productivity-adjusted life year, PALY, provides a new way to examine the burden of different diseases, particularly from the perspective of work and functional capacity. This metric will also enable better assessment of the societal benefits of various preventive measures and treatments in the future,” says Professor Janne Martikainen from the University of Eastern Finland, who led the study.