Exploring the labour market outcomes of the risk factors for non-communicable diseases: A systematic review.

Objective: To look at the associations between labour market outcomes and major risk factors for non-communicable diseases (NCDs) (smoking, heavy alcohol consumption), key metabolic changes resultant of the risk factors (overweight and obesity, hypertension, type 2 diabetes), and major depressive disorder, and examine any gender differences. Design: Systematic review of cohort and longitudinal studies, to establish causality between exposures and outcomes. Methods: A systematic literature search was conducted in MEDLINE (Ovid), Embase (Ovid), EconLit (EBSCO), EconPapers, and Cochrane Database of Systematic Reviews, from inception to July 2022 for all peer-reviewed literature published, guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) framework. Results: 109 studies were eligible for this review. All studies were published in English. 96% of the studies were conducted in high-income countries with 63% from Europe and Central Asia. High BMI was the most frequently reported exposure (reported by 46% of the studies), while income was the most studied outcome (reported by 33% of studies). Though not all estimates presented in the literature can be interpreted as causal impacts, 77% of the studies reported significant (p < 0.05) adverse associations between the exposures and outcomes. Conclusions: All of the studies included in this review that looked at plausible causal relationships between NCD risk factors and labour market outcomes were from high-income and upper-middle-income countries (USA, northern European countries, and South Korea). Based on these studies, we found that individuals with overweight or obesity, diabetes, hypertension, depressive disorders, excessive alcohol use, and cigarette use are more likely to have lower rates of employment, lower income, and higher rates of sickness absence and disability pension.