Compelling link between mobility and income, sheds light on the tangible economic benefits of staying active

The high costs of total joint replacement and other orthopaedic surgical procedures are coming under increased scrutiny from payers. Now, federal government researchers have presented evidence suggesting preventive medicine and musculoskeletal interventions have important economic benefits. The results appear in Clinical Orthopaedics and Related Research® (CORR®), a publication of The Association of Bone and Joint Surgeons®. The journal is published in the Lippincott portfolio by Wolters Kluwer. 

A team led by Timothy Bhattacharyya, MD, of the Clinical Trials and Outcomes Branch of the National Institute for Arthritis and Musculoskeletal and Skin Diseases in Bethesda, MD, showed in an analysis of a nationwide study that greater mobility was strongly associated with higher average annual household income. "Engaging in exercise just once a week can significantly boost mobility over time. This isn't just about staying fit, it's about securing financial stability,” the authors say. 

Drops in mobility tie to reduction of annual income 

The data source for the analysis was the nationwide Rand Health and Retirement Study, in which U.S. adults ages 50 and older were surveyed every two years from January 1992 to December 2018. Along with asking people about their health, the study collected extensive data on income and working status. 

The researchers first evaluated data on 19,430 people who responded to the survey in 2016 (58% men, 66% white and an average age 66). They gave one point for each mobility task the study participants said they could do: walk across a room, walk one block, walk several blocks, climb one flight of stairs, and climb several flights of stairs. For example, those who could do all those things were placed in category 5. 

Average annual household income was $18,100 higher for people in category 5 than those in category 4 ($76,700 vs. $58,600). In turn, people in category 4 had $13,900 higher income than those in category 3. Even in the group of people ages 71 to 80 who were not employed, the drop from category 5 to 4 was associated with an income decrease of $6,400. All differences were statistically significant. 

Maintaining mobility leads to higher employment rates and more income 

To look at the issue another way, the researchers analyzed data on 1,094 employed, middle-income respondents, ages 55 to 65, who completed the survey in 2000 and at least twice more by 2010. At the end of 2010, annual household income differed by $6,500 between those who maintained their mobility for the whole 10 years and those who did not ($41,600 vs. $35,100).  

"Maintained mobility after [age] 55 years was associated with a 19-point higher likelihood of maintaining an active working status,” Dr. Bhattacharyya and his colleagues add. “This connection could bring about substantial economic advantages, because individuals may be less likely to dip into their retirement funds and more inclined to delay claiming Social Security benefits." 

The large association between annual income and conditions that reduce mobility "may reframe the true cost of treatments," the authors continue. "A medication or an intervention that improves mobility may result in several more years of working (and several fewer years of spending retirement funds), which should be included when assessing the cost–benefit of treatment."