Half a million more people are out of the labour force because of long-term sickness

The number of working-age adults who are out of the labour market (known as "economically inactive") because of long-term sickness has been rising since 2019, from around 2.0 million people in spring 2019, to about 2.5 million in summer 2022.

This rise in long-term sickness started before the coronavirus (COVID-19) pandemic, but since the pandemic hit the UK in early 2020, the number of people out of work because of long-term sickness has risen by 363,000.

A range of factors could be influencing this recent increase. We introduce some of these in this article, but more understanding is needed about the impacts of National Health Service (NHS) waiting times, long COVID, and the ageing workforce. Younger people have also seen some of the largest relative increases, and some industries such as wholesale and retail are affected to a greater extent than others.

The number of people out of the labour market because of long-term sickness has been rising in recent years

Cumulative change in number of people aged 16 to 64 years inactive owing to long-term sickness, seasonally adjusted, UK, January to March 2017 to June to August 2022

Download the data for people inactive owing to long-term sickness

Being out of the labour market is known as "economic inactivity" – this term refers to people who are not in work and have not been seeking or not been available for work.

Long-term sickness is an increasingly common reason for economic inactivity, making up 28% of all those out of the labour market in June to August 2022, compared with 25% at the beginning of the COVID-19 pandemic.

Comparing Quarter 2 (April to June) in both 2019 and 2022, the number of people inactive because of long-term sickness who reported their main health condition as “other health problems or disabilities” rose by 97,000 (41%), the largest of any category.

Survey respondents were not given explicit guidance on what main health condition to report for coronavirus-related illnesses such as long COVID. As a result, those with long COVID are unlikely to all fall into one category, having reported the one that relates most closely to their main symptoms. It is likely that “other” would be a common choice because it includes similar conditions to long COVID such as post-viral fatigue syndrome. However, it is unlikely that COVID-19 is a main contributor to the increases seen in recent years. This is because the biggest year-on-year increase was seen between 2019 and 2020, which only covers the very early stages of the pandemic.

“Other” health problems rose 41% between 2019 and 2022

Economic inactivity owing to long-term sickness, by most common primary condition, people aged 16 to 64 years, UK, 2019 to 2022

Notes:

1. In 2020 the Labour Force Survey (LFS) added "autism" as an additional option when asking respondents about their health conditions. This means those who reported autism in 2020 may have listed another condition prior to this option being available.
2. A list of all main health conditions can be found in the accompanying data tables.

Download the data for economic activity owing to long-term sickness by primary condition

Between Quarter 2 in both 2019 and 2022, the number of economically inactive people who reported problems or disabilities connected with the back or neck rose by 62,000 (31%), the second largest increase after “other conditions”. The biggest year-on-year increase was between 2021 and 2022; it is possible that increased home working since the pandemic has given rise to these kinds of chronic conditions.

The number of economically inactive people reporting depression, bad nerves and anxiety as their main health condition has returned to pre-pandemic levels, after increases in 2020 and 2021. However, the number reporting mental illness and nervous disorders has risen 22% over the same period, with the sharpest increases seen after 2020.

While symptoms of long COVID may not be the only contributor to increased long-term sickness in the working-age population, the pandemic’s wider impact on health is still likely to be an important factor in increased long-term sickness.

Median wait times from referral to NHS treatment in England have almost doubled, from around 7 weeks in April 2019 to almost 14 weeks in August 2022. The number of people on Referral to Treatment waiting lists has risen sharply since the first lockdown was introduced to curb the spread of COVID-19, from around 4.4 million people in February 2020 to 7 million in August 2022. We still don't fully understand the extent to which NHS resources being re-directed to address the pandemic affected waiting times.

Further work is required to establish whether and to what extent there is a relationship between growth in NHS waiting lists and long-term sickness in the labour market.

While older people still make up the majority of those inactive because of long-term sickness, the largest relative increases in recent years have been among those aged 25 to 34 years.

Those aged 25 to 34 years saw the largest relative increase in long-term sickness between 2019 and 2022

Change in economic inactivity owing to long-term sickness, by age group, UK, 2019 to 2022

Download the data for change in economic inactivity owing to long-term sickness by age group

Of working-age adults, more than half of those out of the workforce because of long-term sickness in Quarter 2 (April to June) 2022 (55%, or around 1.3 million people) were aged 50 to 64 years. This partially reflects how the prevalence of disability and chronic health conditions increases with age. Since the same quarter in 2019, the number of people aged 50 to 64 years who were economically inactive because of long-term sickness rose by 183,000.

Adults aged over 50 years have been the main contributors to increases in economic inactivity for all reasons seen in recent years. This has been explored further in Reasons for workers aged over 50 years leaving employment since the start of the coronavirus pandemic.

However, the biggest relative increase was seen among those aged 25 to 34 years, who made up 11% of those inactive because of long-term sickness in April to June 2019, and 14% in the same period in 2022 (97,000 more). Of these, nearly 60,000 (61%) were men.

The rise for this age group has been more pronounced since the start of the pandemic (3% between 2019 and 2020, 12% between 2020 and 2021, and 22% between 2021 and 2022). However, for those aged 50 to 64 years, increases in inactivity because of long-term sickness began before the pandemic hit, but have increased again in the last year (5% between 2019 and 2020, 2% between 2020 and 2021, and 8% between 2021 and 2022).

When looking at which main health conditions had affected different age groups, the youngest age groups were combined. This was because the number of people surveyed with long-term sickness in those age groups was relatively small, which affected sample sizes.

Among the youngest age group (those aged 16 to 34 years), the largest overall increase in type of long-term sickness was for mental illness, phobias and nervous disorders, which rose by around 20,000 (a 24% increase). The second largest increase was for progressive illnesses such as cancer, which rose by around 14,000; a 69% increase. Those aged 16 to 34 years were also the only age group to see an increase in depression, bad nerves or anxiety.

Both older age groups saw a decline in the number of people reporting progressive illnesses. While all age groups saw a rise in the number of economically inactive people reporting long-term “other health problems or disabilities” as their main health condition, the largest increase was among those aged 50 to 64 years.

Increases in “other” health conditions most common among those aged 50 to 64 years

Economic inactivity owing to long-term sickness, by age group and most common primary condition, UK, 2019 to 2022

Download the data for change in economic inactivity owing to long-term sickness by age group and primary condition

The number of women economically inactive because of long-term sickness has remained higher than the number of men. However, between 2019 and 2022 the number of men who were inactive because of long-term sickness increased by around 183,000, slightly more than the 172,000 increase seen among women.

While the number of people who are economically inactive because of long-term sickness has increased greatly since 2019, data that tracked people’s economic status from quarter to quarter shows that they were mostly already out of the labour market but had reported another main reason for their inactivity.

Between Quarter 1 2021 and Quarter 2 2022, most of those who became inactive because of long-term sickness were already out of the labour market for another reason in the three months prior (69%). Around one in five (19%) were in employment before becoming long-term sick.

More than two thirds of those who became economically inactive because of long-term sickness were already inactive for another reason

Quarterly inflows into "economically inactive owing to long-term sickness", people aged 16 to 64 years, UK, January to March 2021 to April to June 2022

Notes:

1. Quarterly average data aggregates flows from five separate quarters, meaning some people could have moved from another economic status to long-term sickness more than once over the period.

Download the data for quarterly inflows to economic inactivity owing to long-term sickness

Of those who were economically inactive for another reason in the quarter before reporting long-term sickness, the most common reason was looking after the family or home (22%, or 185,000 people).

Another fifth (21%, 180,000 people) were temporarily sick or injured before reporting long-term sickness. A further 18% were retired (151,000 people) and 12% were students (102,000).

Looking after the family or home was the most common reason for being inactive prior to reporting long-term sickness

Quarterly inflows from "economically inactive" into "inactive owing to long-term sickness", people aged 16 to 64 years, UK, January to March 2021 to April to June 2022

Notes:

1. Data aggregates flows from five separate quarters, meaning some people could have moved from another economic status to long-term sickness more than once over the period.

Download the data for quarterly inflows from economically inactive to inactive owing to long-term sickness

Similarly, of those who were no longer classed as inactive because of long-term sickness in 2021 and 2022, most remained inactive for another reason (63%), while just 16% moved into employment.

Most of those who were no longer classed as long-term sick between 2021 and 2022 remained economically inactive

Quarterly outflows from "inactive owing to long-term sickness", UK, January to March 2021 to April to June 2022

Notes:

1. Quarterly average data aggregates flows from five separate quarters, meaning some people could have moved to long-term sickness more than once over the period

Download the data for outflows from inactive owing to long-term sickness

Of those out of work because of sickness in Quarter 2 of 2019, around 73% said they did not want to work. Over the pandemic, this percentage increased, peaking at 78% in Quarter 2 of 2021. In Quarter 2 of 2022, 76% said they did not want to work; 343,000 more people than in 2019. While the percentage of people with long-term sickness who want to work has always been low, since the pandemic it seems to have reduced further.

When we look at the industries that those who are inactive because of long-term sickness worked in up to two years prior to becoming long-term sick, it seemed that some industries may be struggling with the health of their workforce more than others.

Of the 10 largest industries in the UK by workforce size, former wholesale and retail workers were the most likely to be economically inactive because of long-term sickness, relative to the size of the industry workforce. There were over 10 recently employed retail or wholesale workers who are now inactive because of long-term sickness for every 1,000 current workers in the industry.

The transport and storage, hospitality, health and social work, construction, and manufacturing industries also had more former workers inactive because of long-term sickness for every 1,000 current workers than the UK average.

Meanwhile, for the information and communication, public administration and professional and scientific industries, there were very few former workers now reporting inactivity because of long-term sickness in 2021/22 compared with the number of current workers in the sectors.

For every 1,000 wholesale and retail trade workers, there were 10 former employees out of work on long-term sick

Number of former workers in the last two years economically inactive because of long-term sickness for every 1,000 current workers, by industry, UK, April 2021 to March 2022

Notes:

1. UK rate is based on all workers, including those employed in industries not presented in the chart

Download the data for former workers economically inactive because of long-term sickness by industry

The industries with higher rates of former workers on long-term sick, such as retail, hospitality, and health, include jobs which require more interaction with others, and are less adaptable to hybrid and home working. This may mean they are harder to carry out while managing a long-term sickness. According to data from the ONS’ Business Insights and Conditions Survey from August 2022, 85% of information and communication businesses reported their employees worked from home some of the time, compared with just 9% of hospitality businesses.

At occupation level, there were around 14 former workers economically inactive because of long-term sickness for every 1,000 current workers from both elementary occupations (a category that includes jobs such as labourers, cleaners and postal workers) and process, plant and machinery operative occupations. Meanwhile, professional and managerial occupations had much lower rates.

The lowest paid occupations were more represented among the long-term sick

Number of former workers economically inactive owing to long-term sickness for every 1,000 current workers, by major occupation group, UK, April 2021 to March 2022

Download the data for former workers economically inactive owing to long-term sickness by major occupation group

Jobs with higher rates of former workers on long-term sickness also had lower average wages. In April 2022, the median hourly pay for elementary occupation workers was £10.20, the lowest of all occupation groups, and £12.48 for process, plant and machine operatives.

All occupations with more former workers economically inactive because of long-term sickness than average had an hourly wage below the UK average.

There is a lot more to be understood about rising ill health in the UK working-age population, but it is not possible to assign trends in recent years wholly to one reason. With younger people seeing some of the largest relative increases, and some industries affected to a greater extent than others, it could be that a range of other factors, such as working environment, are also playing a role. Further work is required to consider a range of factors and the extent to which they are driving higher rates of economic inactivity.

Office for National Statistics (ONS), released 10 November 2022, ONS website, article, Half a million more people are out of the labour force because of long-term sickness