More than 2.5 million people in the UK are not currently working because of long-term illness, including 1.3 million due to mental health conditions. Becky Spencer investigates the potential reasons behind this record rise.

One in three working-age people in the UK have a long-term health condition and around a quarter of these 16–64-year-olds are out of the labour market due to ill health.

After working for the same company for nearly 30 years, when Gill Owen went on sick leave from her job at a car factory due to back pain she never thought for one second that she would never return to work. Yet ten years’ later, Gill’s back problems have only got worse and she has never been able to return to employment, relying instead on sickness benefits.

Gill is one of the 10.6 million working-age people (aged 16 to 64) currently living with a long-term health condition in the UK. This number has increased from 8.5 million people in 2016, figures from the Office for National Statistics show. Most of these people are in employment but the number of adults aged 16 to 64 who are out of the labour market (known as “economically inactive”) because of long-term sickness rose to over 2.5 million in 2023 – an increase of around 500,000 since spring 2019.

In fact, research shows that the number of people reporting long-term sickness has been growing by around 0.5 per cent per year over the last 25 years. It is now the most common reason for economic inactivity in the UK, accounting for around 30 per cent of total inactivity.  In addition, the sickness absence rate (the percentage of working hours lost because of sickness or injury) for those people with long-term health conditions who are in work is currently at its highest point since 2008, at 4.9 per cent. The number of working days lost to sickness absence because of long-term health conditions is also at a record high of 104.9 million days.

What sort of health conditions are most prevalent?

Behind all these statistics are people who are living with a health condition, just like Gill Owen. Recent Office for National Statistics’ (ONS) analysis of the Labour Force Survey (which examines the employment circumstances of the UK population) revealed the majority of people who are out of labour market due to sickness have mental health or musculoskeletal conditions. Many have both. The number of people both in and out of the work reporting multiple health conditions is increasing. For those whose long-term sickness has led them to stop working or looking for work, the ONS analysis shows that, in 2023, over a third (38 per cent) report having five or more health conditions. This percentage is up from 34 per cent in 2019 and the total now stands at 937,000 people.

In 2023, over 1.3 million people were out of the labour market due to “depression, bad nerves or anxiety”. This is up from under a million in early 2019. Across the working-age population as a whole, “depression, bad nerves or anxiety” was the most prevalent health condition reported in 2023, affecting five million people (around 12 per cent of 16–64-year-olds in the UK).

Musculoskeletal health conditions (which affect the back, neck, arms, hands, legs and feet) are equally prevalent, with 1.35 million people economically inactive because of long-term sickness reporting them as their main health condition. Over 70 per cent of these people have more than one musculoskeletal condition, for example, 58 per cent of those with back or neck conditions also reported issues with their legs or feet.

The increase in working-age people with long-term health conditions who are out of the labour market has ramifications for employers – who are finding it harder to recruit as the available labour pool shrinks – and for the Government, as more people need to rely on sickness benefits.

Why such a rise?

Addressing the reasons behind the increase is key to getting these people back to work but identifying just what those reasons are is complex. There are clearly many factors at play.

More than half of working-age adults who are out of the labour market due to long-term sickness are aged 50 to 64-years. This is not surprising really because the prevalence of disability and chronic health conditions increases with age and the UK population is an ageing one.  However, the number of 50–64-year-olds reporting long-term sickness as the reason for being out of work has increased by much more than had been predicted. Between 2019 and 2022, it was estimated that around 40,000 extra people would be expected to become inactive because of long-term sickness as a result of an ageing population, but the actual number is much larger at 462,000. This suggests other factors on top of an ageing population are at play, one of the most significant of which may be the increase in the waiting time for NHS treatment over recent years.

There are now around 7.5 million people in England alone waiting for NHS treatment following a GP referral. This includes a third of people who are inactive because of long-term sickness. For those employed and waiting for NHS treatment, 37 per cent say their work has been affected. Of these, nine per cent say waiting for treatment has resulted in them having to go on long-term sick leave. Adults with a disability, those experiencing moderate-to-severe depressive symptoms, and those economically inactive but not retired are the groups most likely to be waiting for NHS treatment.

COVID-19

Staff shortages and the impact of COVID on the NHS are the main reasons given for the long NHS waiting lists but COVID itself is not thought to be a significant cause of the increase in the long-term sick who are out of the labour market. However, the number of people suffering ill health as a result of Long COVID is not known.

The pandemic period did see an increase in the number of younger people (25-34-year-olds) becoming economically inactive because of long-term sickness, rising from three per cent in 2019/20 to 22 per cent in 2021/22, according to the ONS. The largest increase in the type of health condition for this age group was for mental illness, phobias and nervous disorders (a 24 per cent increase).

It has also been suggested that the massive increase in homeworking during COVID (and since) may have contributed to the increase in the number of people reporting musculoskeletal health conditions. Many people were working off laptops rather than ergonomically set-up workstations, and many workers spent more time in front of a screen without the breaks they would have taken if they were in the office. Since 2019, the number of people out of work due to back or neck problems has risen by 217,000 (28 per cent).

Occupations most affected

The role your occupation plays in your likelihood of becoming economically inactive because of a long-term health condition is a significant one. The Office for National Statistics recently looked at the industries that those who are now out of work due to long-term sickness worked in up to two years prior to becoming long-term sick. They found 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. The transport and storage, hospitality, health and social work, construction, and manufacturing industries also had more former workers inactive because of long-term sickness than the UK average.

The ONS analysis also found that jobs with higher rates of former workers on long-term sickness also had lower than average wages, and included jobs which require more interaction with others and are less adaptable to hybrid and homeworking.

Much more research is needed to identify the reasons behind the rise in working-age adults reporting a long-term health condition and the barriers preventing them getting back into work. In September, the Government announced a consultation on changes to how it assesses if people are fit to work and if they are entitled to sickness benefits. This will be a concerning development for the millions of people currently out of work due to long-term health conditions and it does not address the underlying reasons why so many, like Gill Owen, have been unable to return to the labour market in recent years.