Lost Productivity due to Lower Wages and Reduced Workforce Participation
Productivity losses include the value of labor lost due to blindness and visual impairment. We identified median income by self-reported visual function for persons aged 18 to 39, 40-64 and 65 and older in SIPP data (Table 12.1).[4, 5] We assume that self-reported blindness and severe difficulty seeing is analogous to blindness and that self-reported moderate difficulty seeing is analogous to moderate visual impairment. We estimate productivity losses by applying the number of moderately impaired and blind persons in each age group to the average reduction in median household income associated with visual impairment and blindness for that age group. We estimate that total productivity lost due to visual loss was $48.4 billion in 2013.
Table 12.1. Productivity Losses
Lost Productivity due to Informal Care
Care for visually impaired family members constitutes a significant cost from lost productivity. The number of hours and estimated cost for informal care due to low vision among persons aged 40 and older was previously estimated by Frick et al (2007). Following their approach, assuming 8 hours of care per “care day”, we multiplied the hours of informal care by our estimate of the prevalent population of visually impairment and blind aged 40 and older to estimate the total number of care hours, and then multiplied these hours by the US national average wage. We estimate informal care costs for persons aged 40-64 to be $187 million and for persons aged 65 or older to be $1.26 billion. Our costs are higher than those reported by Frick, et al. (2007) because we assume an average wage rate and a more current population estimate, while Frick, et al. (2007) used the minimum wage rate.
Table 12.2. Productivity Losses Resulting from Informal Care
The Frick, et al. (2007) study did not include informal care rates for children. Data on baseline rates of informal care are available for children, but not for young adults. We assume that adults aged 18 to 39 would require zero informal care due to visual loss. We used the American Time Use Survey (ATUS) conducted by the Bureau of Labor Statistics to obtain estimates of the number of hours spent on childcare by adults in households with children younger than age 18. This survey found that caregivers spend an average of 2 hours per day providing primary care for children younger than age 6 and 47 minutes per day caring for children aged 6 to 17. As part of the HID survey conducted by the Institut National de la Statistique et des Etudes Economiques in France, respondents were asked to indicate the limitations placed on them as a result of their work as the caregiver of a disabled individual. Using these data, Lafuma et al. estimated that, compared with control individuals, relatives reported spending 3.3-fold more time caring for blind individuals and 2.0 times as much time caring for those with low vision when controlling for age. As a result, the study suggests that caregivers for the visually impaired in France, Germany, Italy, and the United Kingdom spend an average of 525.25 extra hours per year caring for their relatives as compared to the general population.
We applied the multipliers derived by Lafuma et al. to the base hours of informal care for children from the ATUS to calculate the number of hours of excess care per year for children with blindness and visual impairment. Following the methods employed by Lafuma et al., we then multiplied this estimate by the average hourly wage rate of $19.17 reported by the Bureau of Labor Statistics to obtain the total cost of informal care for children with blindness and visual impairment. We report the $601.6 million attributable to blindness as the cost of informal care for children in Table 12.2.
In 2011, the American Time Use Survey added a new component on elder care. While this survey reported the time spent on elderly care from the perspective of the person providing care, instead of the person receiving care, we were able to approximately replicate the process we used for children for the adult population. When doing so, we estimated a total cost of informal care among adults to be approximately $300 million, less than a quarter of the estimated cost based on Frick et al. (2007) Because Frick et al. (2007) is a direct estimate, and because the structure of the ATUS elder care component required inferring care hours, we rely on the Frick et al approach, but this may indicate that our similar approach for valuing informal care for children may be an underestimate.