Thursday, 31 July 2014

Employment: Norway is tragically the exception

Is Norway's runaway success in relation to MSer employment linked to their top ranking in the Human Development Index? #MSBlog #MSResearch

"Yesterday Mouse Doc discussed the article below that showed the employment rate amongst MSers living in county of Norway was 45% at 19 years. These are by far the best figures I have seen to date. I am hoping they indicate a trend that may be driven by early access to DMTs and an alteration in the natural history of MS. In other words by preventing relapse and the accrual of disability MSers are more likely to be staying in employment. On the other side of the coin these figures may be unique to Norway. Norway Ranks number 1 in the world in relation to the Human development Index (HDI). HDI is considered a better measure of a country's progress than income growth. I have embedded key data slides in relation to HDI for your information; it will allow you to see how well your country is doing. It is tragedy, but not surprising, that a large part of your outcome in relation to MS is probably related to which country you live in. The UK comes, embarrassingly, 27th in the league table; which is kind of where I would expect it be, based on the EMSP's barometer data, if  these figures referred directly to MS outcomes."

"Is being employed a badge of health for MSers? Should we be including relative employment rates when we compare the effectiveness of DMTs? Which DMT is likely to maximize your chances of staying employed, or becoming employed? If only we had this data."

Bøe-Lunde et al. Employment among Patients with Multiple Sclerosis-A Population Study. PLoS One. 2014 ;9(7):e103317. 

OBJECTIVE: To investigate demographic and clinical factors associated with employment in MS.

METHODS: The study included 213 (89.9%) of all MS patients in Sogn and Fjordane County, Western Norway at December 31st 2010. The patients underwent clinical evaluation, structured interviews and completed self-reported questionnaires. Demographic and clinical factors were compared between patients being employed versus patients being unemployed and according to disease course of MS.

RESULTS: After a mean disease duration of almost 19 years, 45% of the population was currently full-time or part- time employed. Patients with relapsing -remitting MS (RRMS) had higher employment rate than patients with secondary (SPMS) and primary progressive (PPMS). Higher educated MS patients with lower age at onset, shorter disease duration, less severe disability and less fatigue were most likely to be employed.

CONCLUSIONS: Nearly half of all MS patients were still employed after almost two decades of having MS. Lower age at onset, shorter disease duration, higher education, less fatigue and less disability were independently associated with current employment. These key clinical and demographic factors are important to understand the reasons to work ability in MS. The findings highlight the need for environmental adjustments at the workplace to accommodate individual 's needs in order to improve working ability among MS patients.


  1. I have (British) family in Norway and know how different employment conditions are. With so much money in their State health and welfare systems, these results are no surprise. The one drawback about living in such a socialist country, according to my niece, is that the State is very controlling. You the patient (or indeed you the parent, you the client) are not easily able to challenge or question on matters of health and welfare. There's apparently no notion of 'second opinion. For example, if an older person goes into care, they have no choice of where they go; if you're referred to a specialist, their decisions are final. She wouldn't move back to the UK, though!

  2. This paper presents data from just one county (Sogn og Fjordane) - would it be the same for all of Norway? I rather doubt it.
    In 2011 Glad SB/Myhr KM published a study from another Norwegian county - 32% were still employed after 22.2 years since diagnosis.


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