Economic Burden of Work-Related Low Back Pain in Indonesia Before and During the COVID-19 Era, 2019–2021: Analysis of Global Burden of Disease Estimates

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Abdul Kadir, Derren DCH Rampengan, Andrean VH Simanjuntak, Theresia Anggriani, Muhammad Dharma Nauval, Muhammad Ichsan Adnan, Surna Lastri, Muhammad Iqhrammullah

2026 ClinicoEconomics and Outcomes Research Vol. 18 Article Cited by 1 SDG 3SDG 17 Quartile

Abstract

Introduction: Occupational ergonomic risk factors are a major contributor to musculoskeletal disorders and productivity loss, yet their welfare implications remain underexplored in low- and middle-income settings. This study aimed to quantify the health and economic burden of ergonomic risks across Indonesian provinces using the Value of Lost Welfare (VLW) framework. Methods: Disability-adjusted life years (DALYs) attributable to ergonomic risks were obtained from the Global Burden of Disease 2019–2021 estimates. VLW was calculated by multiplying DALYs with the Value of a Statistical Life Year (VSLY), derived from GDP per capita and adjusted for purchasing power parity. Both absolute VLW (International Dollar, Int$) and the VLW-to-GDP ratio were computed at national and provincial levels. Socioeconomic inequality was assessed using the slope index of inequality (SII) and relative index of inequality (RII). Results: National VLW increased from Int$ 44.6 billion in 2019 to Int$ 48.5 billion in 2021, with the largest contributions observed in East Java (Int$ 7.3 billion) and West Java (Int$ 6.1 billion), while smaller provinces such as Gorontalo and North Maluku contributed less than Int$ 200 million. Despite a steady rise in DALYs, the VLW-to-GDP ratio followed the economic cycle, increasing during the 2020 downturn (1.47%) and declining to 1.36% in 2021 as GDP rebounded. Socioeconomic inequality in the VLW-to-GDP ratio was statistically significant, with SII of −0.00165 (95% CI: −0.00255 to −0.00074) and RII of −0.118 (95% CI: −0.183 to −0.053). Discussion: Occupational ergonomics imposes a substantial and persistent health–economic burden in Indonesia, amounting to nearly Int$ 50 billion annually. The observed socioeconomic gradient indicates that lower-GDP provinces experience disproportionately greater welfare losses relative to their economic capacity, underscoring the need for sustained workplace interventions and targeted regional policies, particularly in lower-GDP regions. © 2026 Kadir et al.

Affiliations

Occupational Health and Safety Department, Faculty of Public Health, Universitas Indonesia, Depok, 16424, Indonesia; Faculty of Medicine, Universitas Sam Ratulangi, Manado, 95115, Indonesia; Indonesian Agency for Meteorology Climatology and Geophysics (BMKG), Jakarta, 23111, Indonesia; Department of Physiology, Murni Teguh University, Sumatera Utara, Medan, 23111, Indonesia; Postgraduate Program of Public Health, Universitas Muhammadiyah Aceh, Banda Aceh, 23123, Indonesia; Department of Accounting, Faculty of Business and Economics, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia; Postgraduate Program of Management, Universitas Muhammadiyah Aceh, Banda Aceh, 23123, Indonesia

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