OBJECTIVES: To estimate Productivity-Adjusted Life Years (PALYs) for the Chinese population aged 50-64 and quantify PALY losses due to specific health conditions.

METHODS: We utilized a previously validated and published microsimulation model (the China Aging and Retirement Simulation Model, CHARISMA) to simulate PALYs for three age cohorts (50-54, 55-59, 60-64) in China. PALYs were calculated by integrating workforce participation, absenteeism, and death. Probabilistic sensitivity analysis was conducted to account for parameter uncertainty. We estimated condition-specific PALY losses by setting the risk of each condition to zero individually. Results were stratified by sociodemographic factors and reweighted using 2018 population data to project total PALYs accrued by 2032.

RESULTS: The mean PALYs expected before age 65 were 6.80, 4.35, and 1.50 for the 50-54, 55-59, and 60-64 age groups, respectively. Stratified analyses revealed substantial variation in PALYs across subgroups. Males, rural residents, and those with lower education levels generally had higher PALYs. The total PALYs accrued from 2018-2032 for the entire cohort of people who were between 50-64 at the baseline year of 2018 was approximately 1.24 billion. The top five conditions contributing to PALY loss among this cohort were dyslipidemia, hypertension, heart disease, diabetes, and stroke, with each condition differentially affecting each age group. Dyslipidemia and hypertension consistently ranked among the top 3 PALY-decreasing conditions across all age cohorts.

CONCLUSIONS: The current findings highlight substantial variations in PALYs across sociodemographic groups and identify key health conditions contributing to productivity loss. These results can inform targeted health interventions and policies aimed at maintaining workforce productivity in the context of China's aging population.