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8 May 2024

Data can lead us to the truth or, as Rishi Sunak prefers, distort it

The Prime Minister’s cynical attack on “sick-note culture” was a missed chance to investigate the rise in long-term illness.

By Phil Whitaker

The anterior cruciate ligament (ACL) plays a vital role in knee joint stability. Sudden pivoting movements accompanied by abrupt deceleration can cause it to tear or rupture. This is a devastating injury, often requiring reconstructive surgery and certainly entailing prolonged rehabilitation. And it is something to which footballers are particularly prone. It will take a professional player out of the game for a minimum of nine months.

The surge in popularity of women’s football has brought the ACL into the headlines. There’s a disturbing signal in the data that shows female players are up to six times more likely to damage the ligament than their male counterparts. Thirty-seven players were unable to participate in last year’s Women’s World Cup due to ACL injury.

Male and female anatomy differs significantly, leading to differences in biomechanics – the way forces are transmitted through the leg. Then there are the hormone levels at certain times of the menstrual cycle which can affect ligament laxity. There are numerous other potential causal factors. The women’s game is still the poorer relation: training and matches are more likely to take place on unyielding artificial grass or frozen ground, whereas undersoil-heated turf is standard in the top flight of the men’s game. The design of high-performance football boots, tailored over decades to exclusively male biomechanics, may increase the risk of injury when worn by women.

Last month, the players’ international union Fifpro joined forces with the Professional Footballers’ Association, boot manufacturer Nike, and academics at Leeds Beckett University to launch “Project ACL”, a three-year research collaboration into the causes of excess ACL injury among female players. The programme will focus on contributary factors amenable to modification to reduce injury rates.

Contrast this with the response we’ve seen recently to a signal in some different data. Rishi Sunak has been making headlines by vowing to tackle Britain’s “sick-note culture”. He singled out the rise in young people on long-term benefits because of mental illness and observed that “something has gone wrong” since the pandemic. Sunak also raised the spectre of legions of potential workers with “mild” depression or anxiety being signed off by lackadaisical doctors on the basis of “subjective and unverifiable” claims.

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Better to have used the figures to launch a research project. Analysis of the data by the Office for National Statistics (ONS) suggests some interesting avenues for investigation. To start with, the rise in long-term sickness began in 2019; whatever is driving the trend started before Covid. And although Sunak chose to highlight younger people, the largest group by far are the 50-64 year-olds, a million more of whom are on long-term benefits, and whose absolute numbers have swelled by twice those in the 25- to 34-year-old band targeted by Sunak. Presumably, what few Tory voters remain are to be found among the older age groups and it would be imprudent to alienate them.

Long-term sickness varies hugely by industry, with wholesale and retail having the highest rates. Other blighted sectors include transport and storage, hospitality, health and social work, construction, and manufacturing. The ONS notes that these occupations aren’t amenable to home working, which might make continuing to work despite illness more challenging. But it would also be interesting to investigate any correlations with the levels of zero-hours contracts or workers on the minimum wage in different sectors. Chronic insecurity and economic struggle are both associated with poorer health.

Sunak isn’t interested in understanding the true causes of rising sickness rates, though. To do so would reveal uncomfortable truths about the adverse impacts of his party’s policies. Far better to twist one signal in the data to pander to the prejudices of voters he hopes will share his unedifying world-view.

[See also: Neurodiversity is usually just part of being human]

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This article appears in the 08 May 2024 issue of the New Statesman, Doom Scroll