The Impact of Worklife Patterns on Health at Older Ages

Joan R. Kahn, University of Maryland

In spite of the steady improvement in overall health and life expectancy in the U.S., substantial disparities persist, especially along racial and socioeconomic lines. This paper attempts to further our understanding of health disparities by focusing on the impact of worklife patterns on health at older ages. It fits within a growing body of research which examines the linkages between experiences throughout the life course with well-being at older ages. We argue that different aspects of the worklife (e.g., occupational status, job autonomy and stress, job stability/turnover) are likely to have long-term effects on health, either by influencing the accumulation of financial resources or by the exposure to stressful conditions over time. We build on our previous work which showed that financial strain experienced over the life course has a strong cumulative impact on health. In the present study, we will first examine which aspects of the worklife have long-term effects on health. We will then examine the extent to which the impact of worklife patterns are associated with financial strain as opposed to other forms of stress. Because employment patterns differ substantially for men and women, especially among the cohorts who are currently over age 65, we will conduct separate analyses gender. The data on which the analysis is based were collected as part of the Aging, Stress and Health Study, funded by the National Institute on Aging (Leonard Pearlin, P.I.). This prospective study conducted the first round of interviews in 2001 and plans two followup interviews in 2002 and 2003. The sample, consisting of 1167 white and black men and women ages 65 and over in a large mid-Atlantic metropolitan area, is designed to provide sufficient variability by both race and socioeconomic status. Respondents were asked detailed questions about their physical and emotional health, family background and work history, economic conditions, both past and present, family and social relationships and activities, and stressors in their lives. The present study relies on a series of work related questions reflecting: a) parent's occupation, b) respondent's entry into the labor force (e.g., age at entry, steadiness of work, dropped out from school?), c) respondent's work history (e.g., number of different jobs, steadiness of work, full-time/part-time status, self-employment), d) respondent's main occupation (e.g., type of work, degree of autonomy, stress, or repetition) and e) discriminatory experiences at work (e.g., unfairly fired or denied promotion). We anticipate that respondents with more favorable work experiences will also have more favorable health outcomes. However, one of the challenges in studying the relationship between socioeconomic status and health is the problem of health-related selection. That is, while higher SES offers better chances of good health, better health also offers better opportunities for socioeconomic achievement. We will attempt to account for this type of selection by controlling for health status at younger ages. We do this by using retrospective reports of health status at different points during the lifecourse: childhood (under age 18), early adulthood (ages 18-35), middle age (ages 35-50), later middle age (ages 50-65) and currently (after age 65). The survey includes a wide range of self-reported health measures including chronic conditions, health symptoms, functional limitations and subjective health status. We will start our analysis by focusing on respondent's subjective health status as reported on the familiar self-rated health question: "In general, would you say that your current health is excellent, very good, good, fair or poor?" Although this is a subjective measure of well-being, it has been shown to be fairly accurate summary of an individual's health status. It is highly correlated with objective health measures and is also predictive of longevity at older ages. We will also explore the impact of worklife characteristics on the accumulation of chronic conditions and functional limitations.