Health Status of Older US Workers and Nonworkers, National Health Interview Survey, 1997–2011

Introduction Many US workers are increasingly delaying retirement from work, which may be leading to an increase in chronic disease at the workplace. We examined the association of older adults’ health status with their employment/occupation and other characteristics. Methods National Health Interview Survey data from 1997 through 2011 were pooled for adults aged 65 or older (n = 83,338; mean age, 74.6 y). Multivariable logistic regression modeling was used to estimate the association of socioeconomic factors and health behaviors with 4 health status measures: 1) self-rated health (fair/poor vs good/very good/excellent); 2) multimorbidity (≤1 vs ≥2 chronic conditions); 3) multiple functional limitations (≤1 vs ≥2); and 4) Health and Activities Limitation Index (HALex) (below vs above 20th percentile). Analyses were stratified by sex and age (young–old vs old–old) where interactions with occupation were significant. Results Employed older adults had better health outcomes than unemployed older adults. Physically demanding occupations had the lowest risk of poor health outcomes, suggesting a stronger healthy worker effect: service workers were at lowest risk of multiple functional limitations (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.71–0.95); and blue-collar workers were at lowest risk of multimorbidity (OR, 0.84; 95% CI, 0.74–0.97) and multiple functional limitation (OR, 0.84; 95% CI, 0.72–0.98). Hispanics were more likely than non-Hispanic whites to report fair/poor health (OR, 1.62; 95% CI, 1.52–1.73) and lowest HALex quintile (OR, 1.21; 95% CI, 1.13–1.30); however, they were less likely to report multimorbidity (OR, 0.78; 95% CI, 0.73–0.83) or multiple functional limitations (OR, 0.82; 95% CI, 0.77–0.88). Conclusion A strong association exists between employment and health status in older adults beyond what can be explained by socioeconomic factors (eg, education, income) or health behaviors (eg, smoking). Disability accommodations in the workplace could encourage employment among older adults with limitations

Effect of Employment on Health-Related Quality of Life, Healthcare Expenditures, and Healthcare Utilization of Older Adults

The proportion of adults aged 65 years and over in the U.S. population is rapidly increasing due to increasing longevity, as well as decreasing fertility rates. As a result, adults aged 65+ constitute the fastest growing group among workers, and this trend is projected to continue as the baby boomer generation enters retirement age. The positive effects of employment at older age on health has been suggested by previous research, however no comprehensive examination of health status of older workers has been conducted. In addition, the effect of employment at older age on such important health outcomes as health-related qualityof life (HRQL), healthcare use, and healthcare utilization has not been well examined. Finally, the effect of occupation on health outcomes of older workers has been virtually ignored. This study fills this important gap in literature using nationally-representative data and complex statistical modeling techniques, such as structural equation modeling. Using the data from the 1997-2011 National Health Interview Survey (NHIS) and the 2000-2009 Medical Expenditure Panel Survey (MEPS), we found that older workers are generally healththier than the non-workers, with those in more physically demanding occupations (farm, service, and blue collar workers) reporting the best health. Workers in these occupations reported the fewest number of functional limitations and prior diagnoses of chronic illness, and had the highest mental health and overall HRQL scores. They were however just as likely as the white collar workers to rate their health as good or better, and had the same physical HRQL scores. Only service workers had lower healthcare expenditures than other working older adults, which could be explained by poorer healthcare access in this occupation. Unemployment at older age was however among the strongest predictors of increased healthcare costs, poorest HRQL, and poor health outcomes on all other measures. In agreement with previous literature, we find a strong association between later life employment and improved health outcomes. Our results suggest a certain degree of healthy worker effect (e.g. in lower number of chronic health conditions in workers), as well as beneficial effect of employment on health at older age (e.g. improved mental HRQL scores among workers in physical occupations in the absence of differences between workers on physical HRQL scores). We discuss the implications of the results and provide suggestions for potential policy measures aimed at improvement of older adult work opportunities.</p

Engagement in Mindfulness Practices by U.S. Adults: Sociodemographic Barriers

Objective: To examine the effect of sociodemographic factors on mindfulness practices. Methods: National Health Interview Survey Alternative Medicine Supplement data were used to examine sociodemographic predictors of engagement in meditation, yoga, tai chi , and qigong . Results: Greater education was associated with mindfulness practices (odds ratio [OR], 4.02 [95% confidence interval [CI], 3.50–4.61]), men were half as likely as women to engage in any practice, and lower engagement was found among non-Hispanic blacks and Hispanics. Conclusion: Vulnerable population groups with worse health outcomes were less likely to engage in mindfulness practices

Abstract A7: Young adult cancer survivors and substance abuse: Results from the U.S. National Health Interview Survey, 1997–2009

Abstract Introduction: The five-year survival rates for young adult cancers continue to increase. Nonetheless, these young adult survivors may experience health complications or physical late effects that contribute to negative lifestyle behaviors potentiating the use of gateway drugs (e.g. alcohol and cigarettes). Examination of these negative behaviors during emerging adulthood (i.e., ages 18–24) may be particularly critical, as this developmental period is characterized by significant change, instability, identity exploration, and experimentation. In the present study, we examine the use of cigarettes and risky alcohol consumption among U.S. young adult cancer survivors. Methods: We analyzed data on 39,433 U.S. young adults age 18–24 participating in the 1997–2009 National Health Interview Survey, who reported on their cigarette use and alcohol consumption, and socio-demographic characteristics. Results: Among all youth, youth workers are almost twice as likely to smoke cigarettes when compared to their unemployed peers and Whites were more likely to engage in these negative behaviors when compared to their Black peers. There was no significant difference in alcohol or cigarette use by cancer history among young people. Approximately 35% of young cancer survivors were smokers and 70% current drinkers. Analyses did not reveal any significant reports of risky drinking. Conclusions: Periodic clinical assessments for substance use among cancer survivors is important, particularly during the transition from late adolescence to emerging adulthood when baseline rates are relatively high compared to other ages. Research on processes involved in a young cancer survivors’ decisions to use substances will provide better insight regarding how best to intervene and who to include in educational interventions. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A7.</jats:p

State variations of chronic disease risk factors in older Americans

The objective of this study was to examine and compare 3 key health behaviors associated with chronic disease (ie, risky drinking, smoking, and sedentary lifestyle). We used data from the National Health Interview Survey from 1997 through 2010 to calculate the prevalence of these behaviors among older Americans and rank each state, and we analyzed overall trends in prevalence for each behavior over the 14 years. Older adults residing in Arkansas and Montana had the worst chronic disease risk profile compared with other states. These findings indicate the need for improved or increased targeted interventions in these states

Worker Populations at Risk for Work-Related Injuries Across the Life Course

BACKGROUND: Workplace injuries can have a substantial economic impact. Rates of workplace injuries differ across age groups, yet occupations/industry sectors at highest risk within age groups have not been identified. We examined workplace injury risk across industry sectors for three age groups using nationally-representative U.S. data. METHODS: Data from 1997–2009 National Health Interview Survey (NHIS) were pooled for employed adults by age groups: 1) 18–25 (n=22,261); 2) 26–54 (n=121,559); and 3) 55+ (n=24,851). Workplace injury risk comparisons were made using logistic regression, with the Services sector as the referent and adjustment for sample design, gender, education, race/ethnicity, age, and income-to-poverty ratio. RESULTS: Overall 3-month injury prevalence was 0.88%. Highest risk sectors for workers aged 18–25 included: Agriculture/forestry/fisheries (Odds Ratio=4.80; 95% Confidence Interval 2.23–10.32), Healthcare/social assistance (2.71; 1.50–4.91), Construction (2.66; 1.56–4.53), Manufacturing (2.66; 1.54–4.61); for workers 26–54: Construction (2.30; 1.76–3.0), Agriculture/forestry/fisheries (1.91; 1.16–3.15), and Manufacturing (1.58; 1.28–1.96); for workers 55+: Agriculture/forestry/fisheries (3.01; 1.16–7.81), Transportation/communication/other public utilities (2.55; 1.44–4.49), and Construction (2.25; 1.09–4.67). CONCLUSIONS: Agriculture/forestry/fisheries and Construction were among the sectors with highest workplace injury risk for workers across all age groups. Differences in highest risk industries were identified between the youngest and oldest industry groups. Our results indicate a need for age specific interventions in some industries, and a need for more comprehensive measures in others

Cardiovascular Fitness Levels Among American Workers

OBJECTIVE: To explore cardiovascular fitness in 40 occupations using a nationally-representative 3 sample of the U.S. population. METHODS: Respondents aged 18–49 (n=3,354) from the 1999–2004 NHANES were evaluated for 5 cardiovascular fitness and classified into low, moderate, and high levels. Comparisons were 6 made among occupations. RESULTS: Of all U.S. workers, 16% had low, 36% moderate, and 48% high cardiovascular 8 fitness. Administrators, Health occupations, Wait staff, Personal services, and Agricultural 9 occupations had a lesser percentage of workers with low cardiovascular fitness compared to all 10 others. Sales workers, Administrative support, and Food preparers had a higher percentage of 11 workers with low cardiovascular fitness compared to all others. CONCLUSIONS: Cardiovascular fitness varies significantly across occupations, and those with limited physical activity have higher percentages of low cardiovascular fitness. Workplace strategies are needed to promote cardiovascular fitness among high-risk occupations

Nutrient Intake and Adherence to Dietary Recommendations Among US Workers

OBJECTIVE: Assess nutrient intake according to dietary guidelines among US worker groups. METHODS: Participants of 1999–2004 National Health and Nutrition Examination Survey completed two 24-hour recall dietary interviews to assess daily intake of protein, carbohydrate, fat, cholesterol, calcium, sodium, and fiber. Employed participants (n=8,987) were classified as: (1) white collar, (2) service worker, (3) farmer, and (4) blue collar. RESULTS: Nutrient intake varied by occupational group, particularly for fiber, sodium, calories, and percentage of calories from protein, saturated fat, and carbohydrate. Adherence to recommendations was noted for saturated fat and cholesterol, but workers were poorly adherent to recommendations for all other nutrients, particularly fiber. CONCLUSIONS: Workers display differences in nutrient intake across occupational groups with poor eating behaviors evident across all groups. Fiber is particularly poorly consumed, with less than 5% of all US workers meeting the recommendations