Lost Work Opportunity Score Predicts Health in Retirement

Abstract Objectives Under-reporting of unemployment or forced retirement has consequences for measuring the impacts of job changes on health at retirement. We analyzed a comprehensive three-part measure of lost work opportunity for evidence of impact on health. Methods We combined variables from the Health and Retirement Study for 2,576 respondents assessing unemployment, forced retirement, and earlier than planned retirement into a single lost work opportunity score (LOS). We evaluated the reliability and unidimensionality of the LOS. We conducted multivariate regression to assess health impacts controlling for age, gender, education, race, ethnicity, and prior health status. Results The Cronbach’s Alpha for the LOS was a = 0.76 and the LOS variables primarily loaded onto a single component demonstrating undimensionality. The LOS significantly predicted self-reported health (⃞ = .16; p < .001) with higher lost work associated with negative health outcomes (Cox and Snell R2 = 0.07). The LOS score significantly predicted mental health declines (⃞ = .07; p = .002)(Cox and Snell R2 = 0.07). Discussion Population-level data indicates that health declines following both unemployment and retirement, but there is ample evidence that early or planned retirements do not show the same negative health impacts. We examined the health impact of retirement using the construct of lost work opportunity rather than voluntary or involuntary retirement, per se. Our findings indicate that as much as 7% of negative health changes in the early retirement years could be attributable to employment changes that were unplanned or experienced as outside the retiree's control.

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MEASURING QUALITY OF LIFE IN OLDER ADULTS LIVING WITH T2DM: A COMPARISON WITH YOUNGER ADULTS USING 2015 BRFSS DATA

Innovation in Aging ◽

10.1093/geroni/igz038.966 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S258-S259

Author(s):

Brittany Smalls ◽

Myles Moody ◽

Matthew Rutledge ◽

Amy Cowley

Keyword(s):

Older Adults ◽

Burden Of Disease ◽

National Level ◽

Population Level ◽

Younger Adults ◽

Physical Burden ◽

Level Data ◽

Gender Education ◽

The Us ◽

Optimal Health

Abstract Challenges due to burden of disease can affect adherence to self-care behaviors and optimal health outcomes in those living with T2DM. This study utilized state- and national-level data from the 2015 BRFSS to compare QoL measured by the prevalence of physical and mental burden days among older adults (OAs) compared to younger adults living with T2DM. The results of our analysis showed that OAs living in the US were significantly less likely to experience at least one mental burden day when compared to their younger counterparts (OR =0.61, 95% CI: 0.58, 0.64), while gender, education, race, BMI, and depression, CVD, or another chronic condition were significantly associated with the odds of experiencing at least one mental burden day. Whereas, in Kentucky OAs were less likely to experience at least one mental burden day when compared to their younger counterparts (OR= 0.48, 95% CI: 0.35, 0.66). Gender, education, BMI, and depression were significantly associated with the odds of experiencing at least one mental burden day or one physical burden day. The findings of this study suggests that the questions used by BRFSS to measure QoL may not be the most suitable for OAs who likely have different criteria for self-reported mental or physical burden days. When assessing QoL or burden of disease among the aging at a population level, considerable thought should be given into the questions asked and if they appropriately examine patient-level QoL in this population.

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Boundaries of the Construct of Unemployment in the Preretirement Years: Exploring an Expanded Measurement of Lost-Work Opportunity

Work Aging and Retirement ◽

10.1093/workar/waz006 ◽

2019 ◽

Vol 6 (1) ◽

pp. 59-63

Author(s):

Maren Wright Voss ◽

Soham Al Snih ◽

Wei Li ◽

Man Hung ◽

Lorie Gage Richards

Keyword(s):

Convergent Validity ◽

Healthy Aging ◽

Discriminant Validity ◽

Continuous Variables ◽

Related Factors ◽

Involuntary Retirement ◽

Lost Work ◽

Convergent And Discriminant Validity ◽

Survey Responses ◽

Work Opportunity

Abstract There is uncertainty related to whether retirement negatively affects health—possibly due to complexity around retirement decisions. Lost-work opportunity through unemployment or forced retirement has been shown to negatively affect health. Lost-work opportunity can be captured in two measurement fields, either a reported experience of being forced into retirement or reported unemployment. However, 17% of individuals retiring due to the loss of work opportunity identified in qualitative interviewing (i.e., unemployment, temporary lay-offs, company buy-outs, forced relocations, etc.) do not report this unemployment or involuntary retirement in quantitative survey responses. We propose broadening the conceptualization of late-career unemployment to incorporate other lost work opportunity scenarios. Using the Health and Retirement Study (HRS), a lost-work opportunity score (LOS) was computed from items indicating unemployment and forced or unplanned retirement. Correlations were computed between this LOS and all continuous variables in the RAND longitudinal compilation of the HRS to determine its convergent and discriminant validity. The LOS demonstrated a Chronbach’s alpha of α = .82 and had convergent validity with constructs of employment (9 variables), finances (36 variables), and health (14 variables), as predicted by the literature on retirement timing. No other continuous variables in the HRS were identified with a moderate or strong correlation to LOS, demonstrating discriminant validity. Further research should explore whether a combination of variables in the HRS can improve the accuracy of measuring lost-work opportunity. Improved precision in measurement, through an expanded conceptualization of lost-work opportunity, may help explicate the retirement-related factors that affect health, to inform policy and support healthy aging decisions at a societal level.

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Inter-Individual Variability and Non-linear Dose-Response Relationship in Assessing Human Health Impact From Chemicals in LCA: Addressing Uncertainties in Exposure and Toxicological Susceptibility

Frontiers in Sustainability ◽

10.3389/frsus.2021.648138 ◽

2021 ◽

Vol 2 ◽

Author(s):

Li Li ◽

Dingsheng Li

Keyword(s):

Human Health ◽

Dose Response ◽

Human Exposure ◽

Population Level ◽

Health Impact ◽

Health Impacts ◽

Response Relationship ◽

Dose Response Relationship ◽

Linear Dose ◽

Non Linear

Current life cycle impact assessment (LCIA) practices use a characterization factor to linearly scale chemical emission to human health impact assuming a homogeneous exposure and toxicological susceptibility for the entire population. However, both exposure and toxicological susceptibility may vary within the population, making the same emission elicit disproportionate impacts. Here we explore how inter-individual variabilities in human exposure and toxicological susceptibility interact to affect the estimated overall health impacts on the population level. For exemplification, we use the PROTEX model to simulate the exposure of the general American population to dieldrin and heptachlor, two organochlorine pesticides that tend to accumulate in food items. Using a Monte-Carlo analysis, we characterize inter-individual variabilities in exposure by considering variations in anthropometrics and dietary patterns between ages, sexes, and racial groups. We assess the overall health impact on the population level in five scenarios with different combinations of assumptions in exposure (homogeneous/heterogeneous) and the dose-response relationship (linear/non-linear, homogeneous/heterogeneous susceptibility). Our results indicate human exposure can vary by a factor of six among the different demographic groups. Combined with a non-linear dose-response relationship with heterogeneous susceptibility, the estimated overall health impact is substantially higher than the results using homogeneous susceptibility. However, the current LCIA practice of using a linear dose-response relationship produces even higher results that may overestimate the health impacts.

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MEASURING LOST-WORK OPPORTUNITY AT RETIREMENT AGE

Innovation in Aging ◽

10.1093/geroni/igz038.162 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S42-S42

Author(s):

Maren Wright Voss ◽

Soham Al Snih ◽

Wei Li ◽

Man Hung ◽

lorie Richards

Keyword(s):

Convergent Validity ◽

Healthy Aging ◽

Discriminant Validity ◽

Negative Impact ◽

Continuous Variables ◽

Related Factors ◽

Involuntary Retirement ◽

Lost Work ◽

Retirement Decisions ◽

Work Opportunity

Abstract There is uncertainty related to whether retirement negatively impacts health--possibly due to the complexity of retirement decisions. The role of lost work opportunity on retirement decisions may help clarify when retirement has a favorable or negative impact on health. Lost work opportunity can be defined as forced retirement or unemployment prompting an earlier than planned retirement. However, 17% of individuals retiring due to the loss of work opportunity (i.e., unemployment, temporary lay-offs, company buy-outs, forced relocations, etc.) do not report either unemployment or involuntary retirement in survey data. We propose a broader conceptualization of late-career unemployment. Using the Health and Retirement Study (HRS), a lost-work opportunity score (LOS) was computed from items indicating unemployment and forced or unplanned retirement. Correlations were computed between this LOS and all continuous variables in the RAND longitudinal compilation of the HRS to determine its convergent and discriminant validity. The LOS demonstrated a Chronbach’s alpha of α=0.82 and had convergent validity with constructs of employment (9 variables), finances (36 variables), and health (14 variables), as predicted by the literature on retirement timing. No other continuous variables in the HRS were identified with a moderate or strong correlation to LOS, demonstrating discriminant validity. Further research should explore whether a combination of variables in the HRS can improve the accuracy of measuring retirement voluntariness. Improved precision in measurement, through an expanded conceptualization of lost-work opportunity, may help explicate the retirement-related factors that impact health, to inform policy and support healthy aging decisions at a societal level.

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Aligning US Spending Priorities Using the Health Impact Pyramid Lens

American Journal of Public Health ◽

10.2105/ajph.2020.305645 ◽

2020 ◽

Vol 110 (S2) ◽

pp. S181-S185

Author(s):

J. Mac McCullough ◽

Jonathon P. Leider ◽

Beth Resnick ◽

David Bishai

Keyword(s):

Public Health ◽

Health Care ◽

Socioeconomic Factors ◽

Health Care Services ◽

Population Level ◽

Health Impact ◽

Health Impacts ◽

Base Of The Pyramid ◽

Individual Health ◽

Care Services

Thomas Frieden’s “health impact pyramid” presents a hierarchy in which the wide base of the pyramid of socioeconomic factors at a population level has more impact on the health of the public than do individually focused interventions at the pyramid’s top. From this pyramid perspective, the US spending priorities are misaligned, as expenses targeted at public health and socioeconomic factors are far outstripped by spending on individual health care services at the top of the pyramid. The nation’s ongoing debate on health care reform continues to focus on access to individual health care services, despite evidence demonstrating the health impacts of population-level efforts at the base of the pyramid and the synergistic health impacts of health and social service collaboration. We examine the need for improved systems alignment through the lens of the health impact pyramid. We catalog the types of misalignments and their social, political, and systems genesis. We identify promising opportunities to realign US health spending toward the socioeconomic factor base of the health impact pyramid and emphasize the need to integrate and align public health, social services, and medical care in the United States.

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Population-Level Prevalence, Bother, and Treatment Behavior for Urinary Incontinence in an Eastern European Country: Findings from the LUTS POLAND Study

Journal of Clinical Medicine ◽

10.3390/jcm10112314 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2314

Author(s):

Mikolaj Przydacz ◽

Marcin Chlosta ◽

Piotr Chlosta

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Rural Areas ◽

Eastern European Country ◽

Population Level ◽

Eastern European ◽

Level Data ◽

Urban And Rural Areas ◽

Eastern European Countries

Objectives: Population-level data are lacking for urinary incontinence (UI) in Central and Eastern European countries. Therefore, the objective of this study was to estimate the prevalence, bother, and behavior regarding treatment for UI in a population-representative group of Polish adults aged ≥ 40 years. Methods: Data for this epidemiological study were derived from the larger LUTS POLAND project, in which a group of adults that typified the Polish population were surveyed, by telephone, about lower urinary tract symptoms. Respondents were classified by age, sex, and place of residence. UI was assessed with a standard protocol and established International Continence Society definitions. Results: The LUTS POLAND survey included 6005 completed interviews. The prevalence of UI was 14.6–25.4%; women reported a greater occurrence compared with men (p < 0.001). For both sexes, UI prevalence increased with age. Stress UI was the most common type of UI in women, and urgency UI was the most prevalent in men. We did not find a difference in prevalence between urban and rural areas. Individuals were greatly bothered by UI. For women, mixed UI was the most bothersome, whereas for men, leak for no reason was most annoying. More than half of respondents (51.4–62.3%) who reported UI expressed anxiety about the effect of UI on their quality of life. Nevertheless, only around one third (29.2–38.1%) of respondents with UI sought treatment, most of whom received treatment. Persons from urban and rural areas did not differ in the degrees of treatment seeking and treatment receiving. Conclusion: Urinary incontinence was prevalent and greatly bothersome among Polish adults aged ≥ 40 years. Consequently, UI had detrimental effects on quality of life. Nonetheless, most affected persons did not seek treatment. Therefore, we need to increase population awareness in Poland about UI and available treatment methods, and we need to ensure adequate allocation of government and healthcare system resources.

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The domestication of Cucurbita argyrosperma as revealed by the genome of its wild relative

Horticulture Research ◽

10.1038/s41438-021-00544-9 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Josué Barrera-Redondo ◽

Guillermo Sánchez-de la Vega ◽

Jonás A. Aguirre-Liguori ◽

Gabriela Castellanos-Morales ◽

Yocelyn T. Gutiérrez-Guerrero ◽

...

Keyword(s):

Defense Mechanisms ◽

Population Level ◽

Growth Hormones ◽

Comparative Genomic ◽

Structural Variants ◽

Closely Related Species ◽

Level Data ◽

Genomic Analyses ◽

Genotype By Sequencing ◽

Regulation Of Growth

AbstractDespite their economic importance and well-characterized domestication syndrome, the genomic impact of domestication and the identification of variants underlying the domestication traits in Cucurbita species (pumpkins and squashes) is currently lacking. Cucurbita argyrosperma, also known as cushaw pumpkin or silver-seed gourd, is a Mexican crop consumed primarily for its seeds rather than fruit flesh. This makes it a good model to study Cucurbita domestication, as seeds were an essential component of early Mesoamerican diet and likely the first targets of human-guided selection in pumpkins and squashes. We obtained population-level data using tunable Genotype by Sequencing libraries for 192 individuals of the wild and domesticated subspecies of C. argyrosperma across Mexico. We also assembled the first high-quality wild Cucurbita genome. Comparative genomic analyses revealed several structural variants and presence/absence of genes related to domestication. Our results indicate a monophyletic origin of this domesticated crop in the lowlands of Jalisco. We found evidence of gene flow between the domesticated and wild subspecies, which likely alleviated the effects of the domestication bottleneck. We uncovered candidate domestication genes that are involved in the regulation of growth hormones, plant defense mechanisms, seed development, and germination. The presence of shared selected alleles with the closely related species Cucurbita moschata suggests domestication-related introgression between both taxa.

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A qualitative evaluation of Southwark Council’s public health response to mitigating the mental health impact of the 2017 London bridge and borough market terror attack

BMC Public Health ◽

10.1186/s12889-021-11447-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sandra Jumbe ◽

Adrienne Milner ◽

Megan Clinch ◽

Jonathan Kennedy ◽

Richard J. Pinder ◽

...

Keyword(s):

Mental Health ◽

Qualitative Evaluation ◽

Health Impact ◽

Health Needs ◽

Health Impacts ◽

Terror Attack ◽

Terror Attacks ◽

Physical Injuries ◽

Community Stakeholders ◽

Health Response

Abstract Background Over recent years there have been several major terror attacks in cities across Europe. These attacks result in deaths, physical injuries, and pose long-term threats to mental health and wellbeing of large populations. Although psychologists have completed important work on mental health responses to disaster exposure including terrorist attacks, the mental health impacts of such attacks have been comparatively less examined in academic literature than the acute health response to physical injuries. This paper reflects on Southwark Council’s pioneering public mental health response to the June 2017 terror attack at London Bridge and Borough Market. It aims to explore perceptions of the mental health impact of the incident by those living and working in the borough. Methods A rapid qualitative evaluation informed by the logic underpinning Southwark Council’s response was conducted. Seven formative interviews were undertaken with individuals involved in the response planning and/or delivery, enabling the evaluation team to establish the response’s theoretical basis. Subsequently, nineteen semi-structured interviews with consenting Council employees, residents, business owners, and workers from the Borough were conducted to understand perceived mental health impacts of the attack and the success of the Council response. Thematic analysis of transcribed interviews was undertaken to evaluate the extent to which the response was implemented successfully. Results Participants reported feeling the attack had a wide-reaching negative impact on the mental health of residents, those working in the borough and visitors who witnessed the attack. Delivering the response was a challenge and response visibility within the community was limited. Participants suggested a comprehensive systematic approach to health needs assessment informed by knowledge and relationships of key Council workers and community stakeholders is imperative when responding to terrorist incidents. Improved communication and working relationships between statutory organisations and community stakeholders would ensure community groups are better supported. Prioritising mental health needs of terror attack responders to mitigate persisting negative impacts was highlighted. Conclusions This article highlights a potential public health approach and need for developing robust practical guidance in the aftermath of terror attacks. This approach has already influenced the response to the Christchurch mosque shooting in 2019.

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