The Intersecting Consequences of Race-Gender Health Disparities on Workforce Engagement for Older Workers: An Examination of Physical and Mental Health

2021 ◽  
pp. 232949652110538
Author(s):  
Kendra Jason ◽  
Christy L. Erving
Keyword(s):  
Mental Health ◽  
Labor Force ◽  
Older Workers ◽  
Multinomial Logistic Regression ◽  
Later Life ◽  
Multiple Chronic Conditions ◽  
Physical And Mental Health ◽  
Race And Gender ◽  
Logistic Regression Models ◽  
Workforce Engagement

The dramatic growth of older adults’ labor participation over the past 25 years, including women and people of color, is reshaping the American labor force. The current study contributes new knowledge concerning why individuals over age 50 years may be working longer despite negative impacts of deteriorating physical and mental health associated with aging. Inquiries regarding who continues to work and why can be answered, in part, by addressing how workforce engagement and health are shaped by notable social inequities along the dimensions of age, race, and gender. Guided by cumulative advantage/disadvantage and intersectionality frameworks, we examine whether having multiple chronic conditions (MCC)—two or more physical conditions—and depression affect workforce participation. Using multinomial logistic regression models, we analyze the 2014–2016 waves of the Health and Retirement Study ( N = 4250). Findings reveal that having multiple chronic illnesses increase the likelihood of labor force exit, especially among workers who also have depression. We also discover intersectional nuances which illuminate complex race-gender dynamics related to health and work processes in later life. We conclude with recommendations for workplace policy that promote the retention of older workers with chronic illness and depression and aim to decrease disparities in older workers’ work engagement.

Socio-Economic Family Background and Adult Children’s Health in Germany: The Role of Intergenerational Transmission of Education

2020 ◽  
Author(s):  
Oliver Arránz Becker ◽  
Katharina Loter
Keyword(s):  
Mental Health ◽  
Life Course ◽  
Intergenerational Transmission ◽  
Parental Education ◽  
Panel Study ◽  
Later Life ◽  
Children's Health ◽  
Children’S Health ◽  
Physical And Mental Health ◽  
Intergenerational Transmission Of Education

Abstract This study examines consequences of parental education for adult children’s physical and mental health using panel data from the German Socio-Economic Panel study. Based on random-effects growth curve models (N = 15,144 West German respondents born between 1925 and 1998 aged 18–80), we estimate gender-, age-, and cohort-specific trajectories of physical and mental health components of the SF-12 questionnaire for low and high parental education measured biennially from 2002 to 2018. Findings suggest more persistent effects of parental education on physical than mental health. In particular, both daughters and sons of the lower educated group of parents (with neither parent qualified for university) exhibit markedly poorer physical health over the whole life course and worse mental health in mid-life and later life than those of higher educated parents. Thus, children’s health gradients conditional on parental education tend to widen with increasing age. Once children’s educational attainment is held constant, effects of parental education on children’s health mostly vanish. This suggests that in the strongly stratified West German context with its rather low social mobility, intergenerational transmission of education, which, according to our analyses, has been declining among younger cohorts, contributes to cementing long-term health inequalities across the life course.

scholarly journals Educational differences in the influence of health on early work exit among older workers

2020 ◽  
Vol 77 (8) ◽  
pp. 568-575 ◽  
Author(s):  
Sascha De Breij ◽  
Jana Mäcken ◽  
Jeevitha Yogachandiran Qvist ◽  
Daniel Holman ◽  
Moritz Hess ◽  
...  
Keyword(s):  
Mental Health ◽  
Longitudinal Study ◽  
The Netherlands ◽  
Health Effects ◽  
Older Workers ◽  
Cox Regression ◽  
Functional Limitations ◽  
Physical And Mental Health ◽  
Cox Regression Analysis ◽  
Educational Differences

ObjectivesPrevious research has shown that poor physical and mental health are important risk factors for early work exit. We examined potential differences in this association in older workers (50+) across educational levels.MethodsCoordinated analyses were carried out in longitudinal data sets from four European countries: the Netherlands (Longitudinal Aging Study Amsterdam), Denmark (Danish Longitudinal Study of Ageing), England (English Longitudinal Study of Ageing) and Germany (German Ageing Survey). The effect of poor self-rated health (SRH), functional limitations and depression on different types of early work exit (early retirement, economic inactivity, disability and unemployment) was examined using Cox regression analysis. We examined educational differences in these effects by testing interaction terms.ResultsPoor physical and mental health were more common among the lower educated. Poor SRH, functional limitations, and depression were all associated with a higher risk of early work exit. These health effects were strongest for the disability exit routes (poor SRH: HRs 5.77 to 8.14; functional limitations: HRs 6.65 to 10.42; depression: HRs 3.30 to 5.56). In the Netherlands (functional limitations) and England (functional limitations and SRH), effects were stronger in the lower educated.ConclusionsThe prevalence of health problems, that is, poor SRH, functional limitations and depression, was higher in the lower educated workers. All three health indicators increase the risk of early work exit. In some countries, health effects on early exit were stronger in the lower educated. Thus, lower educated older workers are an important target group for health policy and intervention.

Factors associated with workability in Spanish health centre workers

2020 ◽  
Author(s):  
I Mateo-Rodríguez ◽  
E Knox ◽  
A Daponte-Codina ◽  
Keyword(s):  
Multinomial Logistic Regression ◽  
Health Centre ◽  
Cross Sectional Study ◽  
Work And Family ◽  
Physical And Mental Health ◽  
Related Factors ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Spanish Health

Abstract Background The concept of workability provides a conceptual framework and proposes measures for the evaluation of relevant actions focused on a healthy workforce. In Spain, one of the countries with the highest life expectancy, there are practically no scientific studies on workability and its associated factors. Aims The objective of this study is to examine the associations between workability and variables related to health and work in a sample of workers from Spanish health centres. Methods Cross-sectional study including 1184 health centre workers who completed a questionnaire at baseline, comprising measures of workability, health and other work-related factors. Workability has been analysed as a one-factor construct, and as a two-factor construct. Multinomial logistic regression models were used to analyse factors associated with workability. Results As a one-dimensional construct, workability is associated with physical and mental health, number of hours of worked, insomnia, work and family life balance, adequate training, never having had an accident and type of contract. When the two-factor measure was used, sensitivity of findings increased, and it was identified that those participants who were older, lived alone and have more years of service in their profession also show worse workability. Conclusions The present study identified factors associated with the workability of health centre workers. The two-factor workability index (WAI) has better psychometric properties and used in combination with the global measure of WAI, identifies important additional aspects, specifically, age and years of professional experience as additional considerations for the intervention.

scholarly journals Deaths, Disparities, and Cumulative (Dis)Advantage: How Social Inequities Produce an Impairment Paradox in Later Life

2021 ◽  
Author(s):  
Heide Jackson ◽  
Michal Engelman
Keyword(s):  
Black Women ◽  
Multinomial Logistic Regression ◽  
Functional Limitations ◽  
Later Life ◽  
Functional Health ◽  
Race And Gender ◽  
Nationally Representative ◽  
And Gender ◽  
Gender Groups ◽  
The Impact

Abstract Background Research on health across the life course consistently documents widening racial and socioeconomic disparities from childhood through adulthood, followed by stabilization or convergence in later life. This pattern appears to contradict expectations set by cumulative (dis)advantage (CAD) theory. Informed by the punctuated equilibrium perspective, we examine the relationship between midlife health and subsequent health change and mortality and consider the impact of earlier socioeconomic exposures on observed disparities. Methods Using the Health and Retirement Study, we characterize the functional impairment histories of a nationally-representative sample of 8,464 older adults between 1994-2016. We employ non-parametric and discrete outcome multinomial logistic regression to examine the competing risks of mortality, health change, and attrition. Results Exposures to disadvantages are associated with poorer functional health in midlife and mortality. However, a higher number of functional limitations in midlife is negatively associated with the accumulation of subsequent limitations for white men and women and for Black women. The impact of educational attainment, occupation, wealth, and marriage on later life health differs across race and gender groups. Conclusions Observed stability or convergence in later-life functional health disparities is not a departure from the dynamics posited by CAD, but rather a result of the differential impact of racial and socioeconomic inequities on mortality and health at older ages. Higher exposure to disadvantages and a lower protective impact of advantageous exposures lead to higher mortality among Black Americans, a pattern which masks persistent health inequities later in life.

scholarly journals Seeking a pot of gold with integrated behavior therapy and research to improve health equity: insights from the RAINBOW trial for obesity and depression

2021 ◽  
Author(s):  
Elizabeth M Venditti ◽  
Lesley E Steinman ◽  
Megan A Lewis ◽  
Bryan J Weiner ◽  
Jun Ma
Keyword(s):  
Mental Health ◽  
Behavioral Medicine ◽  
Behavior Therapy ◽  
Chronic Conditions ◽  
The United States ◽  
Multiple Chronic Conditions ◽  
Dissemination And Implementation ◽  
Physical And Mental Health ◽  
Medicine Research ◽  
Increased Risk

Abstract More than one third of adults in the United States (U.S.) live with multiple chronic conditions that affect their physical and mental health, functional outcomes, independence, and mortality. The COVID-19 pandemic has exposed not only an increased risk for infection, morbidity, and mortality among those with chronic conditions but long-standing health inequities by age, race, sex, and other social determinants. Obesity plus depression represent one such prevalent comorbidity for which few effective integrated interventions exist, prompting concern about the potential for secondary physical and mental health pandemics post COVID-19. Translational behavioral medicine research can play an important role in studying integrated collaborative healthcare approaches and advancing scientific understanding on how to engage and more effectively treat diverse populations with physical and mental health comorbidities. The RAINBOW (Research Aimed at Improving Both Mood and Weight) clinical trial experience offers a wealth of insights into the potential of collaborative care interventions to advance behavior therapy research and practice. Primary care patients with co-occurring obesity and depression were assigned to either Integrated Coaching for Mood and Weight (I-CARE), which blended Group Lifestyle Balance (GLB) for weight management and the Program to Encourage Active Rewarding Lives (PEARLS) for depression, or usual care, to examine clinical, cost-effectiveness, and implementation outcomes. This commentary highlights the empirical findings of eight RAINBOW research papers and discusses implications for future studies, including their relevance in the U.S. COVID-19 context. Organized by key principles of translational behavioral medicine research, the commentary aims to examine and embrace the heterogeneity of baseline and intervention response differences among those living with multiple chronic conditions. We conclude that to prevent health and healthcare disparities from widening further, tailored engagement, dissemination, and implementation strategies and flexible delivery formats are essential to improve treatment access and outcomes among underrepresented populations.

scholarly journals Trajectories of material living standards, physical health and mental health under a universal pension

2020 ◽  
Vol 74 (4) ◽  
pp. 362-368
Author(s):  
Joanne Allen ◽  
Fiona M Alpass
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Short Form ◽  
Adult Population ◽  
Later Life ◽  
Well Being ◽  
Living Standards ◽  
Poor Health ◽  
Material Hardship ◽  
Physical And Mental Health

ObjectiveAged pension schemes aim to support material and non-material well-being of older populations. The current work aimed to describe dominant trajectories of material living standards in the decades prior to and following eligibility for an aged pension, and describe associated trajectories of physical and mental health.MethodsLongitudinal data on living standards and indices of health Short Form 12 were collected over 2–12 years follow-up from 4811 New Zealand adults aged 55–76. Growth mixture models were used to identify dominant trajectories of living standards with age. Latent growth curve models were used to describe trajectories of physical and mental health associated with each living standards trajectory class.ResultsA group characterised by good living standards with age (81.5%) displayed physical and mental health scores comparable to those of the general adult population. Smaller groups experienced hardship but increasing living standards (11.8%) and hardship and declining living standards (6.8%). While both groups in hardship experienced poor health in the decade prior pension eligibility, mental health improved among those with increasing living standards, while physical and mental health declined among those with declining living standards.ConclusionUnder the current policy settings, a majority of older adults in New Zealand maintain a good level of living standards and health in later life. However, significant proportions experience material hardship and poor health in the decade prior to pension eligibility. Alleviation of material hardship may reduce health inequalities in later life.

Logistic regression models for predicting physical and mental health-related quality of life in rheumatoid arthritis patients

2008 ◽  
Vol 18 (6) ◽  
pp. 601-608 ◽  
Author(s):  
Gholam Hossein Alishiri ◽  
Noushin Bayat ◽  
Ali Fathi Ashtiani ◽  
Seyed Abbas Tavallaii ◽  
Shervin Assari ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Mental Health ◽  
Regression Models ◽  
Health Related Quality ◽  
Physical And Mental Health ◽  
Logistic Regression Models ◽  
Related Quality ◽  
Health Related

Ageing and Mental Health

2021 ◽  
pp. 549-572
Author(s):  
Neelam Verma
Keyword(s):  
Mental Health ◽  
Old Age ◽  
Later Life ◽  
The Elderly ◽  
Psychological Services ◽  
Current Status ◽  
Physical And Mental Health ◽  
Psychological Conditions ◽  
Treatment Services ◽  
Research Findings

Estimated research findings suggest that almost two-thirds of adults with psychiatric conditions do not receive the required treatment services. This chapter enables readers to understand various aspects of ageing, how physical and mental health aspects are correlated, and which mental health conditions are most common in later life. The chapter also discusses major models of mental health in the context of ageing. Major psychiatric and psychological conditions that are most common in old age are outlined along with a major milestone of old age (i.e., retirement: a major lifestyle change that pushes older people towards psychological problems and adjustment issues with a new phase of life). A brief description is presented on the current status of psychiatric and psychological services for mental health issues of the elderly. The chapter concludes by summarizing the contents of discussed areas. Studies are presented throughout the chapter to accompany and enrich the discussion and validate the chapter content.

scholarly journals MULTIMORBIDITY, MENTAL HEALTH, AND TERMINAL DECLINE IN LATER LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S619-S620
Author(s):  
Dorina Cadar ◽  
Lucy Stirland ◽  
Graciela Muniz Terrera
Keyword(s):  
Mental Health ◽  
Psychological Health ◽  
Cognitive Reserve ◽  
Positive Association ◽  
Later Life ◽  
Older Individuals ◽  
Physical And Mental Health ◽  
Term Condition ◽  
Brain Resilience

Abstract The close interlink between physical and mental health outcomes has long been recognised in gerontological research. Mental-physical comorbidities – the presence of at least one physical health long term condition, and at least one mental health-related long term condition are common in older age individuals. Numerous studies have shown a positive association between the prevalence of multimorbidity and age so, as the population of older individuals in developed nations continues to grow, multimorbidity is likely to become increasingly higher in ageing populations. A major goal in current gerontological neuropsychology and neuroepidemiological research is to better understand how interindividual differences in cognitive and mental health in old age emerge. Cognitive reserve (a marker of brain resilience) may come into play when facing stressors that affect cognitive decline and mental health, such as suffering from chronic diseases. We present data from three different longitudinal studies of ageing i) the Lothian Birth Cohort of 1921, ii) PREVENT and iii) the English Longitudinal Study of Ageing from the United Kingdom. These studies are ideally placed to address key research questions related to mental ageing, psychological health, terminal decline and their determinants. We explored the following objectives: 1) to investigate the association between an increasing number of chronic physical conditions, medication and mental disorders 2) to assess the role of childhood intelligence and education on the terminal decline in later life 3) to investigate the associations between different markers of cognitive reserve and dementia

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