Park Sung S, Pebley Anne R, Goldman Noreen, Pratt Boriana, Sheftel Mara Getz
Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA.
California Center for Population Research, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
Demography. 2025 Jun 1;62(3):1003-1028. doi: 10.1215/00703370-11977071.
Work is an important contributor to racial and ethnic disparities in health across the life course. Because functional limitations at older ages are associated with accumulated physical wear and tear throughout life, investigating work-related mechanisms that differentially expose Black and Hispanic Americans to difficult material circumstances over time is an important step toward understanding these disparities. Using a new data source of lifetime work histories from the Health and Retirement Study, this study investigates the role of accumulated years of physically demanding work (PDW) through middle adulthood on the number of functional limitations at age 60 (FL60). This study also assesses whether cumulative PDW accounts for the observed differences in FL60 among U.S.-born Black, Hispanic, and White respondents. We find that cumulative PDW is strongly associated with FL60 and partially accounts for the racial and ethnic gap in FL60 in the presence of extensive control variables. We also demonstrate that a traditional regression model underestimates the Black-White and Black-Hispanic differences in FL60 compared with a marginal structural model with an inverse probability of treatment weighting approach. Our results illustrate the importance of studying work from a life course perspective that ultimately influences the health of the diverse, aging U.S. population.
工作是一生中健康方面种族和族裔差异的一个重要促成因素。由于老年时的功能受限与一生中累积的身体损耗有关，调查随着时间推移使美国黑人和西班牙裔美国人面临不同艰难物质环境的与工作相关的机制，是理解这些差异的重要一步。本研究利用来自健康与退休研究的新的终生工作经历数据源，调查中年时期累积的体力要求高的工作（PDW）年限对60岁时功能受限数量（FL60）的作用。本研究还评估累积的PDW是否解释了在美国出生的黑人、西班牙裔和白人受访者中观察到的FL60差异。我们发现，累积的PDW与FL60密切相关，并且在存在大量控制变量的情况下，部分解释了FL60中的种族和族裔差距。我们还证明，与采用逆概率治疗加权方法的边际结构模型相比，传统回归模型低估了FL60中的黑白差异和黑西班牙裔差异。我们的结果说明了从生命历程角度研究工作的重要性，这最终会影响美国多样化老龄人口的健康。
