People over 65 years old (65+) are the fastest growing group in the US population, and workers 65+ are increasing in number much more rapidly than any other worker age group. By year 2012, workers 65+ are estimated to comprise 16.7% of US labor force. This group of elderly workers is highly diverse (e.g. racial/ethnic and socio-economic status composition), yet their health status is only beginning to be characterized. Furthermore, careful examination of health-related quality of life of the older worker has been virtually ignored by the occupational health/aging research community. Finally, there has been no systematic research into variations in healthcare costs and utilization in this population, despite systemic concern over rising healthcare costs in the United States. This study proposes to use the National Health Interview Survey (NHIS) and the Medical Expenditure Panel Survey (MEPS) to study the health status, medical expenditures, healthcare utilization, and quality of life of employed older adults. Both datasets contain large representative samples of US adults 65+ (n=386,887 and n=17,396). Both descriptive and analytic modeling are proposed within a structural equation modeling (SEM) framework, taking into account socio-economic determinants of health such as occupational segregation and occupational prestige. The study proposes to:1) characterize health disparities, morbidity, health behaviors and conditions, and health-related quality of life of US workers and non-workers 65+ stratified by age, gender, race/ethnicity, education, health insurance, occupational segregation and prestige, employment status and occupational/industry categories;2) using SEM, identify sociodemographic and occupational factors (including occupational prestige and segregation) associated with healthcare utilization and expenditures by workers 65+ after adjustment for health behavior, morbidity and health conditions;and 3) using SEM, predict the health- related quality of life in sub-populations of workers 65+ after adjustment for health behavior, morbidity and health conditions. This study is relevant to four out of five National Institute on Aging (NIA) research goals, including: (1) understanding of disease and disability in older adults;(2) aiding in developing interventions to improve their health and quality of life;(3) understanding the implications of an aging society;and (4) identification of health disparities and interventions to decrease these disparities. The findings of the proposed study can be used by policy makers, employers, and other stakeholders to make health-related and employment-related decisions and implement workplace changes and health promotion programs targeting the senior community in order to improve well-being and quality of life of people 65+.

Public Health Relevance

Adults over 65 years old who remain employed past retirement age constitute a rapidly growing and a highly diverse proportion of US older adults, however their health status, healthcare expenditures, and quality of life are only beginning to be characterized. Using innovative advanced statistical techniques this proposal will describe current older worker socio-demographics characteristics, health status, as well as study linkages between occupational status and occupation on one hand, and health status, healthcare utilization and expenditures, and health-related quality of life on the other.

Agency
National Institute of Health (NIH)
Type
Individual Predoctoral NRSA for M.D./Ph.D. Fellowships (ADAMHA) (F30)
Project #
5F30AG040886-04
Application #
8701207
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Patmios, Georgeanne E
Project Start
Project End
Budget Start
Budget End
Support Year
4
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Miami School of Medicine
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
Kachan, Diana; Tannenbaum, Stacey L; Olano, Henry A et al. (2014) Geographical variation in health-related quality of life among older US adults, 1997-2010. Prev Chronic Dis 11:E110
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Kachan, Diana; Fleming, Lora E; LeBlanc, William G et al. (2012) Worker populations at risk for work-related injuries across the life course. Am J Ind Med 55:361-6
Lee, David J; Fleming, Lora E; LeBlanc, William G et al. (2012) Health status and risk indicator trends of the aging US health care workforce. J Occup Environ Med 54:497-503