Background: According to the Bureau of Labor Statistics, the American workforce is aging. As a result, health problems associated with the aging process, like coronary heart disease (CHD) present new health and safety challenges. Over 3.5 million workers have CHD with significant work limitations and increased disability. Yet, little is known about how aging workers with CHD practice self-care, (i.e., adherence to medication and treatment, symptom monitoring and symptom management) on a daily basis within the context of employment or the consequences of poor self-care behaviors on aging worker health and safety. Furthermore, the effect of organization of work, defined as the work process (e.g., the way jobs are designed and performed) and organizational practices (management and production methods and human resource policies) on the health behavior of self-care and worker productivity in this population has not been explored. The proposed study is the first step in a program of research that addresses the National Occupational Research Agenda (NORA) priority to investigate how organization of work affects the health of the growing aging workforce, to identify risk factors that may disproportionately affect aging workers and to develop recommendations for interventions to improve the health and safety of older workers. The training plan is also aligned with the NORA research priority to prepare experts in organization of work. Purpose: The primary goal of the proposed study is to investigate the self-care practices of aging workers with CHD and the relationship of organization of work, resultant job-level risk factors, self-care, and health and productivity outcomes (health status, quality of life, absenteeism and presenteeism). This proposal has three specific aims: 1) to describe the self-care practices of aging workers with CHD, 2) to identify self-care types of aging workers with CHD and identify the characteristics and work-related determinants of self-care types in this population and 3) to explore the relationship of work organization and job-level characteristics to self-care, health status, quality of life and work-related (absenteeism, presenteeism) outcomes. Methods: To achieve these aims, a longitudinal study using mixed methodology and robust statistical methods is proposed. A sample of 125 adults (over age 50) with CHD who are employed full-time will be recruited from the New York City region. Findings from this study will identify organization- and job-level factors that predict self-care behavior types among aging workers with CHD. The significance of this study lies in its potential to serve as a basis for the development of targeted interventions, aimed at both work organization and job-level factors, to improve self-care among aging workers with CHD. Implications of study results may potentially lead to recommendations for workplace policies and generate novel job accommodations that facilitate self-care within the context of work. Career Development Training Plan: The long term goal of the training plan is to prepare the candidate for an occupational health research career as a successful independent investigator with expertise in organization of work research and a focus on optimizing self-care among aging workers with chronic illness. The immediate goals of this training plan are to provide the candidate with the opportunity to 1) engage in extensive training focused on organization of work theory and research and advanced quantitative methods, and 2) conduct an independent research project examining the self-care practices of aging workers with CHD and the relationship of organization of work, self-care and health and productivity outcomes through guided mentorship by an interdisciplinary team of experts and the extensive resources of New York University and the NIOSH Region II Universities NY/NJ ERC.
By 2015, 31.2 million workers in America will be over age 55. As many workers delay retirement, perhaps due to economic reasons, there is a critical need to understand the health and safety issues associated with the new organization of work (i.e., increased stress, production demands, long hours, shift work) in this population. For the significant portion of aging workers with CHD, engaging in self-care is critical to their health and productivity but may be particularly challenging within the demands of a workday. Results of this study will serve as a basis for the development of a targeted intervention to improve self-care, foster accommodations that facilitate self-care within the context of work;thereby, improving health and productivity among aging workers with CHD.