Work Disability Research Articles

Work Disability Duration Among Mobile Workers: Does Intraprovincial Mobility Matter as Much as Interprovincial Mobility?

The aim of the study is to compare work disability duration of intraprovincially and interprovincially mobile workers with nonmobile workers in British Columbia, Canada. Workers' compensation claims were extracted for workers injured between 2010 and 2019. Employer and residential postal codes were converted to economic regions to define nonmobile, intraprovincially, and interprovincially mobile workers. Quantile regression models using matched cohorts were used to estimate differences in work disability days at different percentiles of the distribution. Compared with nonmobile workers, both mobile worker groups had longer work disability durations, particularly interprovincially mobile workers. Differences persisted in injury-stratified models and were partially or fully attenuated in some industry-stratified models. Workers' compensation systems, employers, and healthcare providers may need to tailor specific interventions for mobile workers who are from out-of-province as well as traveling between regions in the province.

Sequences of vocational rehabilitation services in Germany: a cohort study

BackgroundThis study aimed to describe sequences of vocational rehabilitation services among individuals with approved vocational rehabilitation in Germany and to identify typical service sequences.MethodsWe used administrative data on vocational rehabilitation services and questionnaire data on health and work ability to describe frequencies and sequences of vocational rehabilitation services financed by the Federal German Pension Insurance. Through sequence analysis, we were able to map the service sequences. We did cluster analyses to identify typical different service sequences.ResultsOur sample included 1,652 individuals with 2,584 services. Integration services and two-year vocational retraining were the most common services. We could identify three different service clusters around integration services: shorter ones, followed by employer benefits and without employer benefits. We found two different clusters around two-year vocational retraining: shorter and longer clusters. Two-year vocational retraining was more often initiated by preparatory services and followed by employer benefits than integration services. Longer services in both clusters were associated with better baseline data for physical health, work ability, risk of future work disability, and younger age than shorter services. People in two-year-vocational retraining reported at baseline better general health, better work ability, low risk of future work disability, and less mental illness compared to people in integration services.ConclusionsMultiple services, that is, sequences of services, were more likely to occur among individuals with more complex services like two-year vocational retraining. Utilization of complex services and longer services was influenced by health, age, risk of future work disability, and education.Trial registrationGerman Clinical Trials Register DRKS00009910, registration 25/01/2016.

Pilot Study of aNovel Online Comprehensive Pelvic Floor Program for Urinary Incontinence in Women.

Urinary incontinence (UI) is common in women and has a vast impact on quality of life (QOL), financial health, and work disability. Robust evidence demonstrates the efficacy of comprehensive conservative therapy (pelvic floor muscle training [PFMT], and behavioral and dietary modification) in the treatment of UI. However, numerous barriers impede access to this care, including limited specialized therapists, financial barriers, and scheduling obstacles. To address these barriers, we developed a novel comprehensive online pelvic floor program (oPFP). We performed a prospective study assessing continence and QOL outcomes in women with stress urinary incontinence (SUI), urge urinary incontinence (UUI), or mixed urinary incontinence (MUI) treated with oPFP between May 2019 and November 2022. Outcomes were assessed at baseline and following completion of the 2-month program using the validated International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms, Urgency Perception Scale (UPS), Incontinence Impact Questionnaire (IIQ-7) questionnaires, and 24-h bladder diary. Data were analyzed using linear, Poisson mixed models, or generalized estimating equations. Twenty-eight women (2 SUI, 3 UUI, 23 MUI) were enrolled and 19 (2 SUI, 2 UUI, 15 MUI) completed the study. Following oPFP, participants showed significantly improved SUI domain scores (3.04 ± 0.19 vs 1.81 ± 0.23, p < 0.001), UPS reason score (2.52 ± 0.18 vs 2.05 ± 0.14, p = 0.003), IIQ-7 sum scores (5.16 ± 0.88 vs 3.07 ± 0.70, p = 0.038), and daily incontinence episodes (2.96 ± 0.60 vs 1.06 ± 0.29, p < 0.001). Mean patient-reported improvement was 5.4 ± 2.5 (ten-point Likert scale). Of respondents, 89% reported program satisfaction, ease of use, and would recommend the program to others. The oPFP results in significant improvements to a variety of UI and QOL measures. This program provides an important UI treatment option and gives women greater access to effective conservative therapy.

Health support of people with intellectual disability and the crucial role of support workers

BackgroundPeople with intellectual disability have a poorer health status than the general population. In The Netherlands, support workers play a key role in meeting health support needs of people with intellectual disability. Research on how people with intellectual disability and their support workers experience the support worker’s role in preventing, identifying, and following up health needs of people with intellectual disability is scarce. To enhance health support of people with intellectual disability it is crucial that we understand how health support is delivered in everyday practice. Therefore, this study investigated experiences of people with intellectual disability and support workers with the health support of people with intellectual disability.MethodData collection consisted of six focus group (FG) discussions with between four and six participants (N = 27). The FGs consisted of three groups with support workers (n = 15), two groups with participants with mild to moderate intellectual disability (n = 8), and one group with family members as proxy informants who represented their relative with severe to profound intellectual disability (n = 4). The data was analysed thematically on aspects relating to health support.ResultsWe identified three main themes relevant to the health support of people with intellectual disability: 1) dependence on health support, 2) communication practices in health support, and 3) organizational context of health support. Dependence on health support adresses the way in which support workers meet a need that people with intellectual disability cannot meet themselves, and communication practices and organizational context are identified as systems in which health support takes place.ConclusionThis study investigated experiences with the health support of people with intellectual disability from the perspectives of people with intellectual disability and support workers. We discuss the dependence of people with intellectual disability and the complexity of health support in everyday practice. We provide practical implications that can strengthen support workers in the provision of health support for people with intellectual disability in everyday practice. The findings of this study emphasize the need for intellectual disability care-provider organizations to establish policies around consistency in support staff to make it easier to identify and follow up health needs, and an environment where support staff can develop their expertise concerning communication practices, lifestyle choices, and identifying and following up health needs.

Use of a job exposure matrix to predict the risk of work disability in individuals with back pain: An inception cohort study.

Low back pain has a high economic burden in Germany due to back pain-related sick leave, disability pensions, and health care utilization. Work-related factors can predict disabling back pain. Job exposure matrices can be used to consider job demands and occupational characteristics in routine data analysis. This longitudinal analysis tested whether rehabilitation utilization due to musculoskeletal disorders is associated with occupation-linked job exposures in employees with back pain. Data from a German cohort study were used, including employees aged 45 to 59 years with self-reported back pain in the last three months. Individuals' job titles were assessed in the baseline survey in 2017 and matched with parameters of aggregated job exposure indices. Administrative data from the German Pension Insurance were used to extract information on rehabilitation utilization. Proportional hazard models tested the associations. We considered data of 6,569 participants (mean age: 52.3 years; 57.7% women). During follow-up, with a maximum of 21 months, 296 individuals (4.5%) utilized medical rehabilitation due to musculoskeletal disorders. Adjusted analyses showed that high physical (HR = 2.87; 95% CI 1.74; 4.75) and overall (HR = 2.34; 95% CI 1.44; 3.80) job exposures were associated with a higher risk of rehabilitation utilization. Individuals with back pain working in occupations with high physical job exposures have a higher risk for rehabilitation utilization. To prevent work disability in individuals with back pain, occupational groups with high physical job exposures should be actively informed about tailored intervention options.

Long COVID and Chronic Conditions in the US Workforce: Prevalence, Productivity Loss, and Disability.

This study examines how long COVID, chronic conditions, and work outcomes affect the general workforce. It examines the prevalence of long COVID and its associations with chronic conditions, and other sociodemographic characteristics using 2022 National Health Interview Survey data. Long COVID affected work attendance and disability risk, especially in those with mental health issues, angina, stroke, cancer, diabetes, chronic lung conditions, and musculoskeletal conditions. This study reveals the relationships between long COVID, chronic conditions, and work outcomes.

A Human Digital Twin of Disabled Workers for Production Planning

Including disabled workers in value-creating work processes is a fundamental and guaranteed human right and is, therefore, an essential goal of society. In Germany, sheltered workshops create the conditions for this inclusion since they are essential to companies' value chains. A central challenge is the inclusion of disabled workers in the value-creation processes, such as in manufacturing or assembly areas. The skills of disabled workers vary since they have individual impairments. Therefore, this paper presents a digital human model, a Human Digital Twin (HDT), for disabled workers. The model maps their skills and supports the production planning and assembly processes.

Survival analysis of Chagas disease patients, beneficiaries of social security and social assistance in Brazil, 1942-2016.

To analyze the survival of patients with Chagas disease, beneficiaries of social security and social assistance, in Brazil, from 1942 to 2016. This is a retrospective cohort study with data from the Brazilian Ministry of Social Security. The event of interest was death, and the survival functions were estimated by the Kaplan-Meier and Cox regression methods. In the period "onset of the disease until death", women (HR=0.54; 95%CI 0.43-0.53) and receiving social security benefits (HR=0.13; 95%CI 0.11-0.23) were associated with longer survival. Lower survival was associated with the cardiac form of the disease (HR=2.64; 95%CI 2.23-3.12), living in a rural area (HR=1.23; 95%CI 1.14-1.21), and manifestation of the disease between the years 2000 and 2016 (HR=5.32; 95%CI 4.74-5.93). Likewise, in the period "work disability until death", women (HR=0.51; 95%CI 0.41-0.52) and receiving social security benefits (HR=0.24; 95%CI 0,14-0.45) were associated with longer survival, as well as the cardiac form of the disease (HR=1.95; 95%CI 1.83-2.13), living in a rural area (HR=1.31; 95%CI 1.21-1.54), and manifestation of the disease between 2000 and 2016 (HR=1.53; 95%CI 1.33-1.71) were associated with lower survival. The main predictors of mortality and survival of patients with Chagas disease who receive social security and assistance benefits in Brazil were presented. These findings can guide the definition of priorities for follow-up actions by Primary Health Care, currently recommended for the longitudinal management of the disease.

Investigating the productivity in different assembly system configurations for a better inclusion of disabled workers

One of the United Nations’ Sustainable Development Goals is focused on decent work and growth which aims to reduce and, finally, remove all barriers for people with a form of diversity like disability. In such a context, manufacturing and production systems should be adapted by adopting specific equipment to help workers with disability while executing jobs according to the type of disability they report. Jobs must be properly planned since disabled workers have physical or cognitive disabilities and specific rights to work. Further, aiming to guarantee a real inclusion of workers with disability production systems should be designed to include these workers in the same working environment as workers without disability. This paper focuses on assembly systems, and it aims to investigate how different designs could impact both the productivity and inclusion of disabled workers. Then, due to the higher variety of products belonging to the same family mixed model assembly systems are considered. For each assembly system design, the daily productivity is calculated by using a simulation approach. Finally, according to the obtained results we provide some considerations about the convenience of adopting parallel flows to guarantee higher inclusion without affecting too much the productivity of the assembly system.

Challenges in the Reintegration of Disabled Individuals into the Workforce

The reintegration of disabled individuals into the workforce presents significant challenges and opportunities for enhancing workplace diversity and inclusivity. This study aims to explore the barriers and supports experienced by disabled workers as they navigate their return to employment, highlighting the complex interplay of personal, societal, and institutional factors that influence their reintegration process. This qualitative study utilized semi-structured interviews with 31 disabled individuals who have attempted to re-enter the workforce. Participants were selected through purposive sampling to capture a diverse range of disabilities, ages, and employment backgrounds. Data were analyzed using thematic analysis facilitated by NVivo software, focusing on reaching theoretical saturation where no new themes emerged from the data. Three main themes were identified: Employment Barriers, Support Systems, and Positive Experiences. Employment Barriers included categories such as Physical Accessibility, Social Attitudes, Workplace Policies, Technology and Tools, and Legal and Institutional barriers. Support Systems highlighted Government Programs, Community and Networks, Employer Support, and Personal Strategies. Positive Experiences encompassed Successful Accommodations, Employer Engagement, Career Development, and Advocacy and Awareness, illustrating facilitative aspects that aid reintegration. The study underscores the necessity of a multi-layered approach to the workforce reintegration of disabled individuals. Effective accommodations, proactive employer engagement, and robust support systems are crucial for overcoming the significant barriers these individuals face. Enhancing these areas can significantly improve employment outcomes for disabled workers, promoting a more inclusive and diverse workforce.

О ПИЛОТНОМ ПРОЕКТЕ В РАМКАХ РЕАЛИЗАЦИИ СТРАТЕГИИ ДЕЙСТВИЙ ПО СБЕРЕЖЕНИЮ МУЖЧИН И ПОДДЕРЖКЕ ОТВЕТСТВЕННОГО ОТЦОВСТВА

Significance. The relevance of the study conducted as part of the implementation of the action strategy to protect men and support responsible fatherhood, developed in 2023 by the author's team of leading scientists, members of the Scientific Council “Demographic and Migration Problems of Russia” at the Department of Social Sciences of the Russian Academy of Sciences, is associated with the need to develop and adopt state measures to support young people with acquired disabilities. The purpose of the study is to identify factors determining self-preservation, agent and resource potential of young men with acquired disabilities; to identify public opinion of the citizens of the Russian Federation on the social, economic and reproductive problems of young men under 35 years with acquired disabilities. Material and methods of the study represent the basic provisions of the concept of self-preservation behavior, family well-being, quality of life of the population, normalization of the lives of people with disabilities. The author's pilot study conducted in 2024 in the Vladimir and Nizhny Novgorod regions, have identified the most acute aspects of the socio-psychological problems of young men with acquired disabilities. A sociological study was conducted using a semi-structured survey method (the target sample of the study included 88 respondents aged 18 to 65 years, permanently residing in the Vladimir and Nizhny Novgorod regions). The study used comparative statistical analysis. Results. The result of the study was the data that constitute the opinion of the referents, participants of the pilot stage of the study of the problems of young men with disabilities: assessment of the mechanisms of social rehabilitation, support from the state and society, stigmatization of men with disabilities. The analysis of empirical data made it possible to draw conclusions about the changing attitude of society towards the problem of disability, however, it revealed a contradiction between the legitimized legislation on the rights of persons with disabilities and the real problems faced by men with acquired disabilities in family, work and social spheres of life. Conclusion. Implementing a pilot study within the framework of the project allowed the authors to draw conclusions about the need to develop a mechanism for and a program of public examination of the quality of living environments of young people with acquired disabilities experiencing difficulties in integration; to create models of targeted mobile social work with young men with disabilities; psychological support - self-help groups and mutual support of young people in difficult situations; to disseminate programs on developing independent living skills and abilities among young men with acquired disabilities who have difficulties in integration. Scope of application. The data obtained during the pilot study can be used in practice of social protection institutions, medical rehabilitation institutions, executive authorities and legislative initiatives aimed at increasing the resource potential of young people under 35 with acquired disabilities.

Decolonizing Disability in Social Work: A Conversation on Colonialism

Decolonizing Disability in Social Work: A Conversation on Colonialism

Assistive Technology and Employment Opportunities for People with Disabilities: A Systematic Review and Meta-analysis

Assistive technology (AT) can support the employment of people with disabilities (PwDs). This study aimed to investigate the impact of AT on the employability of PwDs and determine the barriers hindering its effective use in the job market in Saudi Arabia. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. A total of 20 sources were incorporated, inclusive of 7259 participants. To identify articles for this meta-analysis, database search results were screened by considering article titles and abstracts. Statistical analyses, including effect size calculation, weighting, subgroup analysis, and heterogeneity assessment, were conducted using RevMan software (version 5.3). A significant relationship between AT use and the employability of PwDs was found. The meta-analysis indicated that individuals using AT had higher odds of being employed than their counterparts without the devices (odds ratio = 2.41, 95% confidence interval: 1.89-2.93, P &lt; 0.013). Subgroup analysis indicated that PwDs using AT for communication, ergonomic accommodations, and mobility had higher job retention and employability rates than their counterparts without AT. Limited awareness concerning AT, high acquisition costs, and skill insufficiency were found to be major hindrances to the use of AT among PwDs. AT use associates positively with the employability and overall well-being of PwDs. Fiscal aid, targeted education, and awareness campaigns can help disabled Saudi workers utilize AT more effectively.

Long-term work disability: loss of rights, survival and tangency of primary health care.

This article aims to explore the experience of long-term work disability (LWD) of users-workers in primary health care (PHC), understanding the therapeutic itineraries and the search for social protection, the elements that contribute to the incapacitation process and the strategies constructed for living with this condition. LWD is a multidimensional phenomenon, with a negative impact on the lives of workers, families and society. PHC has an important role in caring for people on leave from work. This is a qualitative, descriptive-exploratory study of the daily lives of people in situations of LWD. The comprehensive perspective guides the analysis of data co-produced in interviews and field observation. Cross-cutting themes such as social lack of protection, lack of communication and co-operation between key actors that enhance or mitigate LWD were recognised. The social support network proved to be important to access health care and to avoid social decadence. The Family Health Strategy, with technical support in Occupational Health, emerges with potential in the production of care for worker-users, although the fragility of maintaining long-term care.

Physical Fitness as a Predictor of Disability Retirement: A 9-Year Register Linked Follow-Up Study.

To prospectively examine the association between physical fitness and risk of disability retirement in a large population-based cohort. This study utilized data from Health 2011 survey Physical Activity subsample (n = 4898), combined with information on disability retirement derived from 2 national registers. In total, 2455 individuals aged 18-74years underwent the physical fitness test protocol concerning measures of cardiorespiratory fitness, muscle strength, and balance. The outcome variable was disability retirement, during the follow-up period of 9years. After excluding those not at risk of disability retirement (ie, age ≥63 y) or who had already been granted disability pension, and those who had not completed the fitness protocol, the analytical sample included 1381 participants. Data were analyzed using Cox regression model with SPSS (version 29). During the 9-year follow-up period, 61 individuals (4.4%) transitioned to a disability retirement. Cox regression analysis showed an association between the various physical fitness subdomains and the risk of disability retirement. In model 1, all fitness tests were associated with the risk of disability retirement, except the one-leg stand test with hazard ratios ranging from 1.69 (95% CI, 0.86-3.34) to 5.75 (95% CI, 1.84-17.90). Further adjustment for sociodemographic, health behavior, and health-related covariates attenuated the associations and statistical significance was lost, except for the vertical jump test (hazard ratio = 4.33; 95% CI, 1.32-14.10) and 6-minute walk test (hazard ratio = 3.81; 95% CI, 1.35-10.70). These findings highlight the importance of physical fitness for preventing work disability.

Incapacidade prolongada para o trabalho: perda de direitos, sobrevivência e tangenciamento da atenção primária à saúde

Abstract This article aims to explore the experience of long-term work disability (LWD) of users-workers in primary health care (PHC), understanding the therapeutic itineraries and the search for social protection, the elements that contribute to the incapacitation process and the strategies constructed for living with this condition. LWD is a multidimensional phenomenon, with a negative impact on the lives of workers, families and society. PHC has an important role in caring for people on leave from work. This is a qualitative, descriptive-exploratory study of the daily lives of people in situations of LWD. The comprehensive perspective guides the analysis of data co-produced in interviews and field observation. Cross-cutting themes such as social lack of protection, lack of communication and co-operation between key actors that enhance or mitigate LWD were recognised. The social support network proved to be important to access health care and to avoid social decadence. The Family Health Strategy, with technical support in Occupational Health, emerges with potential in the production of care for worker-users, although the fragility of maintaining long-term care.

Eight-year trends in cardio-vascular risk factors in people living with HIV: A plea for more person-centered care in an ageing population with high medical, nursing and social demands.

Background: The prognosis for people living with HIV (PLWHIV) has improved tremendously in the past years, and life expectancy in PLWHIV is almost the same as in the general population. HIV now is regarded as chronic condition, and as PLWHIV age, additional age-related problems emerge. These seem to occur more often and earlier compared to the general population, due to the virus itself, due to antiretroviral therapy, or due to lifestyle factors. Among these problems are biological factors such as chronic non-communicable diseases, other communicable diseases, and frailty, mental factors like common mental disorders and substance use, as well as social factors like stigma, discrimination, prejudices, work disability and unemployment, and having no partner. It was the aim of this study to monitor medical health burdens in a cohort of PLWHIW over time with an emphasis on cardio-vascular risk factors in order to design a comprehensive, integrated, person-centred care model around the antiretroviral therapy. The study was carried out by researchers and caregivers together with PLWHIV, and supported by a pharmaceutical company.&#x0D; Methods: PLWHIV participated in a baseline study (2013) in an HIV treatment centre and in a follow-up study (2021). At baseline the study population comprised of consecutive patients with HIV, who visited their treating physicians for routine checks. Inclusion criteria were age &gt;= 18 years, documented HIV-Infection and written informed consent. Risk factors were recorded as either having a corresponding diagnosis in the patient´s charts OR being treated with specific drugs, OR having laboratory values outside the normal range. &#x0D; Results: From the initially included 450 participants, 360 (80%) patients participated in the follow-up. The mean age at baseline was 41.4 years, 5.3% were female. 10.8% were affected by hypertension at baseline, and 19.6% at follow-up (P&lt;0.001). Prevalence of type 2 diabetes mellitus was 3.1% at baseline and 5.3% at follow-up (P=0.039), and of dyslipidaemia 76.9% at baseline and 71.4% at follow-up (P=0.042). The proportion of smokers decreased from 42.6% a baseline to 37.1% a follow-up (P=0.007). Prevalence of overweight was 36.6% and of obesity 8.9% at follow-up (no baseline data available). &#x0D; Learnings and next steps: PLWHIV have a high prevalence of cardio-vascular risk factors in an early age, which will increase health problems as this population is ageing. Most cardio-vascular risk factors increased rapidly in PLWHIV and therefore they are a major challenge for comprehensive and integrated care. As an important next step not only medical, but also psycho-social, sexual, spiritual and lifestyle-related health burdens as well as health resources need to be assessed and monitored to ensure care for PLWHIV is truly person-centered. Furthermore, PLWHIV want to be perceived as a partner in their treatment and this needs to become an integral part of routine care. &#x0D;

Navigating the Path to Recovery: A Scoping Review of Return to Work Program for Manufacture Workers After Occupational Injury

Introduction: Workplace accidents in the manufacturing industry may significantly affect both a worker's capacity to return to work and their general well-being. Effective return-to-work programs may help disabled workers rehabilitate. The present scoping review endeavors to scrutinize the extant body of literature pertaining to Return to Work programs tailored specifically for individuals employed in the manufacturing industry who have experienced occupational injuries. Methods: A comprehensive exploration was conducted across various scholarly databases, including PubMed, Scopus, and Web of Science. The search technique includes return-to-work, occupational injury, and manufacturing keywords. Inclusion criteria were used to screen studies. Results: A total of 5 studies were included in the final analysis, representing a range of program types, implementation strategies, and evaluation methods. The results of this review suggest that return-to-work programs can be effective in facilitating workers' return to work after occupational injury and promoting positive health outcomes. Key program components identified as contributing to program effectiveness included workplace accommodations, early return-to-work programs, and rehabilitation services. Conclusion: This scoping review emphasizes the necessity of return-to-work programs for wounded manufacturing employees. The findings of this comprehensive review indicate that return-to-work programs when meticulously crafted and effectively executed, possess the capacity to assume a pivotal function in facilitating the reintegration of injured workers into the workforce, while concurrently enhancing their holistic health outcomes. Additional investigation is warranted to enhance comprehension of the precise constituents of a program that contribute to its triumph and to delve into the efficacy of diverse implementation methodologies.

METABOLIC SYNDROME AND POOR SELF-RATED HEALTH AS RISK FACTORS FOR PREMATURE EMPLOYMENT EXIT

Abstract Poor self-rated health (SRH) is a well-established risk factor for premature employment exit through unemployment, work disability, and early retirement. However, it is not clear whether the premature employment exit risk associated with underlying cardio-metabolic health conditions is fully captured by poor SRH. This study examines the metabolic syndrome (MetS), an early-stage risk factor for cardiovascular disease and type two diabetes mellitus, as a risk factor for premature employment exit while controlling for poor SRH. We analyzed data from N=54,108 middle-aged and older Dutch workers (40-64 years) from five waves of the Lifelines Cohort Study and Biobank. MetS components were based on physical measures, blood markers, and medication use. SRH and employment states were self-reported. The associations between MetS, SRH, and premature employment exit types were analyzed using competing risk regression analysis. During follow-up (4.3 years), MetS was identified as an independent risk factor for unemployment (adjusted subdistribution hazard ratio (SHR): 1.13, 95% CI: 1.03, 1.25) and work disability (adjusted SHR: 1.35, 95% CI: 1.13, 1.61) when adjusted for poor SRH, chronic diseases, and sociodemographic factors. MetS was not associated with early retirement. To conclude, poor SRH did not fully capture the risk for unemployment and work disability associated with MetS. Workers with MetS might thus not be aware of their cardio- metabolic health related risks for premature employment exit. More awareness about MetS as a risk factor for premature employment exit is needed among workers, employers, and occupational health professionals. Further, MetS prevention might help to prolong working lives.

QUANTIFYING CONTRIBUTIONS OF WORK CHARACTERISTICS TO EDUCATIONAL DISPARITIES IN HEALTH-INDUCED WORK LIMITATIONS

Abstract While public policies are incentivizing longer working lives, poor health and inhospitable working conditions pose challenges to working longer, especially for Americans with low educational attainment. This analysis sought to quantify how poor health and inhospitable working conditions each contribute to educational disparities in work disability in mid life and old age. Using the Health and Retirement Study (2006-2016), we showed that educational disparities in reporting “any impairment or health problem that limits the kind or amount of paid work” in ages 51-80 have been profound and persistent over time. Blinder-Oaxaca three-fold decomposition revealed that distributions of income and employer insurance made the largest contribution to explaining different rates of work limitations among respondents with versus without high school degrees, followed by work characteristics (physical job demands, insufficient hours) and health conditions (diabetes, lung disease). Comparing respondents with high school versus college degrees, distributions of health conditions mattered most (high blood pressure, lung disease, heart disease, stroke), followed by health behaviors (smoking, drinking). Health-induced work limitations are often used as a health outcome, but we found that work characteristics explained 57% of the disadvantage of those without a high school degree and 44% of the disadvantage of high school compared to college graduates. Therefore, improving work environments holds promise for reducing educational disparities in mid-to-late-life disability.