Physical work conditions and disparities in later life functioning: Potential pathways.
Physical work conditions and disparities in later life functioning: Potential pathways.
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DOI：
10.1016/j.ssmph.2021.100990
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Pebley AR
中科院分区：
文献类型：
--
作者：
Andrasfay T;Raymo N;Goldman N;Pebley AR
美国关于老年人身体机能下降的社会决定因素的研究通常不认为身体工作条件是造成差异的因素。我们简要描述了职业分层和隔离的模型，回顾和综合职业健康文献，并概述了生理途径，通过该途径，体力劳动暴露可能与身体功能的长期下降。文献表明，姿势，力量，振动和重复是与肌肉骨骼疾病发展有关的主要职业风险因素，无论是急性损伤还是长期磨损。个人风险因素以及环境和结构工作特征可以改变这种关联。从长远来看，这些肌肉骨骼疾病可能成为慢性疾病，最终导致功能限制和残疾，影响一个人的生活质量和保持独立的能力。然后，我们使用与2019年美国社区调查（ACS）相关的职业信息网络（O*NET）的职业特征数据，研究社会人口群体在暴露于这些风险因素方面的差异。对这些体力要求高的职业不仅限于那些传统上被认为是体力劳动或蓝领工作的人，还包括服务业的许多职位。我们记录了一个陡峭的教育梯度，受教育程度较低的工人在工作中遇到的身体需求远远大于受教育程度较高的工人。在这些暴露中存在明显的种族和民族差异，西班牙裔、黑人和美洲原住民工人的风险高于白色和亚洲工人。暴露于这些身体风险因素的职业提供的补偿较低，也不太可能提供雇主赞助的医疗保险，使工人更难以解决因工作而产生的伤害或状况。总之，我们认为，体力劳动暴露可能是一个重要的途径，通过身体功能的差异出现。
Research in the US on the social determinants of reduced physical functioning at older ages has typically not considered physical work conditions as contributors to disparities. We briefly describe a model of occupational stratification and segregation, review and synthesize the occupational health literature, and outline the physiological pathways through which physical work exposures may be tied to long-term declines in physical functioning. The literature suggests that posture, force, vibration, and repetition are the primary occupational risk factors implicated in the development of musculoskeletal disorders, through either acute injuries or longer-term wear and tear. Personal risk factors and environmental and structural work characteristics can modify this association. In the long-term, these musculoskeletal disorders can become chronic and ultimately lead to functional limitations and disabilities that interfere with one’s quality of life and ability to remain independent. We then use data on occupational characteristics from the Occupational Information Network (O*NET) linked to the 2019 American Community Survey (ACS) to examine disparities among sociodemographic groups in exposure to these risk factors. Occupations with high levels of these physical demands are not limited to those traditionally thought of as manual or blue-collar jobs and include many positions in the service sector. We document a steep education gradient with less educated workers experiencing far greater physical demands at work than more educated workers. There are pronounced racial and ethnic differences in these exposures with Hispanic, Black, and Native American workers experiencing higher risks than White and Asian workers. Occupations with high exposures to these physical risk factors provide lower compensation and are less likely to provide employer-sponsored health insurance, making it more difficult for workers to address injuries or conditions that arise from their jobs. In sum, we argue that physical work exposures are likely an important pathway through which disparities in physical functioning arise.
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