Long-Term Health Impacts of Physical and Cognitive Occupational Exposures

描述(由申请人提供)：大多数美国成年人在65岁时，从成年初期到符合联邦医疗保险资格之间，为获得报酬而工作多年。工作是大多数人生活的关键组成部分，越来越多地被视为长期健康结果和死亡率的决定因素，尽管人们对职业的累积健康影响如何影响受益人随后的医疗保健利用需求知之甚少。该项目将通过将健康和退休研究(HRS)受访者报告的所有工作与劳工部职业信息网收集的一套全面的工作和工人特征联系起来，创建一个新的、公开可用的工作特征数据集。我们将使用因子分析技术来开发工作特征的汇总测量，例如职位是否需要力量或重复运动(身体需求)；是否提供认知刺激(认知复杂性)；或对任务完成提供很少的控制(生理需求)。我们使用这些与调查数据和受访者的联邦医疗保险索赔相关联的工作特征来检查工作特征和随后的医疗保险利用率之间的关系，重点是基于索赔的衡量标准，即对关节炎和阿尔茨海默氏症等由累积工作特征(例如，重复的身体动作或非认知复杂的工作)可信地确定的疾病的利用衡量标准。这项研究的结果将提供有关增加老年工人，特别是那些体力要求很高的工作人员工作年限的健康后果的重要信息，以及对后续医疗保险使用的影响。这项研究将提供新的信息，说明就业模式和行业的差异以及对工作特征的累积暴露在多大程度上促进了全美老年人健康和医疗保健利用的地区差异。包含HRS受访者工作特征的数据集将显著扩大研究人员可用于研究工作需求、健康、残疾和退休结果的信息量。

DESCRIPTION (provided by applicant): The majority of American adults work for pay for many years between early adulthood and Medicare eligibility at age 65. Work is a critical component of most people's lives and increasingly appreciated as a determinant of long-term health outcomes and mortality, though little is known about how the cumulative health effects of occupations influence subsequent demand for healthcare utilization among beneficiaries. This project will create a new, publicly available dataset of job characteristics by linking all jobs reported by Health and Retirement Study (HRS) respondents to a comprehensive set of job and worker characteristics collected by the Department of Labor's Occupational Information Network. We will use factor analysis techniques to develop summary measures of job characteristics such as whether positions require strength or repetitive motion (physical demands); provide cognitive stimulation (cognitive complexity); or offer little control over task completion (physiological demands). We use these job characteristics linked to survey data and respondents' Medicare claims to examine the relationship between job characteristics and subsequent Medicare utilization, focusing on claims-based measures utilization measures for conditions such as arthritis and Alzheimer's Disease that are plausibly determined by cumulative job characteristics (for example repetitive physical motions or non-cognitively complex jobs). The results of this study will provide important information about the health consequences of increasing the number of years that older workers, especially those with physically demanding jobs, spend working and implications for subsequent Medicare utilization. This study will provide new information about the extent that variation in employment patterns and industry and cumulative exposure to job characteristics contribute to regional variation in health and healthcare utilization among older adults across the United States. The dataset containing characteristics of HRS respondents' jobs will significantly expand the amount of information available to researchers for studies of job demand, health, disability, and retirement outcomes.