Life course contexts and work - quantifying impacts on aging and chronic disease

描述(由申请人提供)：虽然慢性疾病通常在较年长的年龄首先出现在临床上，但其病因开始得更早。相反，这些疾病是在中年时期，甚至可能在中年之前才有其起源的。大多数人在中年醒着的大部分时间都是在工作场所度过的，这是一个关键但并未得到很好理解的环境。因此，我们必须研究工作环境对慢性老龄化状况的潜在影响，以改善老年人的健康状况。工作场所对健康的一些近期负面影响已经被记录在案，但它们可能在多年后如何影响健康还没有被很好地理解。同样重要的是，工作环境必须 在工作前环境和工作后环境的更广泛的生命过程连续体中学习。部分由于缺乏将更广泛的环境、工作环境和生命多个阶段的慢性疾病联系起来的数据，这些影响对健康的潜在重要性尚不清楚。我获得这个职业发展奖的目标是获得指导和培训，这将使我成为一名独立研究员，专注于了解工作场所对老龄化和慢性病的影响。我已经开发了一个项目，它将建立在我新的培训和我目前在健康研究和流行病学方法的社会决定因素方面的专业知识的基础上，以检查处于生命过程背景中的工作环境如何影响老龄化和慢性病。我提出了三个重点培训和指导领域，以便能够完成我提出的项目并实现我的长期职业目标：1)工作和健康，2)整个生命过程中的衰老，3)人口统计生命阶段分析。具体目标将使用为大约40,000名美国铝业员工收集的独特数据来实现。这个队列是实现这些目标的最佳数据，因为：1)有关于工作环境的详细数据，以及48个不同地点的工作环境有很大的差异；2)我们能够完全将工作和后期生活健康与早期生活环境联系起来；3)我们能够通过额外的链接到长期跟踪的联邦医疗保险记录，来完成他们整个工作历史的医疗索赔记录。具体目标如下：目标1：量化工作场所环境的具体方面对老龄化和慢性病的贡献；目标2：量化早期生活背景、工作生活背景和退休背景对以下方面的贡献 目标3：使用人口统计生命阶段分析来量化早期生活背景、工作生活背景和退休背景对慢性病的未来潜在影响。这一职业发展奖研究部分的预期结果是，目标1和目标2将确定与老龄化和慢性病有关的新因素，目标3将审查这些因素对老龄化和慢性病未来趋势的潜在作用。

DESCRIPTION (provided by applicant): While chronic conditions often first present clinically at older ages, their etiology begins much earlier. It is instead during mid-life, and potentially before, that these diseases have their origins. One critical but not well understood environment where most individuals spend the majority of their waking hours during mid-life is the workplace. It is therefore essential that we examine the potential impacts of the work environment on chronic conditions of aging in order to improve health at older ages. Some of the proximal negative health impacts of the workplace have already been documented, but how they may impact health many years later is not well understood. It is also critical that work environment be studied within a broader life course continuum of pre- work environment and post-work environment. Due in part to the absence of data that links the broader environment, work environment and chronic conditions over multiple stages of life, the potential importance of these impacts on health are unclear. My goal for this career development award is to obtain mentoring and training that will allow me to establish myself as an independent researcher focused on understanding the impacts of the workplace on aging and chronic disease. I have developed a project that will build on both my new training and my current expertise in social determinants of health research and epidemiologic methods to examine how the workplace environment, situated within a life course context, impacts aging and chronic disease. I have proposed three areas of focused training and mentoring to be able to accomplish my proposed project and achieve my long term career goals: 1) work and health, 2) aging across the life course and 3) demographic life stage analysis. The specific aims will be achieved using a unique collection of data that has been assembled for approximately 40,000 Alcoa employees. This cohort is the best data for achieving these aims because: 1) there is detailed data on work environment, and substantial variation in work environment across 48 different locations, 2) we are able to fully link working and later life health to early life environment, and 3) we are able o link to complete medical claims records over their entire work history with additional linkage to Medicare records for long-term follow-up. The specific aims are as follows, Aim 1: Quantify the contribution of specific aspects of the workplace environment to aging and chronic disease, Aim 2: Quantify the contributions of early life context, working life context and retirement context to aging and chronic disease, and Aim 3: Use demographic life stage analysis to quantify the future potential impacts of early life context, working life context and retirement context on chronic disease. The expected outcomes of the research component of this career development award are that aims 1 and 2 will identify novel factors associated with aging and chronic disease, and aim 3 will examine the potential role of these factors on future trends in aging and chronic disease.