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

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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.