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成年早期和65岁的医疗保险资格之间工作多年。工作是大多数人生活的一个重要组成部分，并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对医疗保健利用的需求知之甚少。该项目将创建一个新的，公开可用的工作特征数据集，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络收集的一套全面的工作和工人特征联系起来。我们将使用因素分析技术来开发工作特征的汇总措施，例如职位是否需要力量或重复运动（身体需求）;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医疗保险索赔相关联的工作特征来研究工作特征与随后的医疗保险利用率之间的关系，重点关注基于索赔的措施，如关节炎和阿尔茨海默病等疾病的利用率措施，这些措施可能由累积的工作特征（例如重复的身体运动或非认知复杂的工作）决定。这项研究的结果将提供重要的信息，增加老年工人，特别是那些体力要求高的工作，花在工作上的年数的健康后果，以及对随后的医疗保险利用率的影响。这项研究将提供新的信息，就业模式和行业的变化以及对工作特征的累积暴露，有助于美国老年人健康和医疗保健利用的区域差异。包含HRS受访者工作特征的数据集将显著扩大研究人员在工作需求、健康、残疾和退休结果研究中可用的信息量。

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.