The role of precarious work in the production of health disparities in older ages

摘要 健康方面的教育差距在时间和空间上一直存在；然而，解释这些差距的证据 差距一直没有那么坦率。受过良好教育的人被认为有几个人的健康状况更好 原因：较少的慢性心理社会压力，更健康的生活方式，更好的就业和经济条件。 我们的目标是深入探讨就业影响健康的途径， 使用新颖和复杂的方法对不稳定因素进行概念化、测量和分析 工作--以不稳定、缺乏保护和不安全为特征的恶劣就业条件--更好地 了解其在健康教育差距中的作用。鉴于就业的可变性，我们认为 工作是未来研究的关键和应得的决定因素，这项研究有望改善数百万人的健康 美国人。为了考察不稳定的工作在解释健康教育差距方面的作用，我们将使用 两个互补的具有代表性的纵向数据来源：全国青年纵向调查 (NLSY)，有关于就业质量的广泛数据和收入动态小组研究(PSID) 一套丰富的健康指标。NLSY和PSID一直在跟踪一群美国人40岁和50岁 分别是几年。该项目的目标是首先构建一个纵向工作历史，包括 PSID和NLSY队列的工作不稳定。这将需要三种不同的测量方法，其中之一 它的目标是基于七个领域创建多维集群，这些领域已经被理论化以反映 危险的工作。美国的一群人尚未对早产儿的多维测量进行评估 工人也没有纵向数据。早产儿的衡量标准还将反映当前、累积和年龄界定的情况。 (即职业生涯的早期、中期和后期)。使用这些早熟的衡量标准， 这项研究将评估不稳定的工作在解释自我报告中的教育差异方面的中介作用 健康(SRH)、精神健康和死亡率。将使用尖端因果关系进行调解分析 推理技巧：中介g公式。此外，这项研究还试图比较 与其他中介途径的贡献相关的不稳定工作，如健康行为和 在这些相同的健康结果中造成教育差距的危险的工作条件。最后， 使用差异中的差异方法，这项研究将检查州一级的政策如何影响不稳定 通过检查两个州一级政策(工作权)的影响，发现工作与健康差距有关 和最低工资)通过利用随时间推移的政策变化来影响SRH、心理健康和死亡率差异 以及州与州之间的可变性。我们的研究将为危险工作的重要性提供洞察力 造成和维持健康方面的教育差距的途径。鉴于可修改的性质， 这项研究有可能改善数百万美国工人的健康。

ABSTRACT Educational disparities in health have been persistent over time and space; however, evidence to explain these disparities have been less forthcoming. The well-educated are thought to have better health for several reasons: less chronic psychosocial stress, healthier lifestyles and better employment and economic conditions. Our objective is to provide an in-depth exploration of the pathway through which employment impacts health, using novel and sophisticated approaches to the conceptualization, measurement and analysis of precarious work--poor employment conditions characterized by instability, lack of protection and insecurity--to better understand its role in educational disparities in health. Given the modifiable nature of employment, we believe work is a critical and deserving determinant for future study which is poised to improve the health of millions of Americans. To examine the role of precarious work in explaining educational disparities in health, we will use two complementary representative longitudinal data sources: the National Longitudinal Survey of Youth (NLSY) with extensive data on the quality of employment and the Panel Study of Income Dynamics (PSID) with a rich set of health indicators. The NLSY and PSID have been following a cohort of Americans for 40 and 50 years respectively. This project aims first, to construct a longitudinal work history, including metrics of precarious work for PSID and NLSY cohorts. This will entail three different measurement approaches one of which aims to create multidimensional clusters based on seven domains that have been theorized to reflect precarious work. Multidimensional measures of precarity have not yet been evaluated for a cohort of US workers nor with longitudinal data. Measures of precarity will also reflect current, cumulative and age-defined (i.e. early-, mid- and late-career) time periods across the life course. Using these measures of precarity, the study will evaluate the mediating role of precarious work in explaining educational disparities in self-reported health (SRH), mental health, and mortality. Mediation analysis will be conducted using a cutting-edge causal inference technique: mediational g-formula. In addition, the study seeks to compare the contribution of precarious work relative to the contribution of other mediating pathways such as health behaviors and hazardous working conditions in producing educational disparities in these same health outcomes. Lastly, using a difference-in-difference approach the study will examine how state-level policies that affect precarious work are associated with health disparities by examining the effects of two state-level policies (right to work and minimum wage) on SRH, mental health, and mortality disparities by exploiting policy changes over time and variability between states. Our study will provide insights into the importance of precarious work as a pathway by which educational disparities in health are created and maintained. Given the modifiable nature of work this study has the potential to improve the health of millions of American workers.