Identifying Targets for Interventions to Improve Functional Ability to Work over the Life Course

项目总结/摘要 随着年龄的增长，他们的健康状况可能会下降，在某些情况下会导致关键功能的丧失 使他们能够工作。这些功能丧失危及健康老龄化的前景， 持续参与自己选择的社会生产活动。尽管重要的是 随着年龄的增长保持功能能力，我们还不知道如何损失，特别是认知， 身体或心理社会能力与工作要求相互作用，阻碍工作活动。此外还 不知道公共卫生干预措施是否可以恢复关键能力的损失，或者 甚至在一开始就防止这种损失。了解哪些能力损失会导致最大的损失， 人口的工作能力是确定干预目标的先决条件， 功能性工作能力。一旦了解了这些能力损失及其影响，潜在的工作- 可以确定和评价能力干预措施。工作能力干预的理想目标 是导致人口大量生产力损失的能力损失，但相对较低- 可以制定成本低、效果好的干预措施，如果目前已有干预措施，则可以广泛地采取这些措施 容易接近该项目的目标是建立工作能力干预的研究基础， 可以开发。为此，我们将借鉴《残疾人权利公约》中确定残疾的方法， 荷兰，通过绘制功能能力的标准化衡量标准来衡量工作能力 对整个国民经济的工作要求进行标准化。这张全面的地图 能力和工作之间的关系允许直接计算可行工作和潜力的集合 个人的收入，取决于他们的教育程度。荷兰在世界各国中是独一无二的， 这种方法来确定残疾。首先，我们将调整和协调荷兰的职能， 评估工具，以美国的背景下，然后现场评估的代表性样本， 年龄在25-75岁之间的美国人在两个时间点。在将受访者的功能性能力映射到 美国的职业要求，我们将评估职能工作的横截面水平， 能力以及纵向能力丧失/恢复率，总体和不同年龄组。接下来我们 将进行反事实模拟，以确定关键的功能能力，如果他们的损失， 通过未来的干预逆转，将对美国的工作能力产生最大的影响。 人口由于预防目标与康复目标可能有所不同，我们亦会进行 反向练习：我们将使用反事实模拟来确定关键的功能能力， 如果可以通过未来的干预防止恶化，将对工作产生最大的影响 美国人口的能力。最后，我们将模拟职业变化的影响， 技术变革、流行病风险和气候变化等因素产生的需求。

PROJECT SUMMARY/ABSTRACT As individuals age, their health may decline, in some cases leading to the loss of key functional abilities that enable them to work. These functional losses jeopardize prospects for healthy aging, which calls for ongoing engagement in socially productive activities of one’s choosing. Despite the importance of maintaining functional abilities with age, we do not yet understand how losses in particular cognitive, physical or psychosocial abilities interact with job requirements to impede work activity. In addition, it is unknown whether public health interventions could restore losses in critical abilities once they occur, or even prevent such losses in the first place. Understanding which ability losses cause the most loss in work capacity in the population is a prerequisite to identifying targets for interventions to improve functional work capacity. Once these ability losses and their impacts are understood, potential work- capacity interventions can be identified and evaluated. The ideal targets of work-capacity interventions are ability losses that lead to large productivity losses in the population, but for which relatively low- cost, effective interventions could be developed or, if interventions currently exist, could be made widely accessible. The goal of this project is to build the research base upon which work-capacity interventions may be developed. To do so, we will draw upon methods used for disability determination in the Netherlands, which measures work capacity by mapping standardized measures of functional abilities to standardized requirements of jobs across the national economy. This comprehensive mapping between abilities and jobs allows for direct computation of the set of feasible jobs and potential earnings for an individual, conditional on their education. The Netherlands is unique among countries in this approach to disability determination. First, we will adapt and harmonize the Dutch functional assessment instrument to the U.S. context and then field the assessment to a representative sample of Americans ages 25-75 at two points in time. After mapping respondents’ functional abilities to occupational requirements in the U.S., we will estimate cross-sectional levels of functional work capacity as well as longitudinal ability loss/recovery rates, overall and for different age groups. Next, we will conduct counterfactual simulations to determine the critical functional abilities that, if their loss could be reversed through future intervention, would have the greatest impact on work capacity in the U.S. population. Since prevention targets may differ from rehabilitation targets, we will also conduct the reverse exercise: we will use counterfactual simulations to determine the critical functional abilities that, if deterioration could be prevented through future intervention, would have the greatest impact on work capacity in the U.S. population. Lastly, we will simulate the effects of changes in occupational requirements arising from factors like technological change, pandemic risk, and climate change.