title: Multiple Chronic Conditions, Resilience, and Workforce Transitions in Later Life: A Socio-Ecological Model.
abstract: Despite the growing prevalence of multiple chronic conditions (MCC), a problem that disproportionally affects older adults, few studies have examined the impact of MCC status on changes in workforce participation in later life. Recent research suggests that resilience, the ability to recover from adversity, may buffer the negative impact of chronic disease. Guided by an adapted socio-ecological risk and resilience conceptual model, this study examined the buffering effect of resilience on the relationship between individual and contextual risks, including MCC, and workforce transitions (i.e., leaving the workforce, working fewer hours, working the same hours, or working more hours).
  
  
  
  Using the Health and Retirement Study, this study pooled a sample of 4,861 older workers aged 51 and older with 2 consecutive biannual waves of data. Nonnested multinomial logistic regression analysis was applied.
  
  
  
  MCC are related to higher risk of transitioning out of the workforce. Resilience buffered the negative effects of MCC on workforce engagement and remained independently associated with increased probability of working the same or more hours compared with leaving work.
  
  
  
  MCC are associated with movement out of the paid workforce in later life. Despite the challenges MCC impose on older workers, having higher levels of resilience may provide the psychological resources needed to sustain work engagement in the face of new deficits. These findings suggest that identifying ways to bolster resilience may enhance the longevity of productive workforce engagement.
authors.affiliation: Department of Sociology, University of North Carolina at Charlotte.
authors.forename: Kendra J
authors.initials: KJ
authors.lastname: Jason
authors.affiliation: Stanford Center on Longevity, California.
authors.forename: Dawn C
authors.initials: DC
authors.lastname: Carr
authors.affiliation: School of Social Work, University of Georgia, Athens.
authors.forename: Tiffany R
authors.initials: TR
authors.lastname: Washington
authors.affiliation: American Institutes for Research, Chapel Hill, North Carolina.
authors.forename: Tandrea S
authors.initials: TS
authors.lastname: Hilliard
authors.affiliation: The Gerontology Institute, Georgia State University, Atlanta.
authors.forename: Chivon A
authors.initials: CA
authors.lastname: Mingo
mesh_terms: D000368:Aged; D004651:Employment; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D000071069:Multiple Chronic Conditions; D055500:Resilience, Psychological; D012179:Retirement; D011795:Surveys and Questionnaires
keywords: Multimorbidity; Older workers; Resilience; Risk