title: Health Status of Older US Workers and Nonworkers, National Health Interview Survey, 1997-2011.
abstract: BACKGROUND
  Many US workers are increasingly delaying retirement from work, which may be leading to an increase in chronic disease at the workplace. We examined the association of older adults' health status with their employment/occupation and other characteristics.
  
  
  METHODS
  National Health Interview Survey data from 1997 through 2011 were pooled for adults aged 65 or older (n = 83,338; mean age, 74.6 y). Multivariable logistic regression modeling was used to estimate the association of socioeconomic factors and health behaviors with 4 health status measures: 1) self-rated health (fair/poor vs good/very good/excellent); 2) multimorbidity (≤1 vs ≥2 chronic conditions); 3) multiple functional limitations (≤1 vs ≥2); and 4) Health and Activities Limitation Index (HALex) (below vs above 20th percentile). Analyses were stratified by sex and age (young-old vs old-old) where interactions with occupation were significant.
  
  
  RESULTS
  Employed older adults had better health outcomes than unemployed older adults. Physically demanding occupations had the lowest risk of poor health outcomes, suggesting a stronger healthy worker effect: service workers were at lowest risk of multiple functional limitations (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.71-0.95); and blue-collar workers were at lowest risk of multimorbidity (OR, 0.84; 95% CI, 0.74-0.97) and multiple functional limitation (OR, 0.84; 95% CI, 0.72-0.98). Hispanics were more likely than non-Hispanic whites to report fair/poor health (OR, 1.62; 95% CI, 1.52-1.73) and lowest HALex quintile (OR, 1.21; 95% CI, 1.13-1.30); however, they were less likely to report multimorbidity (OR, 0.78; 95% CI, 0.73-0.83) or multiple functional limitations (OR, 0.82; 95% CI, 0.77-0.88).
  
  
  CONCLUSIONS
  A strong association exists between employment and health status in older adults beyond what can be explained by socioeconomic factors (eg, education, income) or health behaviors (eg, smoking). Disability accommodations in the workplace could encourage employment among older adults with limitations.
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Rm 911, Miami, FL 33136. Email: dkachan@med.miami.edu.
authors.forename: Diana
authors.initials: D
authors.lastname: Kachan
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, United Kingdom.
authors.forename: Lora E
authors.initials: LE
authors.lastname: Fleming
authors.affiliation: Department of Human Development and Family Studies and Statistics, Purdue University, West Lafayette, Indiana.
authors.forename: Sharon
authors.initials: S
authors.lastname: Christ
authors.affiliation: Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Peter
authors.initials: P
authors.lastname: Muennig
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Prado
authors.affiliation: Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Tannenbaum
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Xuan
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Alberto J
authors.initials: AJ
authors.lastname: Caban-Martinez
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lee
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000367:Age Factors; D000368:Aged; D000375:Aging; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity / Q000639:trends*; D004185:Disability Evaluation; D004522:Educational Status; D004651:Employment / Q000145:classification* / Q000523:psychology; D005006:Ethnicity; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D017063:Outcome Assessment, Health Care; D057566:Self Report; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology