workers who participate in the Social Security system have some guaranteed health insurance and disability and retirement income protections, at least after specified periods of participation in covered employment. Beyond this, there are few special legal protections for aging workers. In general, employment policies must be age neutral, so employers are required to treat older workers in the same manner as they treat otherwise equivalent younger workers.

The key question is whether the laws that mandate intervention in employment provide adequate protection to workers as they age so that they can continue to work safely or have the necessary economic security to exit the workforce at the appropriate time. The answer to these questions is not the same for all workers in all industries. There has been little study of the effectiveness of these mandated interventions in relation to older workers’ health and safety needs.

Employment regulation is a patchwork. Independent contractors and self-employed workers are excluded from almost all protective employment laws and collective bargaining agreements. Also excluded are people who do not report their wages. Most protective statutes exclude small employers. Private benefits may be available only to full-time permanent employees. Tension between federal and state regulation further complicates the terrain. In key areas of interest to aging workers (e.g., compensation programs for occupational injuries and illnesses or disorders) the legal rules may vary depending upon the state in which the worker lives and works.

Unlike most other industrialized countries, the United States does not provide universal health insurance to its citizens. In 1995, 72 percent of American workers between 18 and 64 had health insurance coverage under an employer-based plan, either through their own employer or through the employer of another family member; 18 percent of American workers were left totally uninsured. Close to one-third of workers over 55 do not have health insurance provided by their employers. As chronic health conditions increase with age, the lack of health insurance and the accompanying barriers to access to health care may significantly impact the ability of these workers to remain in the workforce.

INTERVENTIONS FOR OLDER WORKERS

The premise of many interventions is that it is preferable to change the working environment to accommodate the needs of workers than to attempt only to adapt the workers themselves through administrative or training interventions. In principle, hazards should be addressed as close to the source as possible. Therefore, job design, including redesign and reengineering to improve the accommodations for older workers, deserves the highest level of attention. There are existing design approaches to accommodate a



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