Health and Safety Needs of Older Workers (2004) / Chapter Skim
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4 The Social and Economic Context of Work for Older Persons
4 The Social and Economic Context of Work for Older Persons
Pages 73-94
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From page 73... ...
During the past two decades, a voluminous research literature has developed around the theme of health disparities -- systematic health differentials within populations that seem to parallel social divisions based on socioeconomic position, race, ethnicity, and gender (Evans, Barer, and Marmor, 1994; Marmot, 1985; Black et al., 1988; Carr-Hill, 1987; Bunker, Gomby, and Kehrer, 1989; Wilkinson, 1986)
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From page 74... ...
To understand causes and possible solutions for health disparities within the aging workforce, it will be important to conduct research not only on detecting patterns among individual-level variables, but also on clarifying ecological, system-level variables having to do with social meanings, institutions, relationships, and interactions. SOCIOECONOMIC POSITION Social Gradient and Health An examination of a social gradient for health is important for the older worker for at least five reasons.
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From page 75... ...
Figure 4-1 shows mortality rates from the original Whitehall Study of British Civil Servants, with men classified according to their employment grade, which is a precise guide to their position in the occupational hierarchy 40- 64 Years 64-69 Years 70-89 Years 2.0 1.9 1.8 1.7 1.6 1.5 1.4 1.3 Rate 1.2 1.1 1.0 0.9 Relative 0.8 0.7 0.6 0.5 Administrative 0.4 0.3 Professional/Executive 0.2 0.1 Clerical 0.0 Other FIGURE 4-1 All-cause mortality by grade of employment: Whitehall men, 25-year follow-up. SOURCE: Marmot and Shipley, 1996.
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From page 76... ...
In addition, there is a substantial social gradient in morbidity that continues well into retirement. Figure 4-2 presents results from a follow-up of the original Whitehall cohort, 29 years after the original baseline examination.
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From page 77... ...
It showed clear social gradients in all-cause mortality. The slope of the gradient increased between 1969 to 1970 and 1997 to 1998.
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From page 78... ...
As noted above, resurvey of men from the original Whitehall study 29 years later showed that employment grade continues to predict mental and physical health and disability after retirement (Breeze et al., 2001)
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From page 79... ...
The Role of Work In the Whitehall studies, employees were classified according to their position in an occupational hierarchy. The Panel Study of Income Dynamics makes clear that classifying people by income or education would also reveal a social gradient in mortality.
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From page 80... ...
(1991) study of health inequalities among British civil servants (the Whitehall II study)
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From page 81... ...
Table 4-1 shows that smoking is strongly related to position in the hierarchy. Similarly, there is a social gradient in hostility.
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From page 82... ...
The 1958 birth cohort did show the expected relation between prior social disadvantage and periods of unemployment, but the worse health of the unemployed could not be attributed to this relationship. For older workers particularly, ill health may well be a reason for being out of the workforce.
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From page 83... ...
These patterns underscore the importance of taking gender into account as an important social determinant of the work experiences of and related health outcomes for older workers. Men and women differ in their earlier lifetime experiences and in the broader contexts of social and historical change that have shaped gender roles (Moen, 1996)
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From page 84... ...
. Gender is important for the health and safety concerns of older workers for several reasons, including its influence on the types of jobs men and women hold, the resulting work-related exposures, the patterns of work over the life course, consequent income differentials, and differences in men's and women's experiences of retirement.
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From page 85... ...
. Working part-time may have the salubrious result of reduced potential for hazardous exposures, or alternatively may place workers at risk of lower income and fewer work benefits.
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From page 86... ...
Understanding differences by gender and social class in the experience of retirement requires that we examine differing work histories, patterns of movement in and out of the workforce, shifting family responsibilities, occupation, and available financial resources for retirement (Moen et al., 1995)
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From page 87... ...
Many minority older workers have been exposed to adverse social circumstances throughout their life courses, including deficits in education and health care during childhood and experiences of poverty, discrimination, and other forms of exclusion during adulthood. The research literature suggests that many of these challenges persist into old age and shape the opportunities and outcomes for minority elders.
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From page 88... ...
The corresponding percentages were higher for those in the 4564 age range: 10 percent non-Hispanic blacks, 8 percent Hispanics, 4 percent APIs, and 1 percent American Indians. The population of Hispanic elderly is growing particularly rapidly and is estimated to increase by the year 2050 to 16 percent of those over age 64 (21 percent of those between ages 45 and 64)
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From page 89... ...
. It is also important to clarify the intersections between race and socioeconomic position, given that the minority elderly are overrepresented among lower income groups.
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From page 90... ...
. For example, focusing on the effects of age discrimination for older African American women who have experienced poverty, racism, and sexism throughout their lives must account for the long-term consequences of social inequalities resulting from multiple forms of discrimination (Dressel et al., 1997; Dressel and Barnhill, 1994; Hill, 2002)
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From page 91... ...
outlines five potential pathways whereby discrimination may influence health outcomes: economic and social deprivation, including residential and occupational segregation; increased exposures to toxic substances and hazardous conditions, resulting from residential or occupational environments; socially inflicted trauma, with consequent physiologic responses; targeted marketing of legal and illegal psychoactive substances, including marketing of pharmaceuticals to older persons; and inadequate health care. Although much research on these pathways has focused on effects of racial discrimination, age discrimination may follow similar pathways to influence the health of older workers and must be studied as well.
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From page 92... ...
UNPAID WORK ROLES The health and safety needs of older workers arise not only from their paid employment, but also from their unpaid work roles, including participation in volunteer work, caregiving responsibilities, and other household responsibilities. Volunteer work may provide important health benefits for older men and women.
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From page 93... ...
, although the healthy worker selection effect may partially explain these findings. Women who successfully manage multiple roles over their life course seem to benefit in terms of increased confidence and self-esteem later in life (Moen et al., 1992; Thoits, 1995)
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From page 94... ...
Both the nature of work and the wider implications of work will be important for the health of older workers. The balance of gains and losses associated with work versus retirement will be influenced by wider social and economic forces.
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