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Center for Health Services and Outcomes Research

Innovative Methods – New Tools

Long-term Health Impacts of Physical and Cognitive Occupational Exposures

The majority of American adults work for pay for many years between early adulthood and Medicare eligibility at age 65. Work is a critical component of most people's lives and increasingly appreciated as a determinant of long-term health outcomes and mortality, though little is known about how the cumulative health effects of occupations influence subsequent demand for healthcare utilization among beneficiaries.

This project is creating a new, publicly available dataset of job characteristics by linking all jobs reported by Health and Retirement Study (HRS) respondents to a comprehensive set of job and worker characteristics collected by the Department of Labor's Occupational Information Network. We use factor analysis techniques to develop summary measures of job characteristics such as whether positions require strength or repetitive motion (physical demands); provide cognitive stimulation (cognitive complexity); or offer little control over task completion (physiological demands). We use these job characteristics linked to survey data and respondents' Medicare claims to examine the relationship between job characteristics and subsequent Medicare utilization, focusing on claims-based measures utilization measures for conditions such as arthritis and Alzheimer's Disease that are plausibly determined by cumulative job characteristics (for example repetitive physical motions or non-cognitively complex jobs).

The results of this study will provide important information about the health consequences of increasing the number of years that older workers, especially those with physically demanding jobs, spend working and implications for subsequent Medicare utilization.