While more Americans are working past age 65 by choice, a growing segment of the population must continue to work well into their sixties out of financial necessity. Research conducted by the Columbia University's Mailman School of Public Health and the University of Miami Miller School of Medicine looked at aging, social class and labor force participation rates to illustrate the challenges that lower income workers face in the global marketplace. The study used the burden of arthritis to examine these connections because 49 million U.S. adults have arthritis, and 21 million suffer activity limitations as a result. The condition is also relatively disabling and painful but not fatal. The researchers found that blue collar workers are much more likely to work past 65 than white collar workers and are much more likely to suffer from conditions like arthritis, reducing their quality of life and work productivity.
The study findings are reported online in the American Journal of Public Health.
The investigators calculated estimates and compared age-and occupational specific data for workers with and without arthritis, merging data from the U.S. National Health Interview Survey (NHIS), Medical Expenditure Panel Survey (MEPS) and National Death Index. They studied 17,967 individuals for the analysis out of 38,473 MEPS participants.
"Arthritis serves as a powerful lens for looking at these convergent phenomena," said Alberto J. Caban-Martinez, DO, PhD, MPH, Department of Epidemiology and Public Health at the University of Miami Miller School of Medicine and first author. "We found that blue-collar workers with arthritis are in much worse health than are all other workers, suggesting that they are struggling to stay in the workforce despite their health condition."
At all ages, blue-collar workers in the workforce are in worse health than white-collar workers. By age 65, 19% of white-collar workers with arthritis remain in the workforce compared with 22% of blue-collar workers. But employed blue-collar workers have more severe disease than employed white-collar workers, and look forward to fewer years of healthy life -- approximately 11 for blue-collar workers and 14 for white-collar workers.
The investigators reported that lower-income workers of older age in the service and farming sectors-- two job types that are unlikely to come with pension plans--are more likely to have arthritis than not, with 58% of service workers and 67% of farm workers continuing to work despite struggling with the painful health condition. Sixteen percent of all blue collar workers are over 65 and 47% report they have arthritis. By contrast, 14% of white collar workers work beyond the age of 65, and 51% of these workers reporting arthritis. Overall, approximately 15% of all workers remain in the workforce at or past retirement age, and 44% have arthritis.
"The increasing age of the U.S. workforce presents new challenges for government, employers and working families," observes Peter Muennig, MD, MPH, associate professor of Health Policy and Management and senior author. "It is estimated that by the year 2030 approximately 67 million adults aged 18 years and older will have arthritis. Because the 'graying' workforce will be disproportionately represented by people from middle and lower occupational classes that also suffer from a higher prevalence of arthritis and a shorter life expectancy than wealthier Americans, Dr. Muennig points out that additional enhancements to federal programs such as better disability, health and unemployment insurance will be needed to maintain a higher quality of life for all workers, particularly for those with chronic conditions such as arthritis. "As the population ages in the face of expanding budget deficits, we face politically difficult choices if the U.S. is to prevent significant declines in its standard of living."
This study was funded by in part the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Institute for Occupational Safety and Health.
About Columbia University's Mailman School of Public Health
Founded in 1922 as one of the first three public health academies in the nation, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,000 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including the International Center for AIDS Care and Treatment Programs (ICAP), the National Center for Disaster Preparedness, and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu
The University of Miami Leonard M. Miller School of Medicine, founded in 1952, was the first medical school in the state of Florida. The Miller School of Medicine is located on the 100-acre University of Miami/Jackson Memorial Medical Center complex in Miami. The medical center includes three University-owned hospitals that make up the University of Miami Health System (UHealth): University of Miami Hospital, Sylvester Comprehensive Cancer Center and Bascom Palmer Eye Institute. Our three primary affiliated hospitals on the campus include Jackson Memorial Hospital, Holtz Children's Hospital and the Miami VA Medical Center. Miller School faculty members conduct more than 1,700 research projects in basic science and clinical care.