Diana Kachan

Engagement in Mindfulness Practices by U.S. Adults: Sociodemographic Barriers

OBJECTIVE To examine the effect of sociodemographic factors on mindfulness practices. METHODS National Health Interview Survey Alternative Medicine Supplement data were used to examine sociodemographic predictors of engagement in meditation, yoga, tai chi, and qigong. RESULTS Greater education was associated with mindfulness practices (odds ratio [OR], 4.02 [95% confidence interval [CI], 3.50-4.61]), men were half as likely as women to engage in any practice, and lower engagement was found among non-Hispanic blacks and Hispanics. CONCLUSION Vulnerable population groups with worse health outcomes were less likely to engage in mindfulness practices.

Nutrient intake and adherence to dietary recommendations among US workers.

Objective: To assess nutrient intake according to dietary guidelines among US worker groups. Methods: Participants of 1999 to 2004 National Health and Nutrition Examination Survey completed two 24-hour recall dietary interviews to assess daily intake of protein, carbohydrate, fat, cholesterol, calcium, sodium, and fiber. Employed participants (n = 8987) were classified as (1) white collar, (2) service worker, (3) farmer, and (4) blue collar. Results: Nutrient intake varied by occupational group, particularly for fiber, sodium, calories, and percentage of calories from protein, saturated fat, and carbohydrate. Adherence to recommendations was noted for saturated fat and cholesterol, but workers were poorly adherent to recommendations for all other nutrients, particularly fiber. Conclusions: Workers display differences in nutrient intake across occupational groups with poor eating behaviors evident across all groups. Fiber is particularly poorly consumed, with less than 5% of all US workers meeting the recommendations.

Worker Populations at Risk for Work-related Injuries across the Life Course

BACKGROUND Workplace injuries can have a substantial economic impact. Rates of workplace injuries differ across age groups, yet occupations/industry sectors at highest risk within age groups have not been identified. We examined workplace injury risk across industry sectors for three age groups using nationally representative U.S. data. METHODS Data from 1997 to 2009 National Health Interview Survey (NHIS) were pooled for employed adults by age groups: (1) 18-25 (n = 22,261); (2) 26-54 (n = 121,559); and (3) 55+ (n = 24,851). Workplace injury risk comparisons were made using logistic regression, with the Services sector as the referent and adjustment for sample design, gender, education, race/ethnicity, age, and income-to-poverty ratio. RESULTS Overall 3-month injury prevalence was 0.88%. Highest risk sectors for workers aged 18-25 included: Agriculture/forestry/fisheries (odds ratio = 4.80; 95% confidence interval 2.23-10.32), Healthcare/social assistance (2.71; 1.50-4.91), Construction (2.66; 1.56-4.53), Manufacturing (2.66; 1.54-4.61); for workers 26-54: Construction (2.30; 1.76-3.0), Agriculture/forestry/fisheries (1.91; 1.16-3.15), and Manufacturing (1.58; 1.28-1.96); for workers 55+: Agriculture/forestry/fisheries (3.01; 1.16-7.81), Transportation/communication/other public utilities (2.55; 1.44-4.49), and Construction (2.25; 1.09-4.67). CONCLUSIONS Agriculture/forestry/fisheries and Construction were among the sectors with highest workplace injury risk for workers across all age groups. Differences in highest risk industries were identified between the youngest and oldest industry groups. Our results indicate a need for age-specific interventions in some industries, and a need for more comprehensive measures in others.

Health Status of Older US Workers and Nonworkers, National Health Interview Survey, 1997–2011

Introduction 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). Conclusion 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.

Prevalence of Mindfulness Practices in the US Workforce: National Health Interview Survey

Introduction Mindfulness-based practices can improve workers’ health and reduce employers’ costs by ameliorating the negative effect of stress on workers’ health. We examined the prevalence of engagement in 4 mindfulness-based practices in the US workforce. Methods We used 2002, 2007, and 2012 National Health Interview Survey (NHIS) data for adults (aged ≥18 y, n = 85,004) to examine 12-month engagement in meditation, yoga, tai chi, and qigong among different groups of workers. Results Reported yoga practice prevalence nearly doubled from 6.0% in 2002 to 11.0% in 2012 (P < .001); meditation rates increased from 8.0% in 2002 to 9.9% in 2007 (P < .001). In multivariable models, mindfulness practice was significantly lower among farm workers (odds ratio [OR] = 0.42; 95% confidence interval [CI], 0.21–0.83]) and blue-collar workers (OR = 0.63; 95% CI, 0.54–0.74) than among white-collar workers. Conclusion Worker groups with low rates of engagement in mindfulness practices could most benefit from workplace mindfulness interventions. Improving institutional factors limiting access to mindfulness-based wellness programs and addressing existing beliefs about mindfulness practices among underrepresented worker groups could help eliminate barriers to these programs.

Health status and risk indicator trends of the aging US health care workforce.

Objectives: To describe the health status and risk indicator trends in a representative sample of US health care workers aged 45 years and older. Methods: Using pooled data from the 1997 to 2009 National Health Interview Survey, logistic regression analyses were performed to determine whether age-group specific morbidity risks differed within occupational subgroups of the health care workforce (N = 6509). Health and morbidity trends were examined via complex survey adjusted and weighted chi-squared tests. Results: Rates of functional limitation and hypertension increased among diagnosing/assessing health care workers. The prevalence of hearing impairment, cancer, and hypertension was two to three times greater in health-diagnosing/assessing workers aged 60 years and older than in younger workers. Health care service workers were up to 19 times more likely to be obese than workers who diagnose/assess health. Conclusions: Healthier workplaces and targeted interventions are needed to optimize the ability to meet health care demands of this aging workforce.

Occupational vs. Industry Sector Classification of the US Workforce: Which approach is more strongly associated with worker health outcomes?

OBJECTIVES Through use of a nationally representative database, we examined the variability in both self-rated health and overall mortality risk within occupations across the National Occupational Research Agenda (NORA) Industry Sectors, as well as between the occupations within the NORA Industry sectors. METHODS Using multiple waves of the National Health Interview Survey (NHIS) representing an estimated 119,343,749 US workers per year from 1986 to 2004, age-adjusted self-rated health and overall mortality rates were examined by occupation and by NORA Industry Sector. RESULTS There was considerable variability in the prevalence rate of age-adjusted self-rated poor/fair health and overall mortality rates for all US workers. The variability was greatest when examining these data by the Industry Sectors. In addition, we identified an overall pattern of increased poor/fair self-reported health and increased mortality rates concentrated among particular occupations and particular Industry Sectors. CONCLUSIONS This study suggests that using occupational categories within and across Industry Sectors would improve the characterization of the health status and health disparities of many subpopulations of workers within these Industry Sectors.

Geographical Variation in Health-Related Quality of Life Among Older US Adults, 1997–2010

Introduction Health-related quality of life (HRQOL) is an important predictor of morbidity and mortality; however, its geographical variation in older adults in the United States has not been characterized. We compared HRQOL among older adults in the 50 US states and the District of Columbia using the Health and Activities Limitation Index (HALex). We also compared the HRQOL of 4 regions: South, West, Midwest, and Northeast. Methods We analyzed pooled data from 1997 through 2010 from the National Health Interview Survey for participants aged 65 or older. HALex scores (which range from 0 to 1.00, with higher values indicating better health) were calculated by combining data on participants’ perceived health and activity limitations. We ranked states by mean HALex score and performed multivariable logistic regression analyses to compare low scores (defined as scores in the lowest quintile) among US regions after adjustment for sociodemographics, health behaviors, and survey design. Results Older residents of Alaska, Alabama, Arkansas, Mississippi, and West Virginia had the lowest mean HALex scores (range, 0.62–0.68); residents of Arizona, Delaware, Nevada, New Hampshire, and Vermont had the highest mean scores (range, 0.78–0.79). Residents in the Northeast (odds ratio [OR], 0.66; 95% confidence interval [CI], 0.57–0.76) and the Midwest (OR, 64; 95% CI, 0.56–0.73) were less likely than residents in the South to have scores in the lowest quintile after adjustment for sociodemographics, health behaviors, and survey design. Conclusion Significant regional differences exist in HRQOL of older Americans. Future research could provide policy makers with information on improving HRQOL of older Americans.

Cardiovascular fitness levels among American workers

Objective: To explore cardiovascular fitness in 40 occupations using a nationally representative sample of the US population. Methods: Respondents aged 18 to 49 years (N = 3354) from the 1999 to 2004 National Health and Nutrition Examination Survey were evaluated for cardiovascular fitness and classified into low, moderate, and high levels. Comparisons were made among occupations. Results: Of all the US workers, 16% had low, 36% moderate, and 48% high cardiovascular fitness. Administrators, health occupations, wait staff, personal services, and agricultural occupations had a lesser percentage of workers with low cardiovascular fitness compared with all others. Sales workers, administrative support, and food preparers had a higher percentage of workers with low cardiovascular fitness compared with all others. Conclusions: Cardiovascular fitness varies significantly across occupations, and those with limited physical activity have higher percentages of low cardiovascular fitness. Workplace strategies are needed to promote cardiovascular fitness among high-risk occupations.

State Variations of Chronic Disease Risk Factors in Older Americans

The objective of this study was to examine and compare 3 key health behaviors associated with chronic disease (ie, risky drinking, smoking, and sedentary lifestyle). We used data from the National Health Interview Survey from 1997 through 2010 to calculate the prevalence of these behaviors among older Americans and rank each state, and we analyzed overall trends in prevalence for each behavior over the 14 years. Older adults residing in Arkansas and Montana had the worst chronic disease risk profile compared with other states. These findings indicate the need for improved or increased targeted interventions in these states.