James W. Grosch

Worksite Health Promotion Programs in the U.S.: Factors Associated with Availability and Participation

Purpose. To examine how the availability of and participation in worksite health promotion programs varies as a function of individual (e.g., age), organizational (e.g., occupation), and health (e.g., high blood pressure) characteristics. Availability of worksite programs was also compared to that reported in two previous national surveys of private companies. Design. Data analyzed were from the 1994 National Health Interview Survey (NHIS), a national cross-sectional probability sample of the U.S. civilian population. Subjects. Five thousand two hundred nineteen NHIS respondents met the inclusion criteria of (1) being currently employed in a company of at least 50 employees, and (2) completing the NHIS section on worksite health promotion. Measures. Employees indicated the availability of, and their participation in, 33 different types of worksite programs. National Health Interview Survey data were also available regarding general health, blood pressure, body mass index, and medical conditions. Results. Smoking cessation programs had the highest mean availability (43 %), followed by health education programs (31 %) and screening tests (31 %). Overall, availability of worksite programs appeared comparable to that reported in a recent national survey. Participation ranged from 32% for health education programs to 5% for smoking cessation programs. Compared to availability, participation depended less on individual and organizational characteristics. Healthy employees were not consistently more likely to participate in worksite health promotion programs than nonhealthy employees. Conclusions. Although availability of worksite health promotion programs remains high, participation by employees in specific types of programs can vary widely. Attempts to increase participation should look beyond individual, health, and organizational variables, to specific features of the work environment that encourage involvement in health promotion activities.

Mental Work Demands, Retirement, and Longitudinal Trajectories of Cognitive Functioning

Age-related changes in cognitive abilities are well-documented, and a very important indicator of health, functioning, and decline in later life. However, less is known about the course of cognitive functioning before and after retirement and specifically whether job characteristics during ones time of employment (i.e., higher vs. lower levels of mental work demands) moderate how cognition changes both before and after the transition to retirement. We used data from n = 4,182 (50% women) individuals in the Health and Retirement Study, a nationally representative panel study in the United States, across an 18 year time span (1992-2010). Data were linked to the O*NET occupation codes to gather information about mental job demands to examine whether job characteristics during ones time of employment moderates level and rate of change in cognitive functioning (episodic memory and mental status) both before and after retirement. Results indicated that working in an occupation characterized by higher levels of mental demands was associated with higher levels of cognitive functioning before retirement, and a slower rate of cognitive decline after retirement. We controlled for a number of important covariates, including socioeconomic (education and income), demographic, and health variables. Our discussion focuses on pathways through which job characteristics may be associated with the course of cognitive functioning in relation to the important transition of retirement. Implications for job design as well as retirement are offered.

Advancing workplace health protection and promotion for an aging workforce.

Objective: To explore issues related to the aging workforce, including barriers to integrating health protection and promotion programs, and provide recommendations for best practices to maximize contributions by aging workers. Methods: Workgroups reviewed literature and case studies to develop consensus statements and recommendations for a national approach to issues related to older workers. Results: Consensus statements and actions steps were identified for each of the Summit goals and call-to-action statements were developed. Conclusions: A national dialogue to build awareness of integrated health protection and promotion for the aging workforce is needed. Workers will benefit from improved health and performance; employers will realize a more engaged and productive workforce; and the nation will gain a vital, competitive workforce.

Occupational differences in depression and global health : Results from a National sample of US workers

Occupational differences in depression and global health were examined in a sample of 8,486 employed persons who completed the 1987 National Medical Expenditure Survey (NMES). Scores on the depression and global health measures in the NMES were adjusted for age, race, sex, tenure, and hours worked per week, and then grouped according to occupations in the 1980 US Census code. In all, 239 different occupations, distributed across 11 occupational categories, were studied. Results indicated that professional and managerial occupations tended to have healthier scores on both depression and global health. Occupations involving the operation of machines or transportation equipment tended to have poorer scores. These findings are discussed in terms of factors that contribute to occupational differences in well-being, and the need for additional research in which more detailed information concerning working conditions is collected.

Examining associations between job characteristics and health: linking data from the Occupational Information Network (O*NET) to two U.S. national health surveys.

Objective:To determine whether the Occupational Information Network (O*NET) database can be used to identify job dimensions to serve as proxy measures for psychosocial factors and select environmental factors, and to determine whether these factors could be linked to national health surveys to examine associations with health risk behaviors and outcomes. Methods:Job characteristics were obtained from O*NET 98. Health outcomes were obtained from two national surveys. Data were linked using Bureau of Census codes. Multiple logistic regression was used to examine associations between O*NET factors and cardiovascular disease, depression, and health risk factors. Results:Seven of nine work organization or psychosocial factors were significantly associated with health risk behaviors in both the National Health and Nutrition Examination Survey III and National Health Interview Survey. Conclusions:This study demonstrates a method for linking independently obtained health and job characteristic data based on occupational code.

The Voices of Kentucky Employers: Benefits, Challenges, and Promising Practices for an Aging Workforce

This study explored Kentucky employers’ preparedness for the aging workforce using focus groups and a survey. Although employers perceived many benefits of older workers, five key challenges of an aging workforce emerged: institutional knowledge loss, older workers’ dependent care commitments, health and safety problems, generation gaps, and lack of technical skills. The results also suggested potential solutions and organizational practices to address each of these challenges. These practices include succession planning, meaningful work, flexible work, safety climate, wellness programs, generational empathy training, technology training, and intergenerational mentoring.