Explaining racial/ethnic differences in all-cause mortality in the Multi-Ethnic Study of Atherosclerosis (MESA): Substantive complexity and hazardous working conditions as mediating factors
Year: 2017
Type: article
Abstract: Research on racial/ethnic health disparities and socioeconomic position has not fully considered occupation. However, because occupations are racially patterned, certain occupational characteristics may explain racial/ethnic difference in health. This study examines the role of occupational characteristics in racial/ethnic disparities in all-cause mortality. Data are from a U.S. community-based cohort study (n=6342, median follow-up: 12.2 years), in which 893 deaths (14.1%) occurred. We estimated mortality hazard ratios (HRs) for African Americans, Hispanics, and Chinese Americans compared with whites. We also estimated the proportion of the HR mediated by each of two occupational characteristics, substantive complexity of work (e.g., problem solving, inductive/deductive reasoning on the job) and hazardous conditions (e.g., noise, extreme temperature, chemicals), derived from the Occupational Information Network database (O*NET). Analyses were adjusted for age, sex, nativity, working status at baseline, and study sites. African Americans had a higher rate of all-cause death (HR 1.41; 95% confidence interval [CI]: 1.19-1.66) than whites. Chinese-American ethnicity was protective (HR 0.59, CI: 0.40-0.85); Hispanic ethnicity was not significantly different from whites (HR 0.88; CI: 0.67-1.17). Substantive complexity of work mediated 30% of the higher rate of death for African Americans compared with whites. For other groups, mediation was not significant. Hazardous conditions did not significantly mediate mortality in any racial/ethnic group. Lower levels of substantive complexity of work mediate a substantial part of the health disadvantage in African Americans. This job characteristic may be an important factor in explaining racial health disparities.
Source: SSM - Population Health
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $2,930
Funders: U.S. Environmental Protection Agency, New York City Department of Health and Mental Hygiene, National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of Environmental Health Sciences, National Center for Research Resources, National Institute for Occupational Safety and Health, National Center for Advancing Translational Sciences
Awards: G1156594538, G1261793039, MESA, G1276754516, G1409423729, G1483344193, G1497137905, G1508998135, G1640378483, G1686417863, G1922428914, G2144938473, G22458031, G2262782284, MESA, G2545476352, MESA, G2837638605, G283874107, G290884426, G291913881, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--EBCT READING, G3106377335, G3581052147, G3647016462, G3667269547, G3687594596, MESA, G399481048, TITLE: MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA), G4401650913, G4459840562, G4512137732, OPTION 3. 4/1/2014 - 3/31/2015. MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA) - READING CENTER, NHLBI, MESA, G5088122703, G5108002584, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-ULTRASOUND, G5605591545, G5787256936, G6095866717, G611940047, G6359107525, Institute for Clinical and Translational Research, MESA, G6514094751, G66341962, G6730884202, G7055397874, G713258703, MESA, G78770644, G805458286, Clinical and Translational Science Award, Interaction of Air Pollution and Psychosocial Stress on Cardiovascular Disease., G991334795
OpenAlex ID: W2612687477