Cumulative Effects of Pre-recession and the Great Recession Precarity on Black-White Disparities in Health Biomarker Trajectories and All-cause Mortality Among Older Workers

Racial disparities among older adults in diabetes, cardiovascular disease (CVD), and mortality have widened, in part due to economic recessions such as the Great Recession (2008-2009). The Great Recession disproportionately worsened employment disruptions including precarious employment, health, and survival for Black relative to White workers. Population health research on employment-related health consequences of the Great Recession however do not address vulnerability of prior exposure to precarious employment, leaving a knowledge gap regarding the extent to which precarity during an economic recession maybe superimposed on prior work precarity. This cumulative precarity could exacerbate health disparities for older workers. Economic recessions also deteriorate psychosocial working conditions among those who remain employed. It, however, remains unclear how psychosocial work conditions such as job strain during an economic recession, influence health and mortality when they occur together with cumulative precarity. The objective of this project, therefore, is to assess how pre-recession and successive Great Recession precarity cumulatively shaped employment and work conditions for older Black and White workers, and along with psychosocial working conditions impacted health biomarker trajectories and mortality. I will use 2006-2018 data from the 1) Health and Retirement Study (HRS) and 2) HRS- linked Occupational Information Network Data (O*NET) data to examine the following 3 specific aims: 1) Examine Black-White differences in the independent and co-occurring effects of pre-recession (2006) and Great Recession (2008-2010) precarity on trajectories (2012-2018) of diabetes and CVD biomarkers (hbA1c, cholesterol, C-reactive protein, and systolic blood pressure) and all-cause mortality, 2) Among those who remain employed during the Great Recession, examine Black-White differences in the association of psychosocial work conditions (job strain) with trajectories of diabetes and CVD biomarkers and all-cause mortality, while accounting for cumulative precarity, and 3) Examine whether gender moderates associations observed in Aims 1 and 2. This project is timely, and provides an opportunity to explore and understand these issues as the remnants of the COVID-19 economic recession persist, with additional and disproportionate insults on both employment and health in Blacks, the full extent of which will not be fully elucidated for years to come. An understanding of these associations is important to inform appropriate policies aimed at building social and health safety nets for older workers approaching and preparing for retirement.