Occupation, Employment Status, and “Despair”-Associated Mortality Risk among Working-Aged U.S. Adults, 1997-2015

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Citation

Gutin, Iliya & Hummer, Robert A. (2020). Occupation, Employment Status, and "Despair"-Associated Mortality Risk among Working-Aged U.S. Adults, 1997-2015. Preventive Medicine, 137, 106129. PMCID: PMC7311220

Abstract

The recent rise in U.S. midlife mortality has been conceptualized as a "working-class" crisis, defined by increasing mortality among blue-collar and/or unemployed workers and the decline of manual labor; yet research on the topic overwhelmingly focuses on educational attainment as the key socioeconomic determinant of midlife mortality, especially among "despair"-related deaths. The present study addresses this gap by using data on 360,146 adults ages 25-64 from restricted-use National Health Interview Survey-Linked Mortality Files (1997-2015; average follow-up 9.87 years) to estimate associations between individuals' occupation and employment status and alcoholic liver disease, suicide, or accidental poisoning mortality risk, net of confounders. Adults in service, manual labor, and transport occupations exhibited two-to-three times the risk of mortality from accidental poisonings compared to those in managerial/administrative positions. Notably, health professionals exhibited the highest accidental poisoning mortality risks. Relative to managerial/administrative professionals, adults not in the labor force had double the suicide risk and nearly seven times the accidental poisoning risk, net of confounders. Unemployed adults and those having never worked also had elevated risks from accidental poisoning mortality. Critically, the fact that individuals' occupations and employment status are independently associated with midlife mortality due to deaths of despair - especially accidental poisoning - highlights the need for measures of socioeconomic status beyond educational attainment and income in understanding rising midlife mortality. Moreover, policies addressing working-aged mortality must target particular workplace contexts and the consequences of unemployment, both of which affect a large and growing segment of the working-aged U.S. population.

URL

http://dx.doi.org/10.1016/j.ypmed.2020.106129

Reference Type

Journal Article

Year Published

2020

Journal Title

Preventive Medicine

Author(s)

Gutin, Iliya
Hummer, Robert A.

Article Type

Regular

PMCID

PMC7311220

Data Set/Study

National Health Interview Survey (NHIS)

Continent/Country

United States of America

State

Nonspecific

ORCiD

Hummer - 0000-0003-3058-6383
Gutin - 0000-0003-4216-8963