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Life course health and socioeconomic profiles of Americans aging with disability

AbstractBackground While cross-sectional data have been invaluable for describing national trends in disability over time, we know comparatively little, at a population level, about the long term experiences of persons living with a disability over the adult life course. Objective In this paper we use nationally representative data from the U.S. Panel Study of Income Dynamics to describe the life course health and socioeconomic profiles of Americans who are aging with a work-limiting disability. Methods Data come from a cohort of adults age 20-34 in 1979, who were followed annually for 30 years to 2009 (to age 50-64). Disability is defined according to repeated measures of work limitations in prime working years. Using growth curve models we describe the life course profile of these Americans aging with work-limiting disability with respect to health, educational attainment, family formation, economic fortunes, and occupational history, and compare them to those who have not experienced repeated work-limiting disability in adulthood. Results Persons with persistent work-limiting disability prior to age 50 experienced lower rates of employment and lower household incomes over adulthood in comparison to those aging without a work-limiting disability. Additionally, in the mid-life period, adults with work-limiting disabilities were more likely to practice poor health behaviors (reflected by smoking, obesity, and sedentary activity) and to experience restrictions in functional independence than those without a work-limiting disability. Conclusions Our findings suggest that there are critical risk factors that make adults aging with work-limiting disability more vulnerable with respect to their health and independence as they age, suggesting avenues for intervention that may equalize the health and independence of Americans aging with and aging into disability in the years ahead.