Introduction
Black Americans encounter more barriers in the job market and earn less than White
Americans. However, the extent to which racial disparities in employment and poverty
histories impact health is not fully understood. This study characterized employment‒poverty
histories for Black and White middle-aged adults and examined their association with
health.
Methods
Respondents born in 1948–1953 and enrolled in the 2004 Health and Retirement Study
(=555, =2,209) were included. Sequence analysis grouped respondents with similar employment‒poverty
trajectories from 2004 to 2016, and confounder-adjusted regression analyses estimated
the associations between these trajectories and health in 2018. Analyses were conducted
in 2021–2022.
Results
More than 23% of Black respondents experienced both employment and poverty fluctuations,
including bouts of extreme poverty (<50% of the federal poverty threshold), whereas
no trajectory for White respondents included extreme poverty. Adversities in employment‒poverty
were associated with worse health. For example, among Black respondents, those who
experienced both employment and poverty fluctuations had worse cognition than those
employed and not poor (β= –0.55 standardized units, 95% CI= –0.81, –0.30). Similarly,
among White respondents, those who experienced employment fluctuations had worse cognition
than those employed (β= –0.35, 95% CI= –0.46, –0.24). Notably, the employed and not
poor trajectory was associated with worse survival among Black respondents than among
White respondents.
Conclusions
Employment fluctuations were associated with worse health, especially cognitive function,
where the association was stronger among Black Americans who experienced both employment
fluctuations and poverty. Findings highlight the importance of enhancing employment
stability and of antipoverty programs, especially for Black Americans.
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Article info
Publication history
Published online: January 14, 2023
Publication stage
In Press Journal Pre-ProofIdentification
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© 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
