THE “OCCUSOME”: WORK EXPOSURES AS A SOCIAL DETERMINANT OF CARDIOMETABOLIC HEALTH

Cardiometabolic-related conditions are among the leading causes of death in the United States.
Over 44 million adults in the U.S. report having at least one cardiometabolic related condition,
and this is expected to continue to increase over the next decade. Given the growing impact of
cardiometabolic conditions and illnesses on overall population health, scholars have begun to
examine the mechanisms and “upstream” factors that may help to promote or diminish
population-level cardiometabolic health and contribute to cardiometabolic-related disparities.
Within this larger body of work, researchers have acknowledged the role that work and
employment play in shaping health processes; however, few studies have comprehensively
examined how work exposures might shape population-level health, especially as it relates to
cardiometabolic health processes. Given that paid work is a central social role and the average
working adult spends approximately one-third of their life working, work may be a critical
mechanism to explain and understand life-long cardiometabolic health, especially as it pertains
to differences across sociodemographic groups. To fill this gap, I propose and leverage a
conceptual model, which I call the Occusome Framework, to better understand the role of work
conditions and exposures in shaping mid-life cardiometabolic-related health disparities. Using a
unique combination of data from the Health and Retirement (Study), the American Community
Survey (ACS), and the Occupational Information Network (O*NET), this dissertation seeks to
comprehensively understand: 1) which stress-, physical-, and environmental-related work
exposures are associated with mid-life cardiometabolic health, 2) understand how
sociodemographic groups might be concentrated in occupations characterized by
cardiometabolic-risky (or protective) work exposures, and 3) assess how work exposures might
help to explain sociodemographic disparities in mid-life cardiometabolic health. Overall,
findings suggest that work exposures are related to mid-life cardiometabolic health. Moreover,
men, racially/ethnically minoritized workers, and workers with lower levels of educational
attainment are particularly concentrated in cardiometabolic health-harming jobs. However,
findings also suggest that work exposures do not seem to mediate cardiometabolic-related
disparities. Although findings from this dissertation show that work exposures do influence
cardiometabolic health, future research should better explore the conditions under which health
disparities are mitigated or exacerbated.