The Role of Extreme Heat and Occupational Heat Exposure in Older Adult Health Trajectories

Over a third of US workers are employed in jobs that involve outdoor exposure or indoor conditions without cooling. Extreme heat exposure is linked to increased mortality and adverse health outcomes, disproportionately impacting workers in these occupations. Existing studies have highlighted elevated immediate risks for heat-related health issues (for example, heat stroke) in certain occupations, but little is known about the extent to which work in heat sensitive occupations exacerbates the link between heat exposure and both health and work disability over time or in the context of an aging workforce. These likely important interactions have not been assessed using nationally representative longitudinal data, or across all occupations. Further, no single data set exists linking necessary measures (longitudinal survey data, heat and occupation data, and administrative data) to analyze and document these risks.

Adopting a life course framework and offering an innovative data integration approach, this project fills this gap by assessing the mid-to-long term health and work disability consequences of exposure to heat-sensitive jobs using panel data from the Health and Retirement Study (HRS) linked with multiple sources of tract-level extreme heat data and occupational characteristics. The first aim is to investigate whether heat-sensitive work modifies the link between extreme heat and health outcomes, focusing on self-rated health, functional limitations, and chronic conditions, with analyses controlling for sociodemographic factors. The second aim is to examine whether heat-sensitive work influences the relationship between extreme heat and work disability outcomes, including self-reported work limitation and Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) claims. This research will enhance our understanding of the role of occupational heat exposure in shaping health and disability outcomes over the medium and long term and highlight those at greatest risk. Finally, the third aim is to carefully evaluate competing measures of occupational and heat exposure to shed light on the scientific value of these measures and inform their use in future research and practice. In sum, the project builds a valuable data infrastructure, informs public health, and guides future research at the nexus of heat, work, and health.