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Construction of Life-Course Occupational Trajectories: Evidence for Work as a Mediator of Racial Disparities in Hypertension

Meyer, John D. MD, MPH; Mutambudzi, Miriam PhD, MPH

Journal of Occupational and Environmental Medicine: October 2012 - Volume 54 - Issue 10 - p 1201–1207
doi: 10.1097/JOM.0b013e31826bb6ac
Original Articles

Objective: To determine whether a life-course model of work may explain racial or ethnic differentials in health. Occupational characteristics are relevant socioeconomic indicators of health disparities and essential determinants of health.

Methods: Growth mixture modeling (GMM) was used to construct longitudinal trajectories of work characteristics from the ages of 20 to 32 years. Path analyses were used to evaluate the association of race, ethnicity, education, and work trajectory on incident hypertension.

Results: Growth mixture modeling yielded three latent class trajectories. Black subjects with postsecondary education were 2.5 times more likely to be found in the lowest occupational trajectory. The three-class trajectory model mediated 43.6% of the direct effect of race on incident hypertension.

Conclusions: Latent class trajectories of work demonstrated a stronger association with incident hypertension than did measures of current work, and clearly mediated the effects of race on hypertension.

From the Department of Environmental and Occupational Health Sciences (Dr Meyer), SUNY-Downstate School of Public Health, Brooklyn, NY; and Section of Occupational and Environmental Medicine (Dr Mutambudzi), Department of Medicine, University of Connecticut Health Center, Farmington, Conn.

Address correspondence to: John D. Meyer, MD, MPH, Department of Environmental and Occupational Health Sciences SUNY-Downstate School of Public Health 450 Clarkson Avenue, Box 43 Brooklyn, NY 11203 (

This study was supported by grant OH 9666 from the National Institute of Occupational Safety and Health (NIOSH).

Authors Meyer and Mutambudzi have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM Editorial Board and planners have no financial interest related to this research.

©2012The American College of Occupational and Environmental Medicine