Occupational Differences in BMI, BMI Trajectories, and Implications for Employment Status among Older U.S. Workers

Abstract

We examined associations between employment and obesity, arguing that risk for unhealthy weight may vary across occupational groups because they shape workplace exposures, social class standing, material resources, and norms and expectations about healthy behaviors and weight. We used a large sample of 51-61-year-old workers from the Health and Retirement study, tracking their body mass index (BMI) over time while accounting for potentially confounding influences of socioeconomic status and gender and exploring whether gender modified associations between occupational group, BMI, and retirement timing. Compared with women in professional occupations, women managers were less likely to be obese at baseline and were less likely to be in the obese upward trajectory class, while female professionals and operators and laborers were less likely than women in farm and precision production to be in the normal stable trajectory. Male professionals were less likely than men in sales, service, and operator and laborer positions to be obese at baseline and more often followed the normal upward trajectory than most other groups, though they and farm and precision production men were more likely to be in the overweight to obese trajectory than men in service occupations. Adjustment for sociodemographic and lifestyle characteristics reduced associations more for men than for women. While retirement risk differed across occupational groups, most of these differences were explained by socioeconomic, demographic, and lifestyle characteristics, especially for men. Obesity at baseline was an independent predictor of retirement but did not further explain differences in the timing of retirement by occupational group.

Figure 1.

Conceptual diagram.

Figure 2.

Predicted probabilities of obesity for men and women by occupational group, after adjustment for all predictors and setting all predictors at gender-specific means.

Figure 3.

Predicted BMI trajectory class values for men and women by occupational group, after adjustment for all predictors and setting all predictors at gender-specific means. Figure 3 shows the difference in predicted proportion of respondents in an occupational group in each BMI trajectory class, after adjusting for all covariates in Model 2, Appendix A, and indicates comparisons that are significantly different from those in other occupational groups. Among women, those in the professional or operations/laborer occupations were less likely to be in the normal-downward BMI trajectory than farm and precision production workers, while managers were less likely than professional women to be in the obese-upward trajectory class. Men in sales, clerical, farm and precision production, and operator and laborer occupations are less likely than professional men to be in the normal upward trajectory class, while professionals and those in farm and precision production occupations are more likely than those in service occupations to belong to the overweight to obese trajectory class.