Construction of life-course occupational trajectories: evidence for work as a mediator of racial disparities in hypertension.

Abstract

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. 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. 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. 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.