Chronic Work Discrimination, Allostatic Load, and HbA1c in Older Workers.

Abstract

Background and objective: Work discrimination is an important public health problem with consequences for health. This study examined the effect of chronic work discrimination on 4-year changes in HbA1c, as a reflection of glucose control and type 2 diabetes risk in older workers and assessed whether allostatic load (AL) impacted the strength of this association.

Research design and methods: We used Health and Retirement Study data (2010-2016, n=3,246). Conditional change multinomial logistic regression examined the association between chronic work discrimination, high AL (4 or more out of 8 high-risk biomarkers), and HbA1c, while accounting for relevant covariates.

Results: Black participants had the highest rates of baseline (22.7%) and follow-up (28%) HbA1c levels, AL (38%), and chronic work discrimination (39%) (p<0.01). Severe chronic work discrimination was associated with elevated HbA1c (RRR=1.61, 95%CI=1.07,2.43). AL was associated with elevated HbA1c (RRR=1.49, 95%CI=1.04,2.14). Relative to White participants, Hispanic (RRR=1.52, 95%CI=1.07,2.16, RRR=1.81, 95%CI=1.051, 3.12) and Black (RRR=2.42, 95%CI=1.82,3.23, RRR=3.00, 95%CI=1.97,4.56) participants had an increased risk of intermediate and elevated HbA1c respectively. Among those with long job tenure (≥ 5 years) both moderate (RRR=1.81, 95%CI=1.11,2.96) and severe (RRR=1.90, 95%CI=1.15,3.12) chronic work discrimination was associated with elevated HbA1c.

Discussion and implications: Chronic work discrimination, was associated with HbA1c, however no moderating effects of AL were observed. Findings underscore a need for organizational and public health measures to establish strong anti-discrimination laws in the workplace, to improve the work environment of older workers and diabetes risk.