Scorching Circumstances: The Role of Extreme Heat in Disability Among Older Workers in Heat Sensitive Jobs

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.

Grant Number: 1R21ES037897-01
NIH Institute/Center: NIH
Principal Investigator: DEBORAH BALK