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BOOK REVIEW |
AARP Public Policy Institute Washington, DC 20049
Health and Safety Needs of Older Workers, edited by David H. Wegman and James P. McGee. The National Academies Press, Washington, DC, 2004, 320 pp., $47.95 (cloth), $32.50 (pdf).
The United States has yet to come to grips with its aging workforce, although the country should be better prepared for it than it is. Boomers' relentless march toward old age has hardly gone unheralded, accompanied, on the one hand, by dire warnings of substantial labor and skills shortages when the boomers retire and, on the other, by encouraging assessments of the potential economic contributions of extended worklives. Yet, older workers do not feature prominently on the agenda of policymakers. More worrisome is the fact that employers, who are certainly cognizant of population aging, have done little to prepare for the possible departure of millions of workers in the next several years (U.S. General Accounting Office, 2001). Nor do they appear prepared to accommodate those who might continue working.
Baby Boomers, Retirement, and Employment Expectations
The oldest boomers are less than 2 years away from the age of eligibility for early retired worker benefits under Social Security. If they are like their parents and grandparents, they will grab those benefits at age 62 or fairly soon thereafter and put away their lunch pails. But for the past 60 years, boomers have indicated that they are not like their parents, and now we hear that they will carry those differences into retirement. For one thing, of course, few boomers carry a lunch pail, having benefited from the shift to service-industry employment and a knowledge economy characterized by indoor work and no heavy lifting. So some of the major impediments to longer worklives have been eliminated, although until fairly recently, those changes weren't enough to keep older Americans in the workforce. Since the mid-1980s, however, the labor force participation rates of older Americans have been inching upward, and they are projected to continue rising (Toossi, 2005). Consequently, by 2014, 1 in 5 labor force participants could be aged 55 or older, up from 1 in 8 in 2000.
It is a whole new ballgame for older workers as they approach retirement today, some contend. Boomers, in fact, are expected to reinvent retirement (Freedman, 1999), to turn it into something more than endless days on the golf course, if that is what it has really ever been for most workers. Americans, claims the U.K.-headquartered banking and financial services giant HSBC (2005), are replacing the old leisured retirement with a new life stage that incorporates periods of both work and leisure, something that boomers are expected to do in large numbers. Although they still see retirement as a time for leisure, hobbies, and families (AARP, 2004), boomers overwhelmingly insist that they expect to work in retirement—upwards of 70%, depending on the survey (AARP, 2003, 2004; Metlife Foundation/Civic Ventures, 2005; Yakobski & Dickemper, 1997). Thus, official labor force projections may be underestimating the actual participation rates of older Americans during the next decade or so. If faced with labor or skills shortages, employers might be induced to offer the employment arrangements that workers at retirement age say they would be interested in—part-time work and phased or gradual withdrawal from the labor force.
However, it is by no means certain that boomers and other older workers will find it easy to realize their employment expectations and desires. Few employers have formal phased retirement programs that would enable employees to ease into retirement in the jobs they know (Hutchens, 2003) and presumably do well. Much part-time work in the United States is both low-wage and physically demanding, even if it is not akin to the foundry work of the last century. In addition, the Congressional Budget Office (CBO) reported in 2004 that 4 million boomers had already left the labor force, most commonly because of disability. CBO went on to caution that should boomers "follow in the footsteps of workers now in their early 60s, perhaps one-third of the men and nearly half of the women will be out of the labor force before their 62nd birthday" (U.S. Congress, 2004, p. 1). Munnell (2006) recently drew attention to a number of factors that could have an adverse impact on the demand for and supply of older workers, the cost of workers being a paramount issue on the demand side, and work limitations and a dearth of the part-time jobs older workers say they want on the supply side. In addition, employers continue to have reservations about the technological competence of older workers, as well as about their flexibility, adaptability, and ability to learn new things.
Health and Safety of Older Workers
Many of these concerns are addressed in Health and Safety Needs of Older Workers, edited by Dave H. Wegman and James P. McGee, the product of a National Research Council and Institute of Medicine Committee. The Committee was convened in 2001 to examine various dimensions of the older workforce over the next 2 to 3 decades and identify policy and research issues surrounding the health and safety needs of older workers. Almost everything one would ever want to know that could be known about older workers' physical and mental well-being and work ability can be found, it seems, in this publication.
The Committee cast a wide net in its search for and examination of issues and factors that may have a bearing on the well-being of older men and women in the workplace and on their decision to exit the workforce. There are the obvious factors, certainly, such as exposure to chemicals, radiation, and biological agents, as well as occupational injuries and illnesses and musculoskeletal disorders, for example. But the Committee also examined programs, policies, and interventions designed to promote safe and productive work by an aging population. These include job redesign, health promotion, Employee Assistance Programs, and laws such as the Family and Medical Leave Act and the Age Discrimination in Employment Act that may not be top-of-mind issues when thinking about the health and safety of older workers. Chapters reviewing trend data on the demographic characteristics of older workers, the changing nature of work, and the social and economic context of work provide a wealth of information on employment settings and the meaning of work for older men and women, much of which isn't readily available elsewhere. The social and economic context of work, disability discrimination, and income replacement programs, for example, all get their due.
Meticulous scholarship is apparent in a well-organized, data-packed, and very readable document that should serve as a handy reference for older worker experts. Oddly, however, epidemiological, demographic, and survival function tables referenced in two appendices do not actually appear there. The reader must go instead to the National Academies Press Web site and, with a bit of difficulty, unearth them. Somehow, paying full price for the book would seem to warrant receiving the full product.
This book is a serious effort to summarize an extensive body of research relating broadly to the health and safety needs of older workers, even though readers will probably be frustrated over how much is not known. It is a book for readers of The Gerontologist, other researchers, and graduate students in search of the next research project or dissertation topic. It isn't just the 16 recommendations at the end of the book, most of which deal with needed research, that should get the adrenalin going. Discussion after discussion in the book concludes with the observation that little research or evaluation has been conducted in a particular area, often an area where research would seem to have very practical applications.
General improvements in health status and a decline in disability at later ages have been well documented in the gerontological literature. Overall, according to Health and Safety Needs of Older Workers, the evidence seems to point to improvements in physical and cognitive functioning in succeeding cohorts of older individuals and workers. If this is true, and not everyone agrees that it is, it augurs well for older workers' continued employment. Especially when coupled with increased educational attainment, these developments should enhance work ability at older ages and increase older workers' appeal to employers.
Are Older Workers Less Attractive to Employers?
Health and Safety Needs of Older Workers does not gloss over some of the concerns that older worker advocates have tended to overlook or ignore in evaluating the ability of older workers to remain in the workforce and their attractiveness to employers. Much as boomers and others might wish it weren't so, older and younger workers do differ from one another, and many of the differences do not favor older persons. Some of the changes are a normal part of aging and others the result of the increased probability of developing abnormal conditions with age. Chronic health conditions increase with age as does the presence of comorbidity, and work capacity may be affected by these changes. Some of the age-associated changes and their impacts, such as a declining capacity for heavy labor, are common knowledge. The potential negative impact of other changes, such as the increase in occupational injuries associated with weakening eyesight or hearing, is less widely recognized. However, many, if not most of these changes may be remediable or amenable to workplace accommodations and adjustment.
The book states baldly that "age-related effects on many measures of cognitive functioning are large and negative" (p. 113). To many readers, the book may become even more discouraging, for example, "there is a slight increase up to about age 50 for measures of knowledge of word meaning and general information, but a continuous decline beginning in the 20s for variables representing memory, reasoning, and special abilities" (p. 115). Thus, in some tests, the "average 70-year-old ... is performing at a level lower than that of over 90 percent of the young adults in the reference distribution" (p. 115). One might be inclined to despair at this point, but it is not clear how relevant these differences are to today's workplaces, especially because, as the book reminds us, "most occupations do not usually require performance at full individual capacity" (p. 101). Moreover, for workers remaining on the same job, there is apparently little evidence that cognitive changes negatively affect worker health, safety, or performance. In other words, even with certain declining facilities, older workers may be perfectly capable of meeting the demands of the jobs they hold—a reason to retain older workers and support the expansion of formal phased retirement programs. How much capacity is required may be the $64,000 question, but if performance meets employers' standards, that is what counts.
And there is more good news: Some attributes actually improve with age, which is what boomers have probably suspected all along. Unlike fluid intelligence/cognition, or the "flexible solution of novel problems" (p. 95), crystallized intelligence/cognition, or accumulated knowledge, apparently increases until age 50 and possibly even beyond. Older workers may be especially effective at tapping into and utilizing past experience and knowledge to deal with workplace issues and problems, which may be what employers are referring to when they applaud the experience, maturity, and judgment of older workers. Even though fluid cognition does show slippage with age, the decline apparently begins at an early age. Most employers would not be well-served by a workforce composed only of workers with the most fluid cognition—20-year-olds—as opposed to one with a healthy mix of workers in their 40s and 50s.
In fact, the impact of many age-associated changes on work capacity is not well understood. Available research, particularly meta-analyses, indicates that age is a poor predictor of performance (e.g., Sterns & McDaniel, 1994). Nonetheless, the empirical research has many weaknesses, according to Health and Safety Needs of Older Workers. Sample sizes are often very small; relatively few older persons, especially those aged 50 and older (and more likely 65 and older), tend to be included in the studies; and the studies may be affected by what is referred to as the "selective survival" phenomenon. This occurs when only the highest performers remain on the job. To these limitations might be added an insufficiency of research projects outside of laboratories or artificial settings that include real workers in real-work situations engaged in real-work tasks. Still, one should not discount the possible mediating effect of job experience when it comes to the lack of a strong relationship between age and job performance. This, too, is another area where research is needed, and it would seem to be a critical one if it is the case that employer decisions regarding the hiring and retention of older workers are based on outmoded or erroneous stereotypes about age and performance. Perhaps it will turn out that, as a result of experience or expertise, older workers have acquired what they need to know "to perform safely and productively" (p. 119); if so, special accommodations might not be needed for older workers. But, once again, the research that might buttress such a conclusion seems to be limited.
It is worth keeping in mind that abilities do not necessarily decline with age across the board; sizable inter- and intracohort differences exist; not every age-related change is relevant to job performance; and interventions, such as employee training, job redesign, or various workplace adaptations or accommodations, might mitigate those that do. However, the tremendous variability in functioning in the older population not only makes generalizations problematic but raises questions about appropriate, successful, and cost-effective intervention strategies.
It also raises, or should raise, questions about just what is "old." A common problem in discussions about older workers involves the tendency to be imprecise about the reference group, often lumping everyone of a certain age—say, 50 or 55+—into the "older worker" category, or just assuming that everyone knows and is in agreement about what is meant by the term. In its 21-country review of aging workforces and employment policies, the Organization for Economic Cooperation and Development (OECD) defines older workers as aged 50 and older, not because 50 is a "watershed in and of itself" (OECD, 2005, p. 3) but because in many countries, the age marks a beginning of a fall in labor force participation. Even so, OECD warns that this should not be taken to imply that all workers in the age group 50 and older are "‘old’ per se" (OECD, 2005, p. 4).
In the United States, as Health and Safety Needs of Older Workers observes, various laws define older differently—aged 40 for the Age Discrimination in Employment Act, aged 55 for eligibility in the Senior Community Service Employment Program, aged 60 for services under the Older Americans Act, and aged 62 for eligibility for Social Security benefits. The publication warns that chronological age can be deceiving, and while this is certainly true, it is likely that employers by and large distinguish among workers in their 50s, 60s, or 70s. The book, however, for the most part refrains from making distinctions among workers in various age groups but does note that "in general the slope [of age-related change] declines at a greater rate with increasing age" (p. 100), so "older workers may need more frequent assessments to characterize the impact of work-related exposures" (p. 100).
From the perspective of employers, managers, or supervisors, what do observations such as this one mean—are we talking about workers from their 50s on, 60s, or even later? What should employers, trainers, the public, or others do with information such as this? In the preface to the book, editors Wegman and McGee maintain that the starting age for attention should be young enough that any interventions make a difference; however, taken to the extremes of the life-cycle perspective, that could be birth or before. This is not a suggestion likely to resonate with employers confronted with workers well beyond the ideal age for intervention. Surely there are accommodations and adjustments that employers can make for those workers.
New Types of Jobs and New Older Workers
Given the shift to service-sector jobs, there seems to be a somewhat disproportionate focus on manufacturing jobs and jobs that expose workers to hazardous materials in Health and Safety Needs of Older Workers. Physically demanding jobs have declined, and cognitively demanding ones have been on the rise. The book does acknowledge that there are health and safety issues associated with some of the so-called "better" jobs, which is important to stress in view of the tendency to assume that such jobs are just the ones for older workers, since they make fewer physical demands on the body. The growing intensification of work, with its potential physical consequences and resultant job stress, may over time have a cumulative effect on the ability and willingness of workers to remain in the workforce. Workers in the service sector might not be hoisting steel beams into place on construction sites or scrambling up ladders, but long days standing in the burger outlet, placating disgruntled customers at the airport ticket counter, or assisting home care patients can take their toll. Keeping workers productive and willing to remain in these and comparable jobs will be a growing challenge in light of the increase in the number and proportion of older persons in the workforce—many in their late 60s and 70s—and the projected growth in the number of what many would consider less than desirable jobs (see, Hecker, 2005, p. 77).
Future cohorts of older workers will likely be healthier and better educated and thus better prepared to work longer than recent cohorts. Policymakers around the world are banking on that. But, as Health and Safety Needs of Old Workers points out, medical advances are keeping alive people who once would not have reached adulthood to be able to participate in the workforce. As evident in recent Congressional Budget Office analyses, disability begins to exact its toll at relatively young ages (U.S. Congress, 2004). Furthermore, there is the healthy worker effect, which occurs when workers with health problems withdraw from the labor force, leaving a generally healthier group of peers behind them. If workers cannot afford to retire at the young ages so many have been doing, the number and proportion of "unhealthy" workers can be expected to increase. This suggests a growing need for interventions to address the health problems of older workers in order to maintain work capacity levels.
Complicating matters is the fact that socioeconomic status—along with exposures and experiences, including health care access, occurring in the distant past—has an impact on well-being late in life. Throw in non-work-related "exposures," such as poor diet, alcohol abuse, or other risky behavior, and a complex relationship between health and work capacity becomes even more difficult to disentangle. As important as this life-cycle approach may be to painting a full picture of the aging process and well-being in later life, it is not all that evident how it can be put to use by employers faced with the here and now. In other words, what are we to do with the boomers now on the threshold of retirement?
The Committee's Recommendations
If the book underscores anything, it really is how much we do not know about human aging and work capacity, which may make practical recommendations tricky. Given the composition of the Committee—all academics and one think-tank scholar—it is not surprising that the report's recommendations focus largely on the need for additional research. To be fair, the Committee was charged with coming up with research recommendations. Its number one recommendation is for new longitudinal data sets that would provide far more detail on employment histories, job demands, and on-the job health and safety. Such compilations would be expensive, as the book admits. It would be years before they yield data and analyses that provide public- and private-sector policymakers with the tools they need to produce and implement policies to enhance the health, safety, and performance of the workforce, particularly its older members. Because the costs might be prohibitive, alternative data collection methods are proposed as well, such as including more relevant queries in existing longitudinal surveys such as the Health and Retirement Study.
Nonetheless, the more far reaching of the recommendations are worth considering, given the millions of older workers who will follow the boomers. Some recommendations, however, would seem to promise more immediate results. Of particular relevance might be the one calling for an evaluation of occupational injury and illness reporting systems to determine if such injuries are underreported. It would seem that potentially useful results from such an undertaking might be obtained in a reasonable period of time.
A particularly intriguing recommendation is for evaluation research to determine the degree to which public policies intended to enable workers to remain at work safely and productively have done so, particularly in the case of older workers. Such policies include the Occupational Safety and Health Act (OSHA), the Americans with Disabilities Act (ADA), the Age Discrimination in Employment Act (ADEA), and the Family and Medical Leave Act (FMLA). The recommended research, depending on the findings, could lead to improvements in those policies, including amendments, additional legislation, or enhanced enforcement. In an example of what the Committee might have had in mind, Neumark (2001) assessed the impact of the ADEA, concluding that, on balance "a relatively positive assessment of age discrimination legislation in the United States is more warranted than a negative assessment" (p. 35). This may not be a ringing endorsement of the legislation, but it indicates that the ADEA is doing some of what it was designed to do and might be made to do it better. On the other hand, some phased retirement proponents have suggested that the ADEA may serve as a barrier to the implementation of phased retirement programs in the United States. If so, then the question arises as to how to ensure the protection of older workers without simultaneously restricting their employment opportunities. Similar questions might be asked about other policies whose effectiveness has not been adequately assessed—again, potentially fruitful avenues of research.
It is unreasonable to criticize the Committee for not producing a book they were not charged to produce. Committee members brought to the undertaking an impressive range of knowledge of various aspects of the field and the relevant research, as well as the expertise to evaluate the reliability and validity of extant research, recognize that research's limitations, and identify unmet research needs. For that we can be grateful, as it steers us from drawing conclusions about the health, safety, and capabilities of older workers that might not be justified. It is true, too, that the focus was to be forward looking, so any complaint that there is less than there might be in the book to enlighten those grappling with older worker issues today is probably unwarranted.
Still, one cannot help speculating on the project's direction had some of the Committee members included men and women who grapple with the demands of a global economy and performance issues on a daily basis, whose decisions may affect the lives of thousands of workers. With one exception, reviewers of the book manuscript, as far as can be told, were all academics as well. It is possible that input was solicited from employers and others involved directly with aging workers and workplace issues, although if so, that is not evident in the book; nor does such information appear to be on the book's Web site. As desirable as the recommended research might be, the workforce is aging, and employers and workers are going to be making employment-related decisions without the benefit of additional research.
Even if the proportion of boomers continuing to work in retirement does not reach 70% or more—and it is not likely to—the number and proportion of older workers postponing full retirement is sure to increase. Many aging individuals will have to work (Munnell, 2006); others want to (e.g., AARP, 2004). Employees can no longer count on the social compact to see them to and through a secure retirement. The freezing of defined benefit plans, the shift to defined contribution plans, and cutbacks in retiree health benefits increasingly place old-age financial security squarely on the shoulders of workers, a responsibility that for many can be more easily assured only by working longer. Workers may have little say over the stock market or changes to their benefit plans, but they do at least have some control over when they retire. The ADEA offers important protections, even if some employers manage to find their way around it.
The Need to Reach Other Audiences
Health and Safety Needs of Older Workers raises many questions, one of which is the choice of the intended audience, which seems to be the academic community. If the book does stimulate more relevant research among that audience, it will have accomplished an important objective. However, one would hope for more given the effort that went into the final product. A Google search of the title generated about 15,000 potential hits. This reviewer is not enough of a masochist to check all 15,000, but there was little evidence from the 40 or so I did look at that the contents of the publication have been written up for personnel or human resource magazines or other publications targeted at potential data users—employers, human resource managers, workforce strategists, and trainers, for example. If this hasn't happened, it should. Or someone should attempt to extract from the book those research findings that can, with some confidence, be accepted without further verification and that might assist employers in promoting the health, safety, and performance of their employees, particularly workers in their 50s and 60s. Much of the information in Chapter 8, "Interventions for Older Workers," in particular, is exactly what employers need to know. One reason that employers have done little to prepare for an aging workforce may be that they haven't known what would have a positive impact on their older workers and workplaces, or what would be cost effective.
Nor could evidence be found in the book of Congressional testimony about the results of the Committee's work. That, too, should occur if it has not because much of the requested research will need to be funded by Congress, which must be convinced of the value of it. This is yet another argument for "translating" the book into a language and format that potential users will be comfortable with. Although the book is exceptionally readable, many of the concepts will not be easily grasped by readers new to them—fluid and crystallized intelligence/cognition being among them. There may be much that we do not know, as the book hammers home, but there is much in Health and Safety Needs of Older Workers that is applicable to workplaces today, and that information should be widely disseminated.
We can always know more. And not knowing enough can sometimes be dangerous. But with or without the research called for in this volume, employers are making and will increasingly make decisions about older worker hiring, retention, training, promotion, and compensation.
Employers, employment counselors, older worker advocates, and workers themselves need some guidance now. The Committee may not have been tasked with coming up with recommendations to aid employers in their current decisionmaking, but somebody should be. What exactly do we know that can (1) mitigate age-related declines of today's older workers, (2) enhance the performance and productivity of those older workers and the boomers coming behind them, and (3) provide employers with the tools they need to fairly and as objectively as possible assess the capacities of their aging workforces? That is a big job, and time is of the essence—for many, a mere year or so away. Capitalizing on the information in Health and Safety Needs of Older Workers is a good place to start.
The views in this essay are those of the author and do not necessarily represent the official policy of AARP.
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