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Population Studied: Data on the children of the NLSY 1979 female respondents will be used. Eleven waves of data have been collected on over 11,000 children. The study population will include over 9,000 children with outcome data in at least one time period between 1988-2006.

Principal Findings: Twelve percent of the children in the sample had an activity limitation reported at some point during the study period. In cross-sectional models controlling for child, mother, and other household characteristics, a $10,000 increase in family income was associated with a -.36% decrease in the probability of parents reporting a activity limitation. After controlling for child fixed effect, the association decreases and becomes statistically insignificant. Using expansion in the EITC to create an instrumental variable for reported income reveals a positive causal effect of income on the probability of reporting any activity limitation. Specifically, a $10,000 increase in family income implies a .8 percent increase in the likelihood of reporting a activity limitation.

Conclusions: Family income is a causal determinant of the way in which parents perceive the limiting effect of their children's chronic conditions.

Implications for Policy, Delivery or Practice: There may be a disparity in the availability and affordability of services to support children with chronic health conditions in families with high income versus low income. There needs to be further description of this causal relationship to understand the source of this disparity.

Study Design: Retrospective cross-sectional analysis of two existing national population-based surveys: the National Ambulatory Medical Care Survey (NAMCS) and National Longitudinal Survey of Youth (NLSY). Pilot studies by us have demonstrated the usefulness of these databases in providing new information about occupational health care. This study will result in descriptive analyses of work-related cases from each database, including stratified sub-analyses comparing patient experiences among racial, ethnic, and socioeconomic patient groups, and selected multivariate analyses to assess the interactive effect of patient sociodemographic characteristics with employment experiences, medical services, and vocational outcomes.

Population Studied: The NAMCS covers physician-reported data for a nationally representative sample of 46,875 ambulatory medical care visits made in 1997-1998. 1,179 of those visits (2.5%) were for diagnosis and treatment of work-related conditions. Our analysis of the NLSY covers the experiences of 7,508 persons aged 33-4 who were interviewed in 1 998, of which 563 (7.5%) self-reported experiencing an occupational injury or illnesses in the 2-year period preceding the interview.

Principal Findings: Both analyses suggest that there are significant disparities among the social groups studied. In the NAMCS, Hispanics with work-related conditions required insurer authorization for care 57% more often than non-Hispanics, and Blacks 1 4% more often than whites. On average, Blacks saw a physician during their visit 6% less often than whites, and Hispanics 5% less often than non-Hispanics. Blacks had blood pressure measured at the visit 32% less often than whites, and Hispanics 11 % less often than non-Hispanics. The NLSY analysis indicated that following a work-related condition, Blacks were 1 6% more likely to miss work, had 28% more missed work days, and were 18% more likely to lose wages than non-Blacks. Similar patterns were observed among Hispanics compared to non-Hispanics, and low-SES (as indicated by educational attainment and family income) compared to high-SES workers.

Conclusions: Preliminary data from two national health care surveys indicates disparities in occupational health and health care for work-related conditions based on patients' race, ethnicity, and SES. These studies have demonstrated the usefulness of national survey databases as a novel source for collecting information about the health and vocational experiences of injured workers.

Implications for Policy, Delivery or Practice: This study helps demonstrate the barriers that Black, Hispanic, and low-SES workers face in accessing occupational health care, and their susceptibility to more severe vocational impacts following a work-related injury. These findings will help alert policymakers and public health advocates to the need to devise specific strategies for protecting the health and earning capacity of minority and low-wage workers.

Population Studied: Two cohorts of children born to mothers in the initial cohort of the 1979 National Longitudinal Survey of Youth (NLSY), a national household survey of high school students aged 14-22 in 1979. We follow 3,228 children aged 1-5 in 1987 and 2,737 children aged 1-5 in 1992, observing them through age 18-22 (Cohort 1) and 13-17 (Cohort 2).

Principal Findings: In sex stratified models, socioeconomic factors alone fully accounted for observed disparities, and provided a protective effect for major and minor morbidities among black and Mexican respondents, compared to white counterparts. Income in particular played a strong role in explaining racial/ethnic differences. The sex and race stratified models revealed that socioeconomic factors impact different population groups in different ways. Income appeared to have a lagged effect among black men and women, and no effect on Mexican men and women. Education exhibited a gradient effect for most sex-race categories and occupational prestige had minimal to no effect on health outcomes of respondents, compared to white counterparts. Income in particular played a strong role in explaining racial/ethnic differences. In sex and race stratified models, income appeared to have a lagged effect among black men and women, and no effect on Mexican men and women. Education exhibited a gradient effect for most sex-race categories and occupational prestige had minimal to no effect on health outcomes.

Conclusions: This study addresses gaps in the literature on whether more complex and perhaps more robust definitions of socioeconomic experience attenuate observed racial/ethnic disparities in health, and on how such socioeconomic patterns over the life course predict health in adulthood. Health status is also key to understanding the health of working adults, where morbidity is relatively low and mortality is disproportionately dominated by HIV, injury and homicide. The working age population represents the most productive segment of the U.S. population, both economically and socially, and represents a much overlooked subgroup ripe for preventive health intervention. Understanding the health differentials and needs during this productive time period, prior to more significant and rapid health declines in later life, are critical. Prior reviews have examined mortality or disease endpoints (e.g. cardiovascular, cancer, other morbidity) with substantially less attention paid to more global concepts of health. Additional research capturing both the longitudinal and contextual dimensions of socioeconomic experience in a broader population is still needed.

Study Design: We present an empirical model that predicts wages as a function of BMI (the direct effect), education and occupation choice (indirect effects of BMI), and other factors. The effect of a unit change in late teen BMI on the logarithm of wages in the early career stage is the full derivative of the logarithm of wages in the early career with respect to late teen BMI, taking into account the indirect effect of late teen BMI through education and occupation choice in the early career. To calculate the indirect effects, we estimate the effect of late teen BMI on the stock of education accumulated by the time an individual reaches their early 30s using OLS. We specify education in the early thirties as a function of late teen BMI and other factors in the early thirties. We then estimate reduced form models of the effect of late teen BMI on occupation choice among white-collar, service, sales, managerial or professional specialty jobs, and blue-collar jobs (based on Census occupational codes), and choice of jobs requiring social interactions with colleagues or customers (based on the Dictionary of Occupation Titles).