Background/Purpose: Research consistently finds that arthritis contributes to work disability. Yet, few studies have examined how employment experiences differ across the life course. This study examines the concept of the life course and its impact on the employment experiences of young, middle-aged and older adults with arthritis.

Methods: A series of focus groups and interviews with young (ages 18 to 34 years, n = 7), middle-aged (ages 35 to 54 years, n = 13) and older adults (>55 years, n = 25) living with arthritis were conducted. Participants were asked about aging with arthritis and ways in which their life circumstances, disease characteristics and career progress changed over time and affected their involvement in paid work. Two investigators independently coded data and incongruences were discussed. A modified grounded theory approach was used to inductively build a conceptual framework of the life course.

Results: The life course was made up of three interconnected domains that included life phase (i.e., changing social roles and responsibilities), career stage/job tenure (i.e., duration of employment and seniority in a job) and disease course (i.e., short- and long-term changes to arthritis symptoms). Life course domains and their impact on work experiences tended to differ based on the calendar age of the participant. Young adults described having to spend more energy transitioning into stable employment and a fear of worsening symptoms. Attributed to an early career phase, young adults were more reluctant to request workplace accommodations. Middle-aged adults discussed how their arthritis disrupted roles outside of work (e.g., parenting and marriage). Being in the mid-career stage and having greater job tenure offered more opportunities to access accommodations and benefits. For both young and middle-aged adults, having arthritis at a non-normative time of life created a barrier to disclosing the details of their condition and asking for help. In contrast, older adults talked about their life phase as being a time where they weighed the decision to retire against continuing to work. Related to a longer disease duration and greater job tenure, older adults discussed a toolbox of strategies they used to manage their arthritis and employment. When compared to the younger age groups, older adults were more likely to acknowledge that an arthritis diagnosis was part of aging and they were more comfortable talking to others about their limitations and requesting support.

Conclusion: Life course differences existed when comparing the employment experiences of young, middle-aged and older adults with arthritis, and should be considered in the development of work disability prevention policies and programs. Future research should also be conducted to identify opportunities for measuring life course domains in population health studies.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/conceptualizing-the-life-course-in-the-employment-experiences-of-working-aged-adults-with-arthritis-a-qualitative-study/