Using Generalized Estimating Equations to Analyze Alcohol Consumption and Job Displacement ...

111 Pages·2015·0.61 MB·English

by  Nita Patel

University of North Texas Health Science Center
UNTHSC Scholarly Repository
Theses and Dissertations
Spring 5-2010
Using Generalized Estimating Equations to
Analyze Alcohol Consumption and Job
Displacement among Older Workers
Nita Patel
University of North Texas Health Science Center at Fort Worth, [email protected]
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Recommended Citation
Patel, N. , "Using Generalized Estimating Equations to Analyze Alcohol Consumption and Job Displacement among Older Workers"
Fort Worth, Tx: University of North Texas Health Science Center; (2010).
http://digitalcommons.hsc.unt.edu/theses/91
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Patel, N., Using Generalized Estimating Equations to Analyze Alcohol Consumption and
Job Displacement among Older Workers. Doctor of Public Health (Biostatistics), May
2010, 94 pp, 9 tables, 2 illustrations, bibliography, 42 titles.
The objectives of this dissertation were to compare differences in alcohol
consumption among the older workers (aged 51 to 61 years) who have experienced job
displacement compared to those who remain continuously employed. Generalized
estimating equations were used to model this relationship using longitudinal data from
the Health and Retirement Study from 1992 to 2006. Approximately 39% of respondents
had died during the study period. We analyzed four models. One model excluded data
for deceased respondents. Another model retained data for deceased respondents. For
the remaining two models, data was imputed using multiple imputation by chained
equations. Data was imputed for only the predictors in one imputation, imputed for both
the dependent variable and the predictors in the second imputation. All models were
weighted and adjusted for key sociodemographic variables.
The results of this study show that being continuously employed, compared to
experiencing job displacement, has a protective effect on the onset of alcohol
consumption. Older workers who were not displaced were less likely to report
consuming alcohol compared to those who had been displaced. This finding remained
statistical significant even after adjusting for key sociodemographic variables. Complete
case analysis and observed sample models provided biased estimates (i.e. wider
confidence intervals, smaller p values) compared to the two multiple imputation models.
Our findings have important public health implications. Older workers are likely
to have varied participation in the labor market. They are likely to be more experienced
and hold senior or management positions, thereby earning higher wages. They may be at
a higher risk of layoff during uncertain economic times, such as a recession. The effects
of alcohol consumption among older individuals have been shown to be negative and
particularly harmful, especially in terms of ethanol toxicity. Additional studies are
needed to examine the health effects of late onset of drinking among older Americans.
USING GENERALIZED ESTIMATING EQUATIONS TO ANALYZE ALCOHOL
CONSUMPTION AND JOB DISPLACEMENT AMONG OLDER WORKERS
Nita Patel, M.P.H.
APPROVED:
Major Professor
Committee Member
Committee Member
Department Chair
Dean, School of Public Health
USING GENERALIZED ESTIMATING EQUATIONS TO ANALYZE ALCOHOL
CONSUMPTION AND JOB DISPLACEMENT AMONG OLDER WORKERS
DISSERTATION
Presented to the School of Public Health
University of North Texas
Health Science Center at Fort Worth
In Partial Fulfillment of the Requirements
For the Degree of
Doctor of Public Health
By
Nita Patel, M.P.H.
Fort Worth, Texas
May 2010

ACKNOWLEDGMENTS
Thank you, Dr. Bae, for your support not only during my time as a student at
UNTHSC, but even before that, when you provided guidance to me as a PHPS fellow.
You used few words, but your words were full of life experience. I really appreciated
having you as my adviser and mentor. Dr. Singh, thank you for bringing humor to
biostatistics, a concentration that sometimes felt really daunting to me. You helped me
see the value of balance – balancing life and work. Dr. Chen, you always had an open
door policy. I always felt comfortable in coming to you when I had questions, even for
classes you did not teach. Thank you. Finally, last but not least, Dr. Lykens, I will
always be grateful to you for your HRSII class. Your knowledge and comfort in all
things health policy and management really impressed me! I will always attribute my
skills and knowledge of STATA to you. Thank you for showing me that whether it's
learning new software or learning a new discipline (i.e. HMAP), it always gets easier
with time and practice. I owe much gratitude to Dr. Biswas, Dr. Suzuki, and Alice for
your help and support to me as a student.
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TABLE OF CONTENTS
Page

LIST OF TABLES....................................................................................................V
LIST OF FIGURES.................................................................................................VI
LIST OF ABBREVIATIONS................................................................................VII
Chapter
1. INTRODUCTION....................................................................................1
Rationale
Study Objectives
2. LITERATURE REVIEW.........................................................................5
Job Instability, Health and Alcohol Consumption
General Reviews of the Literature on Job Instability and Health
Longitudinal Studies of Job Instability and Health among Older
Workers
Alcohol Consumption among the Elderly: Mixed Findings
Alcohol Consumption among Older Workers
Statistical Models for Longitudinal Data Analysis
Traditional Models: Continuous Dependent Variable
Current Approaches: Continuous and Discrete Dependent Variables
Missing Data
3. METHODS............................................................................................29
Background of the Health and Retirement Study
Sampling Design
Binary Dependent Variable
Independent Variables
Data Management
Data Analysis
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