Institutional and individual factors affecting health and employment for low-income women with chronic health conditions

Objectives: This qualitative study explored risk and protective factors affecting employment and health among low-income older women with chronic health conditions or physical disabilities. Methods: The authors conducted a secondary data analysis of 14 intensive interviews with low-income older women with chronic health conditions who had participated in a federally funded training and employment program for workers aged 55 and older. Qualitative data were analyzed using thematic analysis. Results: The physical nature of the work and discrimination were risk factors, with unaccommodating work environments, ageism, and/or ableism, and internalized ageism identified as subthemes of discrimination. Protective factors, namely institutional supports (e.g., access to retraining, time management flexibility) enhanced health and self-confidence. Occupational demands matched with the capacity of the individual resulted in continued employment and improved health. Discussion: Working conditions can degrade health through exposure to mental and physical health risks, or support health through access to financial and interpersonal resources. Institutional supports such as workplace flexibility and retraining are crucial to obtaining a good fit between occupational demands and the capacity of individuals, enabling a positive relationship between employment and health. Legislation designed to prevent discrimination, enhance opportunities for lifelong learning, and encourage flexible work arrangements among low-income women with chronic health conditions may facilitate healthier working lives.