Joint effect of education and main lifetime occupation on late life health: a cross-sectional study of older adults in Xiamen, China

Background: The effects of education and occupation on health have been well documented individually, but little is known about their joint effect, especially their cumulative joint effect on late life health. Methods: We enrolled 14,292 participants aged 60+ years by multistage sampling across 173 communities in Xiamen, China, in 2013. Heath status was assessed by the ability to perform six basic activities of daily life. Education was classified in four categories: ‘Illiterate’, ‘Primary’, ‘Junior high school’ and ‘Senior high school and beyond’. Main lifetime occupation was also four categorized: ‘Employed’, ‘Farmer’, ‘Jobless’ and ‘Others’. Odds ratios (ORs) were estimated by random-intercept multilevel models regressing health status on education and main lifetime occupation with or without their interactions, adjusting by some covariates. Results: Totally, 13,880 participants had complete data, of whom 12.5% suffered from disability, and ‘Illiterate’ and ‘Farmer’ took up the great...