Although education's protective effects on health have been well recognized, specific mechanisms through which higher education is associated with better health are still debated. Occupation, although strongly shaped by education, has rarely been examined as a mediating mechanism. Education attainment is patterned by race in the United States, and the same education does not lead to similar occupations for members of different racial/ethnic groups. Therefore, examining the link from education to jobs to mortality can illuminate potential mechanisms that create racial health disparities. Using a large U.S. national cohort of Black and White men and women, we examined if 2 occupational characteristics, substantive complexity of work and hazardous working conditions, mediate the effect of education on mortality. Data on occupation were collected between 2011 and 2013, and mortality follow-up data up to March 2018 were included in this analysis. The race- and gender-stratified analyses showed that among White men, the association between higher education and lower mortality was mediated by lower hazard on the job. Among Black men and White women, higher complexity of work explained the association between higher education and lower mortality. Among Black women, neither job characteristic mediated the association. These results suggest that occupational characteristics help explain health inequalities not only by education but also by race and gender. Investigating occupation explicitly in the causal chain of health disparities will help us better understand the mechanism of and potential solutions for health inequalities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

中文翻译：

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工作复杂性和危险的工作条件：如何解释死亡率的教育梯度？

尽管教育对健康的保护作用已得到充分认识，但高等教育与更好的健康联系起来的具体机制仍然存在争议。职业虽然受到教育的强烈影响，但很少被视为一种中介机制。在美国，受教育程度是按种族划分的，相同的教育不会导致不同种族/族裔群体的成员从事类似的职业。因此，研究从教育到就业再到死亡率的联系可以阐明造成种族健康差异的潜在机制。我们利用大量美国黑人和白人男性和女性群体，研究了两种职业特征（工作的实质性复杂性和危险的工作条件）是否会介导教育对死亡率的影响。职业数据收集于 2011 年至 2013 年期间，截至 2018 年 3 月的死亡率随访数据也包含在本次分析中。种族和性别分层分析表明，在白人男性中，高等教育与较低死亡率之间的关联是由较低的工作风险介导的。在黑人男性和白人女性中，工作的复杂性较高解释了高等教育与较低死亡率之间的关联。在黑人女性中，这两种工作特征都没有调节这种关联。这些结果表明，职业特征不仅有助于解释教育方面的健康不平等，还有助于解释种族和性别方面的健康不平等。在健康差异的因果链中明确调查职业将有助于我们更好地了解健康不平等的机制和潜在的解决方案。（PsycINFO 数据库记录 (c) 2019 APA，保留所有权利）。