Occupational History and Health Status Among Older Adults in Ecuador: Evidence from the SABE Survey

Highlights: Public health relevance—How does this work relate to a public health issue? Uses nationally representative SABE data to show how lifetime occupational exposures shape health among older adults in Ecuador. Documents that physically demanding and agricultural work is associated with poorer self-rated health and higher chronic respiratory disease, particularly among women. Public health significance—Why is this work of significance to public health? Demonstrates that late-life health inequalities in Ecuador partly reflect long-term, accumulated occupational risks in an unequal and largely informal labor market. Provides rare, population-based evidence from a middle-income Latin American country, complementing existing data from high-income settings. Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health? Supports incorporating structured occupational history into geriatric assessment and risk stratification in primary care and respiratory services. Highlights the need for stronger, gender-sensitive occupational protections—especially in agriculture—to reduce inequities and promote healthy aging. Occupational conditions across the life course may leave a lasting imprint on health in later life, particularly in unequal and largely informal labor markets. This study examined associations between lifetime occupational history and health status among older adults in Ecuador using nationally representative data. We analyzed 5235 participants aged ≥ 60 years from the SABE Ecuador 2009 survey. Occupational history was characterized by economic sector, physical demands, and self-reported exposure to dust, chemicals, heat, and other hazards. Health outcomes included self-rated health, physician-diagnosed diabetes, hypertension, chronic respiratory disease, arthritis, and visual and hearing limitations. We estimated survey-weighted PRs using Poisson regression with robust variance, adjusting for age, sex, education, region, residence, marital status, and household assets, and conducted sex-stratified analyses. Physically demanding work trajectories were associated with a higher prevalence of fair/poor self-rated health (adjusted PR 1.28; 95% CI: 1.10–1.49), with stronger effects in women. Agricultural employment was associated with chronic respiratory disease among women (adjusted PR 1.62; 95% CI: 1.12–2.36), but not men. These findings suggest that long-term occupational exposures contribute to health inequalities in older Ecuadorians and support integrating occupational history into geriatric assessment and strengthening gender-sensitive occupational health protections, particularly in the agricultural sector.