UMBC Gerontology Program

Permanent URI for this collectionhttp://hdl.handle.net/11603/40

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DIVERSITY IN ADULT CHILD CAREGIVERS: EXPLORING THE ASSOCIATIONS BETWEEN IMMIGRANT STATUS, SEX, RACE/ETHNICITY, HEALTHCARE USE, AND DEPRESSIVE SYMPTOMS
(2024/01/01) PARK, MIN KYOUNG; Mair, Christine; Gerontology; Gerontology
The United States is undergoing a significant demographic transformation characterized by increasing racial and ethnic diversity, including a growing multiracial population. Immigration plays a pivotal role in driving this trend, contributing to a surge in the immigrant population. The aging population is also rising, with immigrants comprising a growing proportion of older adults. However, despite their substantial presence, immigrants, particularly those serving as caregivers for older parents, may encounter various obstacles, such as language barriers, limited employment opportunities, acculturation stress, and discrimination. These challenges can exacerbate disparities in healthcare access and use, impacting the well-being of immigrant adult child caregivers and their care recipients. Nevertheless, research on immigrant caregivers remains limited due to data deficiencies and conceptual gaps. To address this gap, this dissertation adopts a "three-paper" structure to examine the relationship between population characteristics—particularly sex and race/ethnicity—healthcare use, and depressive symptoms among adult child caregivers by immigrant status. The first paper (Chapter 2) aimed to explore the basic characteristics and depressive symptoms among caregivers based on immigrant status, highlighting data gaps and describing their characteristics. The second paper (Chapter 3) investigated whether immigrant status moderates the relationship between population characteristics and healthcare utilization. Finally, the third paper (Chapter 4) examined potential differences in the direct and indirect associations among population characteristics, healthcare service use, and depressive symptoms based on immigrant status. I conducted analyses on a sample of 1,587 community-dwelling adult child caregivers using secondary data from Wave 2016 and 2018 of the Health and Retirement Study. I employed a range of statistical analyses including the Chi-square test, t-test, multiple linear regression modeling, and structural equation modeling to fulfill research aims. Key findings unveiled significant demographic variances among caregivers, encompassing racial/ethnicity, employment status, marital status, and insurance coverage. While non-immigrant caregivers tended to be older, more educated, and possess higher incomes, no significant difference in depressive symptoms was observed between them and immigrant caregivers (Chapter 2). Immigrant status exerted an influence on healthcare use, with differences noted based on sex, race/ethnicity, and healthcare usage frequency. Female caregivers exhibited more frequent doctor visits, alongside non-African American/Black, non-Hispanic caregivers, signaling racial/ethnic differences (Chapter 3). The intricate relationship between demographic attributes and depressive symptoms, mediated by healthcare use, implied the heavier caregiving burdens experienced by female caregivers, potentially contributing to heightened depressive symptoms. Direct effects revealed that being female, being non-Black/African caregivers of non-Hispanic origin, and being non-Hispanic were associated with more frequent doctor visits. Indirect effects reveal that doctor visits mediate the relationship between population characteristics and depressive symptoms, particularly among female, non-Hispanic Black/African, and Hispanic caregivers. While no mediating role was found for immigrant status, it was linked to fewer doctor visits, emphasizing the need for further research to develop tailored interventions for diverse caregiver populations (Chapter 4). These findings emphasize the imperative of addressing intersectional relationships to mitigate differences in healthcare use among adult child caregivers for older adults, necessitating targeted interventions and policies informed by these insights to enhance health outcomes among varied caregiver populations. Future studies should explore the underlying mechanisms and design effective interventions specifically tailored to address the unique needs of caregivers from diverse backgrounds.
‘Successfully’ Aging ‘Alone’?: Unequal Global Opportunities and Rising Risks in Family-Based Models of Care Cross-Nationally
(Oxford University Press, 2024-08-10) Mair, Christine A.
For the first time in human history, older adults will outnumber children and a substantial and growing proportion will live alone and lack one or more nuclear family tie. Such unprecedented shifts require a reevaluation of existing models of “successful aging”, particularly in terms of long-term care policies.This paper draws on country-level data from multiple publicly available sources (e.g., World Bank, Organization for Economic Cooperation and Development, Our World in Data, and the World Values Survey) to examine cross-national patterns of development, health, demography, resources and policies, and cultural values in low-, middle-, and high-income countries.Although there exists substantial heterogeneity across countries, country-level patterns illustrate the economic privilege of living alone and the dominance of “successful aging” opportunities in high income countries. Cultural values about family reflect standard patterns of economic development, yet friendship emerges as a particularly consistent global value. At the country-level, living alone and health are associated in higher income countries with lower within-country inequality.Aging “alone” is a risk factor in some contexts, yet a marker of privilege in others. Models of “successful aging” are largely unobtainable in lower income countries or high inequality countries, and therefore require a thorough incorporation of global realities, or final abandonment in favor of more nuanced structural perspectives. Long-term care policies that assume the presence of family will yield increasing risk over time across all global contexts and represent a key vulnerability in the future of healthy aging policy.
A Look at External Political Efficacy and the Role of Digital Skills in the Adults U.S. Population
(Sage, 2024-07-23) Punksungka, Wonmai; Yamashita, Takashi; Narine, Donnette; Helsinger, Abigail; Cummins, Phyllis A.; Kramer, Jenna W.; Karam, Rita
The ability to effectively use digital technology and problem-solve are critical skills for maintaining democratic health, particularly as civil society and the modern digital landscape continuously evolve. However, information on whether individuals have the critical problem-solving skills to use digital technology and confidently affect change is yet to be further explored. Using data from the 2017 Program for International Assessment of Adult Competencies (n = 2749), we examined the associations between digital problem-solving skills and the three levels (low, neutral, high) of external political efficacy in the U.S. adult population. We used multinomial logistic regression and found a positive association between digital problem-solving skills and external political efficacy, while explanations for the three levels of efficacy are nuanced. Continuous development of digital problem-solving skills through adult education has implications for political efficacy, and ultimately for the promotion of a variety of civic engagement in the adult life stages.
Association between pre-hip fracture depression and days at home after fracture and assessing sex differences
(Wiley, 2024-07-20) Mehta, Rhea; Orwig, Denise L.; Chen, Chixiang; Dong, Yu; Shardell, Michelle D.; Yamashita, Takashi; Falvey, Jason R.
Background Hip fracture and depression are important public health issues among older adults, but how pre-fracture depression impacts recovery after hip fracture is unknown, especially among males who often experience greater depression severity. Days at home (DAH), or the days spent outside a hospital or healthcare facility, is a novel, patient-centered outcome that can capture meaningful aspects of fracture recovery. How pre-fracture depression impacts DAH after fracture, and related sex differences, remains unclear. Methods Participants included 63,618 Medicare fee-for-service beneficiaries aged 65+ years, with a hospitalization claim for hip fracture surgery between 2010 and 2017. The primary exposure was a diagnosis of depression at hospital admission, and the primary outcome was total DAH over 12 months post-discharge. Longitudinal associations between pre-fracture depression and the count of DAH among beneficiaries were estimated using Poisson regression models after adjustment for covariates; sex-by-depression interactions were also assessed. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) reflecting relative differences were estimated from these models. Results Overall, beneficiaries with depression were younger, White females, and spent 11 fewer average DAH compared to counterparts without depression when demographic factors (age and sex) (IRR = 0.91; 95% CI = 0.90, 0.92; p < 0.0001) and social determinants of health (race, Medicaid dual eligibility, and poverty) were adjusted for (IRR = 0.92; 95% CI = 0.91, 0.93; p < 0.0001), but this association attenuated after adjusting for medical complexities (IRR = 0.99; 95% CI = 0.98, 1.01; p = 0.41) and facility and geographical factors (IRR = 1.0037; 95% CI = 0.99, 1.02; p = 0.66). There was no evidence of effect modification by sex. Conclusions The comorbidity burden of preexisting depression may impact DAH among both male and female Medicare beneficiaries with hip fracture. Results suggest a holistic health approach and secondary prevention of depressive symptoms after hip fracture.
Motivations for Facebook Use in Adults 65 and Older
(2024-01-01) Im, Katherine; Morgan, Leslie; Gerontology; Gerontology
Social media sites have become powerful vehicles for social interaction, the dissemination of information, and the shaping of culture and public attitudes. No social media site has a greater reach than Facebook, particularly among older adults who have adopted the platform in growing numbers year after year. Previous research investigating the motivations for Facebook use among older adults often utilized measures normed on young adults, thus providing an incomplete picture of the older user experience. This qualitative study used a life course perspective to consider how one’s position in the life course might inform why and how older adults use Facebook. Semi-structured interviews were conducted with 25 Facebook users, aged 65 and older (19 women, 6 men) who logged onto Facebook at least 5 times a week. Interviews were conducted between August 2022 and May 2023. Interviews included a life history, questions about Facebook use, and a “guided tour” of participants’ Facebook pages. An initial inductive thematic analysis revealed six motivations for using Facebook, including social connectedness, social support, information gathering, self-expression, work-related, and passing time. To establish whether these motivations were aligned with life course concepts, participant responses were re-analyzed for codes deduced from several well-known life course theories. Five of the six motivations found in the initial thematic analysis appeared to be related to aging themes. Responses suggested that Facebook’s design and structure support older adults in three ways: supporting weak social ties, supporting personal growth in later life, supporting storytelling. Limitations, future directions, and implications of using a life course perspective to inform theory, practice, and research are discussed. The use of a non-representative sample limited generalizability but highlighted the need to extend this research to more diverse samples. The study underscores the need to consider life course when determining whether Facebook or other social media tools could be used to promote meaningful aging.
Digital Skills, STEM Occupation, and Job Automation Risks among the Older Workers in the United States
(Oxford University Press, 2024-06-05) Yamashita, Takashi; Narine, Donnette; Chidebe, Runcie C. W.; Kramer, Jenna W.; Karam, Rita; Cummins, Phyllis A.; Smith, Thomas J.
Advancing automation technologies are replacing certain occupations such as those involving simple food preparation more than occupations such as those in STEM fields (e.g., engineering, health care). Older workers generally face higher job automation risks in part due to their lower levels of digital skills. A better understanding of the associations between job automation risk, digital skills, and type of occupation (e.g., STEM vs. non-STEM) can facilitate preparations for job automation and workforce population aging. We analyzed a nationally representative sample (N = 1,560) of middle-aged and older U.S. workers aged 50–74 years from the 2012/2014/2017 Program for International Assessment of Adult Competencies (PIAAC) restricted-use file. The estimated job automation risks (i.e., percentage of jobs to be automated in the next decades) were derived from the previous studies. PIAAC digital problem-solving skills proficiency (measured on a scale of 0-500 points) was assessed based on a series of practical digital tasks (e.g., finding a job research website that does not require registration). Linear regression analysis showed that greater digital skill proficiency (b = −0.04, p < .05) and STEM occupations (b = −17.78, p < .001) each were associated with lower job automation risks, even after adjusting for a series of demographic, socioeconomic, and civic engagement characteristics. Education and labor policy interventions to promote digital skills among older workers and non-STEM workers may better prepare an aging workforce for the dynamic labor market needs in the United States.
Limited family diversity in Japan
(Taylor & Francis, 2023-05-03) Yamashita, Takashi
The objective of this chapter is to provide an overview of family forms and functions in Japan from a sociological perspective. The brief social, cultural, and historical backgrounds on the definition of family are introduced. Then, the current welfare policy and family-related demographic data are examined. Several selected family formation topics, including same-sex marriage, adoption, and medically assisted reproduction, are also briefly depicted. Finally, the limited family diversity as well as the seemingly resistant nature of Japanese society against the emerging forms of family, in view of the possible explanations, established form, and role of the family in the Japanese tradition, stemming from the cultural norm (e.g., Confucian familism) are explored. The chapter concludes with a brief discussion of two overarching themes that emerged and recommendations for future research and family policy in Japan.
Residents' views about assets, challenges, and renewal options in the Brooklyn, MD community
(2020-02-24) Adler, Marina; Schumacher, John; Bovard, Melanie; Denakpo, Audrey; Punksungka, Maia
Marital Quality and Depressive Symptoms among Older Hispanic Adults in the United States
(Oxford University Press, 2024-03-09) Nazario-Acevedo, Jaminette M.; Yamashita, Takashi; Bulanda, Jennifer Roebuck; Brown, J. Scott
Objectives Despite the cultural importance of marriage as a social support system and its well-established link to mental health, older Hispanic adult populations, which are the largest racial and ethnic minoritized groups, remain understudied. The current study examined how positive and negative dimensions of marital quality are associated with depressive symptoms. Methods Data from Hispanic adults aged 51 years and older (n = 1,012) were obtained from the 2016 and 2018 Health and Retirement Study (HRS) waves. The CES-D scale (0-8 symptoms) was modeled as a function of positive and negative marital quality measures (1-4), as well as the relevant covariates. Results Results from a negative binomial regression model showed that a one-unit change in positive and negative marital quality was associated with a 23.61% reduction and a 23.74% increase, respectively, in depressive symptoms. The interaction terms with marital quality and gender, as well as marital quality and religion, were not statistically significant. Discussion In the U.S., a large percentage of older Hispanic adults are immigrants, and their extended family tends to reside in their countries of origin. As such, older Hispanic adults may have smaller social networks, and marital quality most likely represents a culturally important social support network in later life. Significant associations between depressive symptoms and marital quality among older Hispanic adults should receive more attention in family and public health policy discussions, particularly given the increasing diversity in U.S. society.
The Roles of Education and Literacy in the Digital Divide Among Middle-Aged Adults: Cross-National Evidence from the United States, Japan, and South Korea
(ProLiteracy, 2024) Yamashita, Takashi; Kim, Giyeon; Liou, Chih-Ling; Ando, Takatoshi; Bardo, Anthony R.; Liu, Darren
Internationally representative data of middle-aged adults 45 – 65 years old [n(United States) = 2,150; n(Japan) = 2,318; n(South Korea) = 2,800] from the 2012 Program for International Assessment of Adult Competencies were analyzed to examine the roles of education and literacy in relation to the digital divide. Results from survey-weighted binary logistic regressions showed that both educational attainment and literacy were positively associated with all four measures of information and communication technology (use of the computer, email, online information and transaction) use in all three countries. The middle-aged adults in the United States benefited more from the educational attainment than those in Japan, in terms of email and online information use. The middle-aged adults with lower education and basic skills (i.e., literacy) may benefit from the educational intervention and additional information and communication technology training, and in turn, improve the digital divide in later life, regardless of differences in culture and economy.
Examining Racial/Ethnic Disparities in Coping and Stress Within an Environmental Riskscape
(Springer, 2023-02-17) Mair, Christine A.; Peek, M. Kristen; Slatcher, Richard B.; Cutchin, Malcolm P.
Existing research on racial/ethnic differences in stress and coping is limited by small samples, single-item measures, and lack of inclusion of Mexican Americans. We address these gaps by analyzing data from the Texas City Stress and Health Study, a cross-sectional sample of Black (N = 257), White (N = 304), US-born (N = 689), and foreign-born (N = 749) Mexican Americans residing in proximity to a petrochemical complex. We compared active and avoidant coping by race/ethnicity and explored multivariable associations between coping and perceived stress. Black and foreign-born Mexican American respondents had the highest stressor exposure yet displayed different patterns of coping and perceived stress patterns. Active coping may be particularly effective for African Americans but may not offset extreme stress disparities. For Mexican Americans, the lack of association between coping and stress underscores the need for more work focused on the culturally diverse coping experiences.
End-of-Life Experiences Among “Kinless” Older Adults: A Nationwide Register-Based Study
(Mary Ann Liebert, 2023-08-07) Mair, Christine A.; Thygesen, Lau C.; Aldridge, Melissa; Tay, Djin L.; Ornstein, Katherine A.
Background: The population of older adults who are unpartnered and childless (i.e., “kinless”) is increasing across the globe, and may be at risk for lower quality end-of-life (EoL) experiences due to lack of family support, assistance, and advocacy. Yet, little research exists on the EoL experiences of “kinless” older adults. Objectives: To document associations between family structure (i.e., presence or absence of partner or child) and intensity of EoL experiences (i.e., visits to medicalized settings before death). Design: The study design is a cross-sectional population-based register study of the population of Denmark. Subjects: Participants include all adults age 60 years and older who died of natural causes in Denmark from 2009 to 2016 (n = 137,599 decedents). Results: “Kinless” older adults (reference = has partner, has child) were the least likely group to visit the hospital (two or more times; odds ratio [OR] = 0.74, confidence interval [CI] = 0.70–0.77), emergency department (one or more times; OR = 0.90, CI = 0.86–0.93), and intensive care unit (one or more times; OR = 0.71, CI = 0.67–0.75) before death. Conclusions: “Kinless” older adults in Denmark were less likely to experience medically intensive care at the EoL. Further research is needed to understand factors associated with this pattern to ensure that all individuals receive high quality EoL care regardless of their family structure and family tie availability.
The Subjective Construction of Disease Control among Older Adults with Type II Diabetes
(2015-01-01) Girling, Laura; Eckert, J. Kevin; Gerontology; Gerontology
While the development and progression of some chronic conditions is predominately beyond the control of the individual, diabetes, one of the most prevalent chronic conditions, is largely considered a controllable disease. Although diabetic control is well-defined within the medical community and associated literature, little is known about how the diabetic population themselves understand this concept. In order to address this gap in the literature, in-depth secondary qualitative analyses were conducted of interviews with 83 (European-American, n=42; African-American n=41) older adults (³50 years) diagnosed with diabetes. Inductive content analysis of 4,237 pages of interview data revealed an explanatory framework of five themes describing varied understandings of diabetes control: (a) glycemic control, (b) treatment adherence, (c) asymptomatic, (d) level of pharmaceutical need, and (e) illusory. Analyses also revealed several management approaches coinciding to oneÕs conceptualization of control: (a) reactive, (b) informed, (c) medicinal reduction, (d) fatalistic. Furthermore, race and gender differences emerged from the data. Results demonstrate that among those with diabetes, the term control is multifaceted and its meanings extend the standard clinical definition of this concept. Findings inform clinical practice, psychometric assessment, and refine research in this area.
”Kinlessness” and Aging w/ Dr. Christine Mair
(UMBC Center for Social Science Research, 2023-10-30) Anson, Ian; Mair, Christine A. ; Yamashita, Takashi
On this episode I speak with Dr. Christine Armstrong Mair, Associate Professor of Sociology and Gerontology and Director of the Center for Health, Equity, and Aging (CHEA) in the Department of Sociology, Anthropology, and Public Health (SAPH) at UMBC. We discuss Dr. Mair’s ongoing research into aging and older adult lifestyles across the world. Dr. Mair mentioned the following resources in our discussion: Gateway to Global Aging Data SMaRT Scholars Program National Academies of Science, Engineering, and Medicine (NASEM), Seminar on Kinlessness and Living Alone at Older Ages (Drs. Margolis, Carr, Taylor, and Mair)
Associations between education, information-processing skills, and job automation risk in the United States
(Sage, 2023-11-07) Narine, Donnette; Yamashita, Takashi; Chidebe, Runcie C. W.; Cummins, Phyllis A.; Kramer, Jenna W.; Karam, Rita
Job automation is a topical issue in a technology-driven labor market. However, greater amounts of human capital (e.g., often measured by education, and information-processing skills, including adult literacy) are linked with job security. A knowledgeable and skilled labor force better resists unemployment and/or rebounds from job disruption brought on by job automation. Therefore, the purpose of this study was to advance understanding of the association between educational attainment and literacy, and job automation risk. Using the 2012/2014/2017 Program for the International Assessment of Adult Competencies (PIAAC) data, survey-weighted linear regression was used to model the risk of job automation as a function of education, and literacy proficiency. Higher educational attainment (college or higher vs. less than high school: b = −18.23, p < .05) and greater literacy proficiency (score 0–500 points: b = −.038, p < .05) were associated with a decrease in job automation risk among the U.S. workforce.
Reliance on Social Networks and Health Professionals for Health Information in the U.S. Adult Population
(Springer, 2023-10-21) Narine, Donnette; Yamashita, Takashi; Punksungka, Wonmai; Helsinger, Abigail; Kramer, Jenna W.; Karam, Rita; Cummins, Phyllis A.
Background: The subpopulation of adults depends on non-online health information sources including their social networks and health professionals, to the exclusion of online sources. In view of the digital divide and health information disparities, the roles of race/ethnicity and digital skills are yet to be explored. Methods: A nationally representative sample of 6,830 adults from the Program for the International Assessment of Adult Competencies (PIAAC) was analyzed, using binary logistic regression. Results: Black adults and adults with higher digital skills were less likely to be reliant on non-online health information sources, compared to White adults and those with lower digital skills, respectively. Discussion: Differences in non-online health information source reliance by race/ethnicity and digital skills might be further nuanced by the relevant demographic and socioeconomic characteristics. Increasing digital skills may expand one’s health information sources to include reliable online sources and empower adults to promote their health.
Examining Literacy Skill Performance of Black Adults in the U.S.: A Case of Civic Engagement and Political Efficacy
(American Institutes for Research, 2023-10) Alston, Geleana Drew; Yamashita, Takashi; Goings, Ramon; Saal, Leah Katherine
The Issue: Black adults’ beliefs about civic and political engagement are possible avenues toward social equality. The Black population is far from a monolith (Saal et al., 2023). Little is known about how Black adults’ literacy skill level impacts their civic engagement and political efficacy. Within the Black adult population, a better understanding of gender differences is critical to inform civic and democratic educational initiatives. The Research Question: 1. Are the levels of information processing skills (i.e., adult literacy proficiency) associated with civic engagement and political efficacy among Black adults in the U.S.? 2. Are there any gender differences in the associations between civic engagement, political efficacy, and information processing skills (i.e., adult literacy proficiency) among Black adults in the U.S.? The Findings: Black adults have comparable civic engagement and political efficacy to the general adult population. Black adults with college degrees (s) tend to volunteer more often than those without. Black adults with higher levels of literacy proficiency, college education, and older age tend to have higher political efficacy than those without. Black women and Black men had similar literacy proficiency. Black women with higher educational attainment had greater civic engagement. Black men who live with their spouses had greater civic engagement. Black women with high literacy proficiency had greater political efficacy than their counterparts with low literacy proficiency. Black men with higher educational attainment had greater political efficacy. The Implications: Promoting the political efficacy of Black adults with low literacy skills should be on a policy agenda. Civic and political education should be provided throughout adult life stages, and be considerate of sociocultural (e.g., race, gender) differences.
The STEM Wage Premium Across the OECD
(Sage, 2023-05-11) Even, William E.; Yamashita, Takashi; Cummins, Phyllis A.
Using data from the Program for the International Assessment of Adult Competencies, this paper compares the earnings premium and employment share of jobs in Science, Technology, Engineering and Mathematics (STEM) across 11 member countries of the Organisation for Economic Co-operation and Development. The results reveal that the STEM wage premium is higher in the United States than in any of the other comparison countries, despite the fact that the U.S. has a larger share of workers in STEM jobs. We also find evidence that the premium varies significantly across STEM sub-fields and education levels, and that the premium tends to be higher in countries with lower unionization rates, less employment protection, or a larger share of employment in the public sector.
Assessing Unmet Dementia-Related Care Needs of Informal Care Partners for Persons with Dementia by Spousal Status
(2023) Tucker, Gretchen G.; Gruber-Baldini, Ann; Samus, Quincy; Girling, Laura; Eckert, J. Kevin; Wallace, Brandy; Orwig, Denise
Background: 80% of persons with dementia reside in the community and are cared for by family and friends considered informal care partners (ICPs) • Research on ICPs for people with dementia has focused on spousal care partners and mother-daughter dyads. • There is a paucity of information on non-spousal ICPs, particularly male non spousal ICPs. Objective: Evaluate differences in the type and frequency of unmet dementia related care needs between spousal and non-spousal ICPs by gender and race.
Adult Numeracy Skill Practice by STEM and Non-STEM Workers in the USA: An Exploration of Data using Latent Class Analysis
(Taylor & Francis, 2022-11-14) Yamashita, Takashi; Punksungka, Wonmai; Narine, Donnette; Helsinger, Abigail; Kramer, Jenna W.; Cummins, Phyllis A.; Karam, Rita
Adult numeracy is one of the essential skill sets to navigate through numeric information-rich labour markets in general, and STEM industries in particular. Yet, relatively little is known about how numeracy skills are used in different settings in the USA. This study examined numeracy skill use patterns of STEM and non-STEM workers at work and home. Data were obtained from the 2012/2014/2017 Program for International Assessment of Adult Competencies, USA restricted-use file. Adults who were employed and aged between 25 and 65 years old (n = 5,220) were included in this study. Latent class analysis revealed four numeracy skill use patterns: non-users, non-occupational (i.e. at home) simple numeracy users, ubiquitous numeracy users, and occupational numeracy users. Additional multinomial logistic regression analysis showed that the STEM occupation was associated with a greater likelihood of being ubiquitous users than being non-occupational simple users. Results also showed that numeracy proficiency, socioeconomic statuses (i.e. educational attainment and income), as well as demographic characteristics (i.e. gender and race/ethnicity), were predictive of the numeracy skill use patterns in terms of the level of engagement and settings. Findings from this study inform policies and interventions which promote skill engagement and improvement among workers in the USA.

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