Introduction The working lives of Americans have become less stable over the past several decades and older adults may be particularly vulnerable to these changes in employment quality (EQ).

Objective We examined later-life multidimensional EQ and retirement trajectories of older Americans and the potential consequences worsening EQ may have for cardiometabolic health and health inequities in this population.

Methods Using longitudinal data on employment stability, material rewards, workers’ rights, working-time arrangements, unionization, and interpersonal power relations from the Health and Retirement Study, we used principal component analysis to construct an EQ score. Then, we used sequence analysis to identify late-career EQ trajectories (age 50–70 years; N=11,958 respondents), overall and by race, gender, educational attainment, marital status. Finally, we estimated the association between trajectory-membership and post-sequence-analysis-period prevalence of poor cardiometabolic health.

Results We identified ten EQ trajectories; the most prevalent trajectories were Minimally Attached and Wealthy (13.9%) and Good EQ to Good Retirement (13.7%), however, 42% of respondents were classified into suboptimal trajectories. Those in suboptimal trajectories were disproportionately women, Hispanic and/or Black, Indigenous and People of Color, and those with lower educational attainment. Moreover, those in suboptimal trajectories tended to report the worse cardiometabolic health. For example, the prevalence of hypertension was lowest for those in the Wealthy Business Owners trajectory and highest for Workers with Premature Mortality, followed by workers with Fair EQ and Good but Diminishing Wealth in Retirement.

Conclusion EQ is inequitably distributed and may play a role in cardiometabolic health inequities in later life.