Gendered exposures: exploring the role of paid and unpaid work throughout life in U.S. women’s cardiovascular health

Abstract

The paper explores how paid and unpaid labor history over the life course influence women's cardiovascular disease. U.S. women comprise about 50% of the paid workforce and perform the majority of unpaid labor. However, the influence of women's work on their health is under-researched. Our sample was drawn from the Women's Health Initiative Observational Study, a cohort of post-menopausal women in the U.S. aged 50-79 at recruitment. Women were categorized into five groups according to paid labor history: worked in paid jobs consistently throughout adult life; left the workforce early; entered the workforce later; discontinuous work history; never worked outside the home. Live birth history (none, at least one, missing) served as a proxy for unpaid labor in prime age. Cox proportional hazard models were used to estimate the hazard ratio of CVD associated with different paid work histories. We then assessed the effect of unpaid labor on the relation between paid labor and CVD. Paid labor participation was not associated with CVD risk among women without unpaid labor after adjusting for age, education, and birth cohort.Among those with unpaid demands, leaving the workforce early or having discontinuous work history was protective. In this U.S. sample, the association between paid work participation history and CVD risk depends on the presence of unpaid labor. Our results demonstrate the necessity of including work -paid and unpaid -in consideration of women's health.

Do Different Patterns of Employment Quality Contribute to Gender Health Inequities in the U.S.? A Cross-Sectional Mediation Analysis

“…In terms of identifying future research directions, another limitation of this analysis is our inability to incorporate information on potential mechanisms that contribute to biases and unequal power across women and men, including the asymmetrical burden of unpaid labor, intersectionality with other sources of marginalization, and the societal-level regimes shaping these dynamics. In particular, occupational health research that has accounted for family roles and demands has shown that unpaid labor affects working women and men in distinct ways—typically contributing to greater stress and ill health among women [ 9 , 32 , 39 ]. Thus, future studies that include information on workers’ household circumstances such as family composition, housework, or dependent care responsibilities could further elucidate dynamics between gender, EQ, and health [ 72 ].…”

“…There is also some indication that EQ produces differential health effects between women and men. Asymmetrical social expectations related to household responsibilities and caregiving may make it more difficult for women to balance work and family spheres [ 9 , 11 , 39 ]. For instance, women often take on a ‘second shift’ of unpaid labor in addition to their formal employment [ 40 ], which could adversely affect both physical and mental health [ 9 , 32 ].…”

A systematic review comparing cardiovascular disease among informal carers and non-carers

“…They also face the additional financial costs that come with supporting the needs of a person who cannot independently sustain themselves [ 4 ]. Moreover, the demands of informal care can significantly compromise carers’ capacity to perform and be available for paid employment [ 5 ].…”