Lifetime employment, tobacco use, and alcohol consumption trajectories and cardiovascular diseases in old age

Abstract

Despite the great advances of life course epidemiology studies during the last decade in understanding the general health effects of employment trajectories, research has yet to evaluate the effects of employment trajectories along with other major risk factors, such as tobacco and alcohol consumption, on cardiovascular diseases (CVDs)—the main cause of deaths worldwide. This is highly relevant, since health advantages in one domain (e.g., being a permanent formal full-time worker) may offset health disadvantages in other domains (e.g., being a regular smoker or alcohol consumer); conversely, disadvantages in both domains may interact, leading to even greater health risks. Considering these knowledge gaps, this research has two main objectives: (1) to reconstruct simultaneous employment, tobacco use, and alcohol consumption trajectories over the life course (from birth to old age) and (2) to measure the association between these trajectories and CVD in old age. Drawing on a rich and comprehensive life history dataset and using multichannel sequence and regression analyses, we analyzed a cohort of individuals aged 65–75 in Chile, a Latin American country with high social inequalities and scarce research on this matter. Our study shows that following a trajectory of formal employment together with no tobacco and alcohol use reduces CVD risk by 36 percentage points relative to a similar employment trajectory but with regular tobacco and alcohol use. Even with an employment trajectory characterized by constant informal employment or permanent inactivity, a life course free of regular tobacco and alcohol use shows protective effects against CVD. This study stresses the importance of health policies that consider CVD as a condition that strongly depends on individual experiences in multiple life domains and across different life stages.

Childhood Socioeconomic Position and Cardiovascular Disease Among Older Women and Men: The Moderating Role of Parenthood Onset

“…This study contributes to understanding little explored cardiovascular risk factors, which might optimize cardiovascular prevention strategies throughout life. These findings contribute to greater understanding of the role of unexplored cardiovascular risk factors such as parenthood transition timing, and therefore might be used to optimizing lifelong cardiovascular prevention strategies [ 36 ].…”

Part-time work and health in late careers: Evidence from a longitudinal and cross-national study

“…We used MCSA to estimate simultaneous employment and health trajectories separately for each age group in Germany, Sweden, the US, and Italy. MCSA, an extension of sequence analysis ( Gauthier et al, 2010 ; Madero-Cabib et al, 2021 ), is a longitudinal statistical method that examines how similar or different every pair of individual sequences is in two or more domains (in our case employment and health domains), the sequential order in which individuals experience status changes, and the timing of these status changes. A pairwise distance matrix summarizes the ‘distance’ between the individual sequences – that is, the number of modifications needed to make one sequence be exactly like another.…”

“…We used individual-level longitudinal data and sequence analysis to create clusters of individuals with similar sequences ( Macindoe & Abbott, 2004 ). Furthermore, with multichannel sequence analysis (MCSA; Gauthier et al, 2010 ; Madero-Cabib et al, 2021 ), we explored older workers’ simultaneous sequences of both employment and health. We relied on a harmonized pooled-country dataset from large representative panel surveys, HRS, and the Survey of Health, Ageing and Retirement in Europe (SHARE) and provide novel empirical analyses.…”