Work, marital status, and heart disease

Reviere, Rebecca; Eberstein, Isaac W.

doi:10.1080/07399339209516016

Cited by 17 publications

(11 citation statements)

References 19 publications

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“…Several factors may account for the contrasting results observed in that study including different participant composition (all white), the inclusion of angina in the definition of CHD, and an earlier time period (1960s) when the transition of married women into the work force was in the beginning stages 14. Our finding of a decreased risk of CHD events (fatal and non-fatal) among women employed outside of the home is comparable to the previous finding reported by Reviere et al13 of a higher risk of CHD among homemakers. The association observed in our study did not vary for fatal or non-fatal events but it persisted after adjustment for socioeconomic and cardiovascular factors.…”

Section: Discussionsupporting

confidence: 68%

“…In the Tecumseh Study, self-reported heart attacks were greater among homemakers, although no difference in diagnosed CHD was noted between employed women and homemakers 12. Also, homemakers had an increased risk of CHD in the National Health and Nutrition Survey 13, while no difference in CHD incidence between employed women and homemakers was reported in the Framingham Study 14.…”

Section: Introductionmentioning

confidence: 86%

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Employment Status, Coronary Heart Disease, and Stroke Among Women

Carson

Rose

Catellier

et al. 2009

Annals of Epidemiology

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Purpose To investigate the association of employment status with CHD and ischemic stroke among middle-aged women. Methods Proportional hazards regression was used to assess the association of employment status, incident CHD, and incident ischemic stroke among 7,058 women, aged 45-64 years at baseline (1987-89), from the Atherosclerosis Risk in Communities Study. Results After adjusting for age and race-field center, women employed outside the home had a decreased risk of CHD (hazard ratio (HR) =0.70, 95% confidence interval (95% CI) =0.56, 0.86) and ischemic stroke (HR=0.62, 95% CI=0.47, 0.84) compared to homemakers. Differences in cardiovascular disease risk factors partially accounted for the association of employment status and CHD (HR=0.79, 95% CI=0.63, 0.99) and stroke (HR=0.79, 95% CI=0.58, 1.08). Also, modest differences were noted when the results were stratified by education, with employed women having a lower risk of CHD (HR=0.65, 95% CI=0.45, 0.93) than homemakers among those with less than a high school education. Conclusions Women employed outside of the home had a lower risk of CHD and stroke compared to homemakers and for CHD, this association was stronger among women with less than a high school education. These findings suggest additional research into the varied occupational experiences of women, socioeconomic status, and health is warranted.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 86%

Employment Status, Coronary Heart Disease, and Stroke Among Women

Carson

Rose

Catellier

et al. 2009

Annals of Epidemiology

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“…17,47,48 Relatedly, we also suspect that a history of divorce may have had negative consequences for medication adherence, healthcare utilization, and disease management that may have precipitated or worsened vascular pathology. 15,18,49,50 Accordingly, studies have shown that spouses (particularly wives) encourage concordant health behaviors—such as proper diet, exercise, and medication compliance—that promote cardiovascular health. 30-32 Therefore, we encourage future studies to explore these mechanisms to help explain how repeated exposure to divorce incurs increasing risks for AMI.…”

Section: Discussionmentioning

confidence: 99%

“…10 Although studies have shown that divorce is a major life stressor linked to poor health outcomes, 11-17 research has focused almost entirely on the cross-sectional risks related to current marital status and have largely ignored lifetime exposure to divorce and its potential consequences for the cardiovascular health of men and women. 13,16,18-23 …”

mentioning

confidence: 99%

Association Between Divorce and Risks for Acute Myocardial Infarction

Dupre

George

Liu

et al. 2015

Circ: Cardiovascular Quality and Outcomes

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Background Divorce is a major life stressor that can have economic, emotional, and physical health consequences. However, the cumulative association between divorce and risks for acute myocardial infarction (AMI) is unknown. This study investigated the association between lifetime exposure to divorce and the incidence of AMI in U.S. adults. Methods and Results We used nationally representative data from a prospective cohort of ever-married adults aged 45 to 80 (n=15,827) who were followed biennially from 1992 to 2010. Approximately 14% of men and 19% of women were divorced at baseline and more than one-third of the cohort had at least one divorce in their lifetime. In 200,524 person-years of follow-up, 8% (n=1,211) of the cohort had an AMI and age-specific rates of AMI were consistently higher in those who were divorced relative to those who were continuously married (P<.05). Results from competing-risk hazard models showed that AMI risks were significantly higher in women who had 1 divorce (HR, 1.24; 95% CI, 1.01-1.55), 2 or more divorces (HR, 1.77; 95% CI, 1.30-2.41), and among the remarried (HR, 1.35; 95% CI, 1.07-1.70) compared with continuously married women after adjusting for multiple risk factors. Multivariable-adjusted risks were elevated only in men with a history of 2 or more divorces (HR, 1.30; 95%CI, 1.02-1.66) relative to continuously married men. Men who remarried had no significant risk for AMI. Interaction terms for sex were not statistically significant. Conclusions Divorce is a significant risk factor for AMI. The risks associated with multiple divorces are especially high in women and are not reduced with remarriage.

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“…[5][6][7] The literature to date examining the association between women's employment status and CVD and mortality has been inconsistent. Reviere et al 8 reported homemakers were more likely to be diagnosed with coronary heart disease (CHD) than employed women. In contrast, there was no difference in the rate of diagnosed CHD between the employed women and homemakers in the Tecumseh Study, and self-reported occurrence of heart attacks was higher among homemakers than employed women.…”

Section: Introduction Wmentioning

confidence: 99%

Women's Employment Status and Mortality: The Atherosclerosis Risk in Communities Study

Rose

Carson

Catellier

et al. 2004

Journal of Women's Health

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Background: As women's labor force participation in the United States has increased over the past decades, there has been an interest in the potential health effects of employment. To date, however, research findings have been contradictory.Methods: Thus, the aim of this study was to investigate the association between employment status and mortality among 7361 middle-aged African American and white women who participated in the Atherosclerosis Risk in Communities (ARIC) Study. Women were classified as employed or homemakers at the baseline examination (1987-1989) and were followed for approximately 11 years. Proportional hazards regression was used to estimate unadjusted and adjusted hazard ratios.Results: After adjusting for sociodemographic factors and selected risk factors for mortality, employed women had a lower risk of mortality than homemakers (hazard ratio [HR] ϭ 0.65, 95% confidence interval [CI] ϭ 0.49, 0.86). This decreased risk of mortality persisted in additional analyses that excluded those who died within the first 2 years of follow-up or, alternatively, those with a history of coronary heart disease (CHD), stroke, cancer, hypertension, diabetes, or a perception of fair or poor health at baseline. In cause of death-specific analyses, the mortality advantage among employed women persisted for circulatory systemrelated deaths; however, the association for cancer-related deaths was weaker, and the CI included one.Conclusions: As the association between employment status and mortality was not explained by known risk factors for mortality, additional research is needed to identify other potential factors that may help to explain this relationship.

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Work, marital status, and heart disease

Cited by 17 publications

References 19 publications

Employment Status, Coronary Heart Disease, and Stroke Among Women

Employment Status, Coronary Heart Disease, and Stroke Among Women

Association Between Divorce and Risks for Acute Myocardial Infarction

Women's Employment Status and Mortality: The Atherosclerosis Risk in Communities Study

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