Job Worries Up Women's Heart Attack Risk

Layoffs, Long Hours, Little Support Take Their Toll

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Sept. 4, 2003 -- Worries about layoffs increase a woman's risk for heart attack.

That's the finding from a study of nearly 37,000 nurses that was conducted during a time of rampant hospital consolidation and reorganization. The study appears in the current issue of Annals of Epidemiology.

"The evidence already exists to link unemployment with health problems such as immune system dysfunction, depression, suicide, and death," says lead researcher Sunmin Lee, ScD, with Brigham and Women's Hospital in Boston.

"Our study demonstrates that in addition to actually being laid off, job insecurity may also threaten one's health," Lee adds.

Many studies have pointed to high blood pressure, insomnia, anxiety, and depression -- as well as increased levels of the stress hormone cortisol -- that come with job insecurity and layoffs. This is the first to look at heart-attack risk.

In fact, "job insecurity may constitute a major source of stress for people working in industries that are downsizing or undergoing intense market competition," writes Lee.

Layoffs, Long Hours

In this study, Lee and colleagues examined the connection between job insecurity and incidence of heart attack and death in nearly 37,000 middle-aged and older women, most of whom were registered nurses.

During the study period -- in the 1990s -- the spread of managed care and economic factors intensified economic pressures on hospitals. Nurses faced a host of uncertainties, including layoffs. For those who kept their jobs, it meant working longer hours.

At the study's outset, all the women completed a survey aimed at assessing their level of job security. They were also asked about job demands, job control, and social support they had on the job.

Researchers also factored in other heart-attack risk factors, including smoking, alcohol, whether the women were overweight, blood-pressure problems, diabetes, whether they were menopausal, and how much physical activity they got.

Women who felt most insecure were also more likely to report high blood pressure and diabetes; they also were single, doing part-time work, and had a high level of education.

Least Job Security = More Heart Attack Risk

During the four-year study period, there were 113 nonfatal heart attacks and 41 deaths among the women, Lee reports.

Those women who worried about their employment were at almost twice the risk of having a nonfatal heart attack -- at least, in the short term. Also, women who did not feel support in their workplace -- and who felt they had little control in their jobs -- faced an even greater risk of heart attack, Lee reports.

"These findings are important given the current economic situation in which 2.7 million jobs have been lost since 2000 and there is a high level of job insecurity in the labor market," says Lee.

Job security is not only an economic issue but also a threat to women's health because of the increased heart attack risk.

Show Sources

SOURCES: Annals of Epidemiology, Jan. 2003; vol. 13, no. 5: pp. 1-7. News release, Brigham and Women's Hospital, Boston.
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