Unemployed Women At Higher Risk For Cardiovascular Disease

There have been conflicting reports on the relationship of women's health and employment status, according to Sheree Marshall-Williams, Ph.D., behavioral scientist at the Centers for Disease Control and Prevention in Atlanta, Ga.

Researchers found that women who had become involuntarily unemployed experienced more high blood pressure and cardiovascular disease such as heart attack, chest pain and stroke. They also faced a deterioration of mental health such as increases in stress, depression and emotional problems.

"Unemployed women who want to be employed clearly standout from the employed and homemakers as being at high risk for cardiovascular disease and poor mental health," she said. "We are surmising that the unemployed women have more social stress in response to being laid off and not being able to locate a job."

While results show an association between unemployment and cardiovascular disease and mental health, the reason for the worse health outcomes cannot be determined with the cross-sectional data in this study.

The data was drawn from 34,879 black and white American women, ages 25–64 years, from the 2003 Behavioral Risk Factor Surveillance System (BRFSS) survey. They categorized the women into three groups: employed, involuntarily unemployed and homemakers. The women were asked about their mental and health status, and whether they had been diagnosed with high blood pressure or had cardiovascular disease such as a previous heart attack, chest pain or stroke.

Researchers controlled for other health factors such as diabetes and weight. Women with disabilities that precluded employment were excluded from the study.

Unemployed women reported the worst physical health, with 28 percent having high blood pressure and 6 percent, having either a self-reported heart attack, chest pain or stroke. Employed women had the best physical health with only 19 percent having high blood pressure and only 2 percent with cardiovascular disease.

Homemakers generally had health conditions comparable to employed women with the exception of cardiovascular disease, which was 1.7 times higher among the homemakers than among employed women. Nineteen percent of the homemakers had high blood pressure, identical to employed women, but about 4 percent reported they had cardiovascular disease.

"We weren't expecting differences in the employed women and the homemakers," Marshall-Williams said. "It may be that employed women have more access in the workplace to health intervention such as screening for high blood pressure and stress reduction programs. That may be one protective factor for employed women."

The findings differed significantly by race with homemaker and unemployment status having a more negative impact on African-American women's physical health. The odds of reporting cardiovascular disease for involuntarily unemployed African-American women was 2.6 times greater than that of employed African-American women.

The women also were asked about their general mental health, self-reporting their own sense of well-being and the number of good and bad days during the past month as a global measure.

Unemployed women also reported more poor mental health days than the employed women and homemakers. Women who had lost their jobs reported an average of nine poor mental health days in the past month. Employed women only reported four poor mental health days in the past 30 days. Homemakers reported five poor mental health days.

"Unemployed women had double the amount of poor mental health days as employed women, and clearly saying their mental health is suffering as a result of unemployment. Unemployed women may have less access to healthcare and are under financial stress," she said. "Unemployed women are more likely to be underinsured or uninsured. This plays a role."

Also, with 50 percent of American families living on double incomes, financial pressures also create stress with unemployment, she said.

Past studies have shown conflicting results; some showing that women's employment was a stress in itself, she said. "We found that employment itself is not a stressor in women. For women in this study employment actually may be protective. This definitely is an area that needs further study. It may be that we can target unemployed women for intervention."

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The conference is jointly sponsored by the American Heart Association, the Centers for Disease Control and Prevention, the American College of Cardiology Foundation, the World Heart Federation, the National Heart, Lung, and Blood Institute, and the Heart and Stroke Foundation of Canada.

This abstract was published in the February 2005 issue of Circulation: Journal of the American Heart Association.

Co-author is Sari D. Hopson, Centers for Disease Control and Prevention.

Statements and conclusions of study authors that are published in the American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect association policy or position. The American Heart Association makes no representation or warranty as to their accuracy or reliability.