Abstract 18520: Job Strain, Job Insecurity, and Incident Cardiovascular Disease in the Women's Health Study
Introduction: Prior research on the relation between work-related stress and cardiovascular disease (CVD) has produced mixed findings. Moreover, a paucity of data exists regarding the long-term associations between job strain and job insecurity and CVD among women. Considering the current economic climate in the US, it is important to understand the relationship between job stress and CVD outcomes.
Methods & Results: We examined the relationship between job strain, job insecurity, and incident CVD among 17,415 apparently healthy female health professionals participating in the Women's Health Study (WHS; mean age 57±5 years). During 10 years of follow-up there were 134 myocardial infarctions (MI), 125 ischemic strokes, 342 coronary revascularizations, and 40 CVD deaths. Using Cox proportional hazard models adjusted for age, race, and education, high job strain and job insecurity were significantly associated with established risk factors for CVD. High job strain predicted increased risk of physical inactivity and hypercholesterolaemia (all p-values<.05), and women reporting job insecurity had increased risk of smoking, physical inactivity, hypertension, diabetes mellitus, hypercholesterolaemia, and higher BMI (all p-values <.05). In models adjusted for age, race, education, and income, women with high job strain were 40% more likely to experience a CVD event than their counterparts who reported low job strain (Risk Ratio (RR)=1.40, Confidence Interval (CI)=1.06, 1.86). Outcome-specific analyses revealed that high job strain predicted MI (RR=1.88, CI=1.07, 3.30), and coronary revascularization (RR=1.43, CI=1.01, 2.01), but not stroke (RR=1.31, CI=0.74, 2.32) or CVD death (RR=0.99, CI=0.37, 2.67). No evidence of an association between job insecurity and risk for CVD was observed.
Conclusion: Job strain but not job insecurity was related to increased CVD risk among women participating in WHS. Interestingly, job insecurity was significantly related to CVD risk factors suggesting that this measure might be more temporally related to health behavior. With the increase in dual career and childrearing responsibilities for women, these data emphasize the importance of assessing job stress in CVD prevention efforts among working women.
- © 2010 by American Heart Association, Inc.