Occupational Hierarchy, Economic Sector, and Mortality from Cardiovascular Disease among Men and Women: Findings from the National Longitudinal Mortality Study

Muntaner, Carles; Sorlie, Paul; O'Campo, Patricia; Johnson, Norman; Backlund, Eric

« Previous Next »Annals of Epidemiology
Volume 11, Issue 3 , Pages 194-201, April 2001

Occupational Hierarchy, Economic Sector, and Mortality from Cardiovascular Disease among Men and Women:

Findings from the National Longitudinal Mortality Study

Carles Muntaner, MD, PhD
- Departments of Behavioral and Community Health Nursing & Epidemiology and Preventive Medicine, University of Maryland, University of Maryland–Baltimore, Baltimore, MD USA
Paul Sorlie, PhD
- Division of Epidemiology and Clinical Applications National Heart, Lung, and Blood Institute, Bethesda, MD USA
Patricia O'Campo, PhD
- Departments of Population and Family Health Sciences & Epidemiology, The Johns Hopkins School of Hygiene and Public Health, Baltimore, MD USA
- Address reprint requests to: Patricia O'Campo, Ph.D., The Johns Hopkins University, Population and Family Health Sciences, 624 N. Broadway, #390, Baltimore, MD 21205
Norman Johnson, PhD
Eric Backlund, MS
- Demographic and Statistical Methods Division, Bureau of the Census, Suitland, MD USA

Received 28 October 1999; received in revised form 24 April 2000; accepted 26 August 2000.

Abstract

PURPOSE: Although socioeconomic position has been identified as a determinant of cardiovascular disease among employed men and women in the U.S., the role of economic sector in shaping this relationship has yet to be examined. We sought to estimate the combined effects of economic sector—one of the three major sectors of the economy: finance, government and production—and socioeconomic position on cardiovascular mortality among employed men and women.

METHODS: Approximately 375,000 men and women 25 years of age or more were identified from selected Current Population Surveys between 1979 and 1985. These persons were followed for cardiovascular mortality through use of the National Death Index for the years 1979 through 1989.

RESULTS: In men, the lowest cardiovascular mortality was found for professionals in the finance sector (76/100,000 person/years). The highest cardiovascular mortality was found among male non-professional workers in the production sector (192/100,000 person years). A different pattern was observed among women. Professional women in the finance sector had the highest rates of cardiovascular mortality (133/100,000 person years). For both men and women, the professional/non-professional gap in cardiovascular mortality was lower in the government sector than in the production and finance sectors. These associations were strong even after adjustment for age, race and income.

CONCLUSIONS: Characteristics of government, finance and production work differentially influence the risk of cardiovascular disease mortality. Men, women, professionals and non-professionals experience this risk differently.

Keywords: Cardiovascular Disease, Mortality, Occupational Exposures, Socioeconomic Status, Social Inequalities, Social Class, Women's Health

Abbreviations: CVD = cardiovascular disease, CPS = Current Populations Survey, NDI = National Death Index, NLMS = National Longitudinal Mortality Survey