Employment Status, Coronary Heart Disease, and Stroke Among Women

Purpose

To investigate the association of employment status with coronary heart disease (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, ages 45–64 years at baseline (1987–1989), 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 with 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 with 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.

Key Words: Coronary Disease, Employment, Socioeconomic Status, Stroke, Women

Selected Abbreviations and Acronyms: HDL, high-density lipoprotein, CHD, coronary heart disease, ARIC, Atherosclerosis Risk in Communities Study, MI, myocardial infarction, LDL, low-density lipoprotein, CVD, cardiovascular disease, HR, hazard ratio, CI, confidence interval