Job Loss Doubles Cardiovascular Risk for Patients Over 50

NEW HAVEN, Conn., June 22 - The stress of losing a job after age 50 can double the risk of a heart attack or stroke, researchers here reported.

The findings of the 10-year longitudinal study applied to women as well as men, reported William T. Gallo, Ph.D., of Yale today online in the journal Occupational and Environmental Medicine.

The study examined data from 4,301 individuals participating in the U.S. Health and Retirement Survey. They were 51 to 61 years old in 1992 at the start of the survey, and they were followed for 10 years. Half were women.

Over the 10 years, 582 individuals lost their jobs. In addition, 202 heart attacks were reported during the study period, including 23 in the job-loss group. There were 140 strokes, 13 in the job loss group.

Significant variables affecting heart attack risk included being female (0.57; 95% CI=0.34 to 0.93; being white (HR=3.18; 95% CI=1.36 to 7.41), and having a higher income (HR=1.07; 95% CI=1.00 to 1.15).

However, after adjusting for sex, race, income and other variables, the researchers found that job losers had more than twice the risk of myocardial infarction compared with those who were still employed (hazard ratio=2.48; 95% confidence interval=1.49 to 4.14).

Similarly, job loss more than doubled the risk for stroke (HR=2.43; 95% CI=1.18 to 4.98). The only other significant variable here was diabetes (HR=2.68; 95% CI=1.15 to 6.23).

Several limitations were noted by the authors. A chief limitation of the study was that it relied on self-reports of heart attack and stroke, which were not confirmed by medical records, the authors said. In addition, the 10-year followup increases the potential for occurrence of unmeasured, mediating events which may explain the associations between job loss and health outcomes. Finally, important risk factors, such as family history, were not measured in the data.

"For many individuals, late career job loss is an exceptionally stressful experience, with the potential for provoking numerous undesirable outcomes, including cardiovascular and cerebrovascular events," the authors said.

"Physicians who treat individuals who lose jobs as they approach retirement should therefore consider the loss of employment, with its associated anxiety and affective symptomatology, a risk factor for adverse vascular health changes," they said.

Policy-makers should also be aware of the risks of job loss, so that interventions to help return jobless individuals to work can be designed and implemented "to ease the multiple burdens of joblessness," they said.

"Based on our results, the true costs of unemployment exceed the obvious economic costs and include substantial health consequences as well," the authors concluded.