The impact of late career job loss on myocardial infarction and stroke: a 10 year follow up using the health and retirement survey
- 1Dept of Epidemiology & Public Health, Yale University, New Haven, CT, USA
- 2Depts of Medicine and Epidemiology & Public Health, Yale University, New Haven, CT, USA
- Correspondence to: Dr W T Gallo Yale University School of Medicine, Department of Epidemiology & Public Health, 60 College Street, PO Box 208034, New Haven, CT 06520-8034, USA;
- Accepted 19 May 2006
- Published Online First 23 June 2006
Background: Involuntary job loss is a major life event associated with social, economic, behavioural, and health outcomes, for which older workers are at elevated risk.
Objective: To assess the 10 year risk of myocardial infarction (MI) and stroke associated with involuntary job loss among workers over 50 years of age.
Methods: Analysing data from the nationally representative US Health and Retirement Survey (HRS), Cox proportional hazards analysis was used to estimate whether workers who suffered involuntary job loss were at higher risk for subsequent MI and stroke than individuals who continued to work. The sample included 4301 individuals who were employed at the 1992 study baseline.
Results: Over the 10 year study frame, 582 individuals (13.5% of the sample) experienced involuntary job loss. After controlling for established predictors of the outcomes, displaced workers had a more than twofold increase in the risk of subsequent MI (hazard ratio (HR) = 2.48; 95% confidence interval (CI) = 1.49 to 4.14) and stroke (HR = 2.43; 95% CI = 1.18 to 4.98) relative to working persons.
Conclusion: Results suggest that the true costs of late career unemployment exceed financial deprivation, and include substantial health consequences. Physicians who treat individuals who lose jobs as they near retirement should consider the loss of employment a potential risk factor for adverse vascular health changes. Policy makers and programme planners should also be aware of the risks of job loss, so that programmatic interventions can be designed and implemented to ease the multiple burdens of joblessness.
Published Online First 23 June 2006
Funding: this research was supported by a career development grant from the National Institute on Aging (grant number: K01AG021983) and by a grant from the Claude D. Pepper Older Americans Independence Center at Yale (grant number: P30AG2130432)
Competing interests: none declared