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Study: Unemployment means higher risk of MI

Monday November 19, 2012
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Unemployment, multiple job losses and short periods without work may be associated with increased risk for acute myocardial infarction, according to a study.

Many adults in the United States are affected by the strain of employment instability, but little is known about the cumulative effect of multiple job losses and unemployment on the risks for AMI, according to background information in the study, which appeared Nov. 19 on the website of the Archives of Internal Medicine.

Matthew E. Dupre, PhD, and colleagues from Duke University, Durham, N.C., examined the associations between different dimensions of unemployment and the risks for AMI in 13,451 U.S. adults ages 51 to 75 in the Health and Retirement Study, in which biennial follow-up interviews were conducted from 1992 to 2010.

"Results demonstrated that several features of oneís past and present employment increased risks for a cardiovascular event," the authors wrote. "Although the risks for AMI were most significant in the first year after job loss, unemployment status, cumulative number of job losses and cumulative time unemployed were each independently associated with increased risk for AMI."

The study group (median age 62) had 1,061 AMI events during 165,169 person-years of observation. In the study group, 14% of the individuals were unemployed at baseline, 69.7% had one or more cumulative job losses and 35.1% had spent time unemployed, according to the study.

Statistical analysis indicated that AMI risks were significantly higher among the unemployed and that risks increased incrementally from one job loss to four or more cumulative job losses compared with no job loss. The risks for AMI also were "particularly elevated" within the first year of unemployment but not thereafter, according to the results.

"We found that the elevated risks associated with multiple job losses were of the magnitude of other traditional risk factors, such as smoking, diabetes mellitus and hypertension," the authors wrote. "In the context of the current U.S. economy and projected increases in job instability and unemployment among workers, additional studies should investigate the mechanisms contributing to work-related disparities in AMI to identify viable targets for successful interventions."

In an accompanying commentary, William T. Gallo, PhD, of the City University of New York, called for an end to outcomes-based studies of unemployment, writing that the focus should turn to "why and how a socioeconomic exposure, such as job loss, influences health."

"Sufficient evidence exists of the negative influence of job loss on health," Gallo concluded. "The next generation of studies should identify reasonable pathways from job separation to illness so that nonoccupational interventions may be developed and targeted to the most vulnerable individuals."

The study abstract is available at http://archinte.jamanetwork.com/article.aspx?articleid=1392492.


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