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International Archives of Occupational and Environmental Health

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01-08-2015 | Original Article

Unemployment is associated with high cardiovascular event rate and increased all-cause mortality in middle-aged socially privileged individuals

Authors: Pierre Meneton, Emmanuelle Kesse-Guyot, Caroline Méjean, Léopold Fezeu, Pilar Galan, Serge Hercberg, Joël Ménard

Published in: International Archives of Occupational and Environmental Health | Issue 6/2015

Abstract

Purpose

To assess prospectively the association between employment status and cardiovascular health outcomes in socially privileged individuals.

Methods

The incidence of fatal and non-fatal cardiovascular events and all-cause mortality rate were monitored during 12 years in a national sample of 5,852 French volunteers, aged 45–64 years, who were free of cardiovascular disease or other overt disease at baseline. The association between health outcomes and employment status was tested using Cox proportional modelling with adjustment for confounding factors.

Results

Compared to randomly selected individuals, these volunteers were characterized by higher education level and socio-economic status and lower cardiovascular risk and mortality rate. A total of 242 cardiovascular events (3.5 events per 1,000 person-years) and 152 deaths from all causes (2.2 deaths per 1,000 person-years) occurred during follow-up. After adjustment for age and gender, both cardiovascular event risk [HR (95 % CI) 1.84 (1.15–2.83), p = 0.01] and all-cause mortality [2.79 (1.66–4.47), p = 0.0002] were increased in unemployed individuals compared to workers. These poor health outcomes were observed to the same extent after further adjustment for clinical, behavioural and socio-demographic characteristics of individuals at baseline [HR (95 % CI) 1.74 (1.07–2.72), p = 0.03 and 2.89 (1.70–4.69), p = 0.0002, respectively]. In contrast, neither cardiovascular event risk nor all-cause mortality was significantly increased in retired individuals compared to workers after adjustment for confounding factors.

Conclusions

These results support the existence of a link between unemployment and poor cardiovascular health and suggest that this link is not mediated by conventional risk factors in middle-aged socially privileged individuals.

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Title: Unemployment is associated with high cardiovascular event rate and increased all-cause mortality in middle-aged socially privileged individuals
Authors: Pierre Meneton
Emmanuelle Kesse-Guyot
Caroline Méjean
Léopold Fezeu
Pilar Galan
Serge Hercberg
Joël Ménard
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: International Archives of Occupational and Environmental Health / Issue 6/2015
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-014-0997-7

At a glance: The STEP trials

Springer Medicine

Unemployment is associated with high cardiovascular event rate and increased all-cause mortality in middle-aged socially privileged individuals

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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