Employment status, coronary heart disease, and stroke among women

Ann Epidemiol. 2009 Sep;19(9):630-6. doi: 10.1016/j.annepidem.2009.04.008. Epub 2009 Jul 12.


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.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Coronary Disease / epidemiology*
  • Educational Status
  • Employment / statistics & numerical data*
  • Female
  • Humans
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Regression Analysis
  • Stroke / epidemiology*
  • United States / epidemiology
  • Women's Health*
  • Women, Working / statistics & numerical data