Use of life course work-family profiles to predict mortality risk among US women

Am J Public Health. 2015 Apr;105(4):e96-e102. doi: 10.2105/AJPH.2014.302471. Epub 2015 Feb 25.


Objectives: We examined relationships between US women's exposure to midlife work-family demands and subsequent mortality risk.

Methods: We used data from women born 1935 to 1956 in the Health and Retirement Study to calculate employment, marital, and parenthood statuses for each age between 16 and 50 years. We used sequence analysis to identify 7 prototypical work-family trajectories. We calculated age-standardized mortality rates and hazard ratios (HRs) for mortality associated with work-family sequences, with adjustment for covariates and potentially explanatory later-life factors.

Results: Married women staying home with children briefly before reentering the workforce had the lowest mortality rates. In comparison, after adjustment for age, race/ethnicity, and education, HRs for mortality were 2.14 (95% confidence interval [CI] = 1.58, 2.90) among single nonworking mothers, 1.48 (95% CI = 1.06, 1.98) among single working mothers, and 1.36 (95% CI = 1.02, 1.80) among married nonworking mothers. Adjustment for later-life behavioral and economic factors partially attenuated risks.

Conclusions: Sequence analysis is a promising exposure assessment tool for life course research. This method permitted identification of certain lifetime work-family profiles associated with mortality risk before age 75 years.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Female
  • Humans
  • Middle Aged
  • Mortality / trends*
  • Risk
  • Smoking / mortality
  • Socioeconomic Factors
  • United States / epidemiology
  • Women's Health / statistics & numerical data*
  • Work / statistics & numerical data*