22 Jun 2006

Job loss can trigger heart attack

New US research finds that job loss doubles the risk of heart attack or stroke for workers in their 50s and 60s.

"For many individuals, late career job loss is an exceptionally stressful experience with the potential for provoking numerous undesirable outcomes, including [heart attacks and stroke]," the Yale University team wrote in the June 21 online issue of Occupational and Environmental Medicine.

How the study was conducted
In a their study, William Gallo, an associate research scientist in the School of Public Health, and colleagues collected data on over 12 600 individuals who participated in the US Health and Retirement Survey.

The first surveys were carried out in 1992 and involved over 4 300 people aged 51 to 61, all of whom were working at the time. A decade later, over 1 200 people had retired and nearly 600 had died. Another 450 had temporarily stopped work, and 960 had left full-time work for other reasons. Of the rest, 582 people had lost their jobs and 3 719 were still in work.

During those 10 years, 202 people had a heart attack. Just over 10 percent (23) of those heart attacks occurred in people who were jobless after being laid off. In addition, 140 people suffered a stroke. Close to 24 percent (33) of those strokes occurred among the jobless, and 9 percent (13) occurred just after the person lost his or her job, the researchers found.

Double the stroke/heart attack risk
The bottom line: People over 50 who had been laid off were more than twice as likely to suffer a heart attack or stroke during the study period, compared with those who kept their jobs, the researchers found.

"Results suggest that the true costs of late career unemployment exceed financial deprivation, and include substantial health consequences," the authors concluded.

"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," they added.

Stress can trigger heart attacks
One expert believes stress can definitely help spur heart attack or stroke.

"It is well known that stress can trigger heart attacks," said Dr Byron Lee, an associate professor of cardiology at the University of California, San Francisco. "It is not surprising that the emotional stress of loss of a job could lead to major cardiac events," he added.

Lee said experts don't yet understand the underlying connection between stress and cardiovascular troubles. "We know there is a connection, but we don't know the mechanism," he said.

People under stress who had heart attacks or strokes may have a pre-existing cardiovascular condition that has not been recognized, Lee said. Or, it's possible that "declining health led to job loss and the heart attack or stroke."

Another expert believes the findings have implications that go far beyond medicine.

Surprising for being unsurprising
"This paper is only surprising for being so unsurprising," said Dr David L. Katz, an associate professor of public health and director of the Prevention Research Centre at Yale University School of Medicine. "Of course losing one's job is detrimental to health. Stress, depression, social isolation, decreased physical activity, less self care, and even the use of harmful chemicals, are all potential by-products of job loss."

But while the story may be unsurprising, the implications are more subtle, Katz said. "Some of the most important goals for health cannot be pursued through health care. A focus on the clinical mediators of health, such as blood pressure and cholesterol, is important, but an exclusive focus on such factors may miss the forest for the trees," he said.

Education, job training, and an array of social supports are as vital to health as anything exchanged in a doctor-patient encounter, Katz said. "The system we refer to as 'health care' often deals impressively well with disease. But to prevent disease and promote health, we have to think outside the coronary care unit. Medicine and public health are interdependent," he said. – (HealthDayNews)