Job losses linked to myocardial infarction in US cohortBMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e7839 (Published 21 November 2012) Cite this as: BMJ 2012;345:e7839
Unemployment has often been linked to poor mental and physical health, and the latest study reports a significant association between a disrupted employment history and risk of myocardial infarction in middle aged US adults. Risk rose steadily as the number of job losses accumulated, so that adults who had lost at least four jobs were 63% more likely to report a new myocardial infarction during eight years of follow-up than adults who had lost none (hazard ratio 1.63, 95% CI 1.29 to 2.07). Risk was particularly high in the first year of unemployment in analyses adjusted for more than a dozen social, demographic, and clinical variables including symptoms of depression⇑.
The new study analysed data from more than 13 000 adults, who were interviewed every two years between 1994 and 2010. It adds power and a dose response dimension to previous analyses, says a linked comment (doi:10.1001/jamainternmed.2013.1835). The study also looked at myocardial infarctions occurring after job losses, to help rule out reverse causation. The evidence linking unemployment and poor health is now compelling, and it may be time to stop looking for associations and start exploring why this happens, says the comment. If losing a job or losing multiple jobs causes poor health (and it probably does), then what are the mechanisms and can we do anything to modify them? We don’t yet know, although there are many theories. Poverty, social withdrawal, risky behaviours such as smoking, raised cortisol concentrations, and chronic anxiety are all possible contributors.
Cite this as: BMJ 2012;345:e7839