Abstract
IntroductionWomen’s participation in the workforce grew substantially since 1950. Among women, older women have been projected to have the largest percentage increase in labor force participation. However, research on the effect of occupation on cardiovascular health among older women is limited.MethodsThe American Heart Association introduced the Cardiovascular Health (CVH) Score in 2010. We examined the association between occupation and poor CVH in the Women’s Health Initiative (WHI) observational study. Our analysis included 65,249 post-menopausal women with complete data on occupation and CVH metrics (mean age = 63.1). Major occupations held since age 18 were classified using the standard occupation classification broad group (5-digit) and we focused on the 20 most common occupations in our sample. CVH score was computed by summing scores for each of the 7 CVH behavioral and clinical risk factors, with a numerical value of 1 for ideal and 0 as non-ideal (range 0 - 7, representing the least to most ideal CVH score). Women with total CVH score of 0, 1 or 2 were classified as having ‘poor CVH’. Multivariable logistic regression was used to examine the association between each of the top 20 occupation categories and poor CVH, adjusting for age, marital status, education and race. We used the Benjamini and Hochberg correction to account for multiple comparisons.ResultsIn our study population, 8,300 (12.7%) of women had poor CVH. After adjustment for confounders, we observed an increased risk of poor CVH among social workers (OR:1.36, 95%CI1.18 - 1.57), cashiers (OR:1.33, 95% C.I1.16 - 1.53), nursing, psychiatric, and home health aides (OR1.16, 95%CI1.01 - 1.35) and Registered Nurses (OR:1.14, 95%CI1.04 - 1.25). We also noted a reduced risk of poor CVH among real estate brokers and sales agents (OR:0.76, 95%CI0.67 - 0.92) and secretaries and administrative assistants (OR:0.89, 95%CI0.84 -0.95).ConclusionsWe identified several common occupations associated with poor CVH among women. Results could be used to support future research to examine CHD risks in women using biomarkers of occupational exposure and intermediate markers of effect.