Unemployment is hard on the heart, and the harm may add up

After four or more bouts of joblessness, risk of heart attack increases to 63%, a new study finds.

Story highlights

  • Repeated job loss may damage the heart as much as smoking or high blood pressure
  • The heart attack risk seems to rise with every new period of unemployment
  • A study analyzed more than 13,000 middle-aged and older adults
  • Factors contributing to the increased heart attack risk remain unclear
In a study published in the Archives of Internal Medicine, researchers report that repeated job losses may be as damaging to the heart health as smoking, high blood pressure, or diabetes.
Among Americans aged 50 to 75, the unemployed suffer heart attacks at a rate that is 35% higher than that among employed people with otherwise similar risk factors, and the rate seems to rise with every new period of unemployment.
The team of researchers from Duke University analyzed data on more than 13,000 middle-aged and older adults who agreed to biennial interviews about their work and health status.
The study is not the first to connect employment status and heart attack risk, but unlike most previous research on the topic, it follows participants over many years — in this case, 18 years. That gave the team a rare opportunity to clarify the effects of multiple periods of unemployment, to see if the effect of job loss of the heart is cumulative.
The answer, apparently, is yes. After the first job loss, the increased risk of heart attack during the study period among the unemployed was around 22% compared to those still working, but that risk increased to 63% after four or more bouts of joblessness.
"The (magnitude) of the impact was striking to us," says Dr. Eric Peterson, a cardiologist at Duke and the senior author on the study. "There is this compounded effect of multiple job losses on an individual's health. I think that was interesting and unique to see."
Peterson and his co-authors used data from the U.S. Health and Retirement Study that was conducted between 1990 and 2010, a period that spanned both economic boom years and recessions. In addition to questions about their occupational status and heart health, the study participants were asked about their age, sex, race or ethnicity, educational background, and a whole host of health behaviors, such as smoking and exercise patterns, and health conditions like hypertension or diabetes.
Even after adjusting for these factors, all of which are known to influence heart attack risk, Peterson and his colleagues found that unemployment remained strongly associated with higher heart attack rates. And while the effect is generally biggest in the first year after a job loss, that excess risk does not go away entirely once a person returns to work.
The more times a person loses a job during his or her career, it seems, the higher the risk of heart attack. In fact, the difference between a person who has never lost his job and someone who has been unemployed four or more times is as big as the difference between a nonsmoker and a smoker, or between a non-diabetic and a diabetic, when it comes to heart problems.
What remains unclear, however, is what factors are contributing to the increased heart risk. Stress is certainly a factor, but the cumulative effect of unemployment suggests something more complicated may be contributing to the trend. No one thinks it's pleasant to get fired or laid off. But, as the authors of an editorial accompanying the research say, the precise mechanism linking joblessness to heart attacks remains unknown.