Low-quality Employment and Heart Disease

In this Article (Index)

• CVD and Low-quality employment
• Corroborating study

Cardiovascular Disease and Low-quality Employment

A study published in April 2022 (1) looked into the effects of low-quality employment in Sweden on cardiovascular health.

The authors point out that the death rate due to cardiovascular disease in Sweden has been dropping since the 1970s but it is still the main cause of death both in that country and globally. The drop is considerable, from around 300 deaths per 100,000 inhabitants in 1979 to around 50 nowadays.

The decline in mortality and morbidity is due to two factors: (1) prevention and (2) better treatment techniques. But both of them tend to exclude the people at the lower end of the social pyramid.

This study used the data from almost 1,584,000 individuals aged between the ages of 40 and 61 . The authors analyzed jobs, employment quality, income, and health outcomes.

Previous studies have shown that low income and a low education level are linked to an increase in the risk of cardiovascular disease. This study focused on the work conditions.

Findings

• Borderline precarious employment and a constant state of precarious employment increased the risk of myocardial infarction or MI, by 8% and 13% respectively. For stroke, the values were 10% and 24% respectively.
• Those who had been former job agency employees had a 32% higher risk.
• Those who had lost the cover given by collective work agreements (trade unions and better income. Note that health services in Sweden are provided by the government and accessible to all) had a 10% higher risk.
• A constant low or very low income for both men and women was "associated to an increased risk of MI and stroke," of 19%.

Interestingly the study didn't find an association between having precarious jobs and a higher risk of stroke or MI for women. The authors suggest this could be due to women's lifestyle, which tends to be healthier than men's (alcohol, smoking, poor diet). Another factor is that men tend to work in jobs with a higher occupational risk, like construction, fisheries, and mining.

Corroborating Study

These findings are echoed by another study conducted in 2023 (2) that found a link between socioeconomic position and cardiovascular disease risk.

We conclude that patients with a low socioeconomic position, severe mental illness, or immigrant status receive inadequate CV care, including acute care, leading to an impaired CV prognosis Højstrup, Signe et al., (2023) (2)

These disparities between the affluent and the poor can be seen in life expectancy, where the gap between highly and lower-educated men is 4.0 years. This is lower than the average European Union gap (6.9 years) but, it is significant.

Lifestyle factors like smoking, unhealthy diets, sedentarism, obesity, and alcohol consumption are risk factors that account for 70% of cardiovascular mortality. Living alone, and mental illness are other contributing factors.

But despite the efforts of the Swedish government through the implementation of lifestyle change programs, and the guidelines for medical therapy following a heart attack, there are differences between social groups that lead to recurring cardiovascular disease among the low-income segment.

Closing comments

Lifestyle factors that can be modified have an important impact on your health.
Higher levels of education, strong family bonds, support from friends and kin, and social integration all contribute towards better employment. These factors also help people to adhere to post-disease treatment and healthy behavior.