Employment patterns and their effect on health outcomes among women with rheumatoid arthritis followed for 7 years.
OBJECTIVE
To evaluate the effect of employment on health outcomes in a sample of women with rheumatoid arthritis (RA) and to test the hypothesis that employment confers a health benefit to women.


METHODS
Seven hundred sixty women with a diagnosis of RA were recruited from a national random sample of private rheumatology practices in 1988, and 416 remained in the study after 7 years of followup in 1994. Women were interviewed each year by telephone to collect data on demographic variables, health status, and employment status. Clinical data were provided by referring physicians.


RESULTS
Most women (175, 42%) were not employed outside the home 1988-94, although 96 of those women (23% of the sample) had been employed previously. Twenty-seven percent (n = 112) were employed all 7 years and 31% (n = 129) had been employed between one and 6 years. Women who were employed had significantly better health outcomes measured by pain, disability, role functioning, and clinical status compared to those who were never employed and those who had been employed before the study. Women who were previously employed, but not employed during the study period experienced the worst health outcomes. This difference in health status, however, appeared before entry into this study.


CONCLUSIONS
Employed women with RA had better health status than women who were not employed outside the home. Previously employed women had worse health outcomes than both working women and women who were never employed, suggesting that loss of employment is associated with worse health. Further research is needed to investigate underlying factors contributing to worse health status among unemployed women and to better health among employed women.
Reisine
S
S
University of Connecticut School of Dental Medicine, Department of Behavioral Sciences and Community Health, and the University of Connecticut Multipurpose Arthritis and Musculoskeletal Diseases Center, Farmington 06030, USA.
Fifield
J
J
Winkelman
D K
DK
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000453:epidemiology*; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D017063:Outcome Assessment, Health Care