title: The impact of late career job loss on myocardial infarction and stroke: a 10 year follow up using the health and retirement survey.
abstract: BACKGROUND
  Involuntary job loss is a major life event associated with social, economic, behavioural, and health outcomes, for which older workers are at elevated risk.
  
  
  OBJECTIVE
  To assess the 10 year risk of myocardial infarction (MI) and stroke associated with involuntary job loss among workers over 50 years of age.
  
  
  METHODS
  Analysing data from the nationally representative US Health and Retirement Survey (HRS), Cox proportional hazards analysis was used to estimate whether workers who suffered involuntary job loss were at higher risk for subsequent MI and stroke than individuals who continued to work. The sample included 4301 individuals who were employed at the 1992 study baseline.
  
  
  RESULTS
  Over the 10 year study frame, 582 individuals (13.5% of the sample) experienced involuntary job loss. After controlling for established predictors of the outcomes, displaced workers had a more than twofold increase in the risk of subsequent MI (hazard ratio (HR) = 2.48; 95% confidence interval (CI) = 1.49 to 4.14) and stroke (HR = 2.43; 95% CI = 1.18 to 4.98) relative to working persons.
  
  
  CONCLUSIONS
  Results suggest that the true costs of late career unemployment exceed financial deprivation, and include substantial health consequences. Physicians who treat individuals who lose jobs as they near retirement should consider the loss of employment a potential risk factor for adverse vascular health changes. Policy makers and programme planners should also be aware of the risks of job loss, so that programmatic interventions can be designed and implemented to ease the multiple burdens of joblessness.
authors.affiliation: Dept of Epidemiology & Public Health, Yale University, New Haven, CT 06520-8034, USA. william.gallo@yale.edu
authors.forename: W T
authors.initials: WT
authors.lastname: Gallo
authors.forename: H M
authors.initials: HM
authors.lastname: Teng
authors.forename: T A
authors.initials: TA
authors.lastname: Falba
authors.forename: S V
authors.initials: SV
authors.lastname: Kasl
authors.forename: H M
authors.initials: HM
authors.lastname: Krumholz
authors.forename: E H
authors.initials: EH
authors.lastname: Bradley
mesh_terms: D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000523:psychology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D020521:Stroke / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000523:psychology*