%0 Journal Article %J Social Science and Medicine %D 2015 %T The long-term mortality impact of combined job strain and family circumstances: A life course analysis of working American mothers %A Erika L. Sabbath %A Mejía-Guevara, Iván %A Noelke, Clemens %A Lisa F Berkman %K Adult children %K Employment and Labor Force %K Health Conditions and Status %K Healthcare %K Public Policy %K Risk Taking %X Background: Work stress and family composition have been separately linked with later-life mortality among working women, but it is not known how combinations of these exposures impact mortality, particularly when exposure is assessed cumulatively over the life course. We tested whether, among US women, lifelong work stress and lifelong family circumstances would jointly predict mortality risk. Procedures: We studied formerly working mothers in the US Health and Retirement Study (HRS) born 1924-1957 (n = 7352). We used sequence analysis to determine five prototypical trajectories of marriage and parenthood in our sample. Using detailed information on occupation and industry of each woman's longest-held job, we assigned each respondent a score for job control and job demands. We calculated age-standardized mortality rates by combined job demands, job control, and family status, then modeled hazard ratios for death based on family constellation, job control tertiles, and their combination. Results: Married women who had children later in life had the lowest mortality risks (93/1000). The highest-risk family clusters were characterized by spells of single motherhood (132/1000). Generally, we observed linear relationships between job control and mortality hazard within each family trajectory. But while mortality risk was high for all long-term single mothers, we did not observe a job control-mortality gradient in this group. The highest-mortality subgroup was previously married women who became single mothers later in life and had low job control (HR 1.91, 95 CI 1.38,2.63). Practical implications: Studies of associations between psychosocial work characteristics and health might consider heterogeneity of effects by family circumstances. Worksite interventions simultaneously considering both work and family characteristics may be most effective in reducing health risks. (C) 2015 Elsevier Ltd. All rights reserved. %B Social Science and Medicine %I 146 %V 146 %P 111 %G eng %4 Social determinants of health/sequence analysis/Single motherhood/Job control/Work family conflict/Job stress/Job strain/mental health/risk factors/cardiovascular disease/public Policy/Working women/Health risk assessment/Occupational stress/Working mothers %$ 999999 %0 Journal Article %J American Journal of Epidemiology %D 2015 %T Who Suffers During Recessions? Economic Downturns, Job Loss, and Cardiovascular Disease in Older Americans %A Noelke, Clemens %A Mauricio Avendano %K Employment and Labor Force %K Health Conditions and Status %K Public Policy %K Risk Taking %X Job loss in the years before retirement has been found to increase risk of cardiovascular disease (CVD), but some studies suggest that CVD mortality among older workers declines during recessions. We hypothesized that recessionary labor market conditions were associated with reduced CVD risk among persons who did not experience job loss and increased CVD risk among persons who lost their jobs. In our analyses, we used longitudinal, nationally representative data from Americans 50 years of age or older who were enrolled in the Health and Retirement Study and surveyed every 2 years from 1992 to 2010 about their employment status and whether they had experienced a stroke or myocardial infarction. To measure local labor market conditions, Health and Retirement Study data were linked to county unemployment rates. Among workers who experienced job loss, recessionary labor market conditions at the time of job loss were associated with a significantly higher CVD risk (hazard ratio = 2.54, 95 confidence interval: 1.39, 4.65). In contrast, among workers who did not experience job loss, recessionary labor market conditions were associated with a lower CVD risk (hazard ratio = 0.50, 95 confidence interval: 0.31, 0.78). These results suggest that recessions might be protective in the absence of job loss but hazardous in the presence of job loss. %B American Journal of Epidemiology %I 182 %V 182 %P 873-882 %G eng %N 10 %4 business cycles/recessions/unemployment/cardiovascular disease/GREAT RECESSION/STROKE/MORTALITY/labor market participation/Risk assessment/Labor market %$ 999999 %R 10.1093/aje/kwv094 %0 Journal Article %J American journal of public health %D 2014 %T Recessions, job loss, and mortality among older US adults %A Noelke, Clemens %A Beckfield, Jason %K Employment and Labor Force %K Health Conditions and Status %K Public Policy %X OBJECTIVES: We analyzed how recessions and job loss jointly shape mortality risks among older US adults. METHODS: We used data for 50 states from the Health and Retirement Study and selected individuals who were employed at ages 45 to 66 years during 1992 to 2011. We assessed whether job loss affects mortality risks, whether recessions moderate the effect of job loss on mortality, and whether individuals who do and do not experience job loss are differentially affected by recessions. RESULTS: Compared with individuals not experiencing job loss, mortality risks among individuals losing their job in a recession were strongly elevated (hazard ratio = 1.6; 95 confidence interval = 1.1, 2.3). Job loss during normal times or booms is not associated with mortality. For employed workers, we found a reduction in mortality risks if local labor market conditions were depressed, but this result was not consistent across different model specifications. CONCLUSIONS: Recessions increase mortality risks among older US adults who experience job loss. Health professionals and policymakers should target resources to this group during recessions. Future research should clarify which health conditions are affected by job loss during recessions and whether access to health care following job loss moderates this relation. %B American journal of public health %I 104 %V 104 %P e126-34 %G eng %N 11 %4 Job Loss/labor Force Participation/recessions/mortality risk/mortality risk/Unemployment %$ 999999 %R 10.2105/ajph.2014.302210