Involuntary job loss near retirement more than doubles the risk of heart attack and stroke, researchers at Yale School of Medicine report in a major national study published in Occupational and Environmental Medicine.

The results are based on 10-year observations of 4,301 individuals between age 51 and 61 out of which 582 had lost their jobs during that period. The study is the extension of an earlier study, in which the same sample was tracked for six years. The earlier research indicated heightened risk of stroke, but not a definitive link between job loss and heart attacks.

"With longer follow-up and heart attack and stroke events, we were able to better assess the association between employment separation and the medical outcomes," said William T. Gallo, the lead author of the study and associate research scientist in the Department of Epidemiology and Public Health at Yale School of Medicine.

The researchers used 10 years of data from the nationally representative Health and Retirement Survey in their research. Starting with a sample of employed individuals, they identified 582 workers who were either laid off or left jobless because of a business closing. The study compared their risk of heart attack and stroke to a group that included 3,719 workers who remained employed. In considering the effect of job loss, the researchers also took into account other risk factors such as smoking, high blood pressure, obesity and depressive symptoms.

"Job loss is associated with a range of stressful outcomes, including loss of pay and non-wage benefits, limited access to medical care, and severance of identification and work-based social support," said Gallo. "Older individuals could be at increased risk for stress after being let go from work. We know that workers over 50 may have difficulty finding new positions, which frequently offer lower compensation than the pre-separation job did. This can obviously affect their later pension amount."

Gallo said that physicians who treat individuals who lose jobs as they approach retirement should consider the loss of employment a credible risk factor for adverse vascular health changes. Similarly, policy makers should also be aware of the risks of job loss, so that intervention programs can be implemented to ease the multiple burdens of unemployment.

Co-author Elizabeth Bradley said, "We do a lot of downsizing in our country and older individuals are often affected. We need to recognize not only the economic consequences, but also the health consequences."

In addition to Gallo and Bradley, Yale co-authors include Hsun-Mei Teng, Tracy Falba, Stanislav Kasl and Harlan Krumholz.

Citation: Occupational and Environmental Medicine, om26823 (June 21, 2006)

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