%0 Journal Article %J Medicina (Kaunas) %D 2023 %T Adverse Childhood Experiences, Social Isolation, Job Strain, and Cardiovascular Disease Mortality in U.S. Older Employees. %A Matthews, Timothy A %A Li, Jian %K Adverse Childhood Experiences %K Cardiovascular Diseases %K Humans %K Risk Factors %K social isolation %K Surveys and Questionnaires %K United States %X

Stress is a key driver of cardiovascular disease (CVD), yet the contribution of psychosocial stressors to the development of CVD has not been systematically examined in United States (U.S.) populations. The objective of this study was to assess prospective associations of adverse childhood experiences (ACEs), social isolation, and job strain with CVD mortality. Data were from the large, nationally representative, population-based Health and Retirement Study (HRS). ACEs, social isolation and job strain were assessed using validated survey instruments at baseline between 2006-2008, and death information was followed up through 2018. Cox proportional hazards regression models were used to examine prospective associations of ACEs, social isolation, and job strain with CVD mortality among 4046 older employees free from CVD at baseline. During 42,149 person-years of follow-up time, 59 death cases of CVD were reported. After adjustment for covariates, ACEs and job strain were significantly associated with increased risk of CVD mortality (aHR and 95% CI = 3.67 [1.59, 8.48] and 2.24 [1.21, 4.11], respectively), whereas social isolation demonstrated an inflated but nonsignificant association (aHR and 95% CI = 1.62 [0.72, 3.66]). These findings highlight the role of psychosocial exposures as novel and clinically relevant risk factors for CVD.

%B Medicina (Kaunas) %V 59 %G eng %N 7 %R 10.3390/medicina59071304 %0 Journal Article %J Journal of Psychosomatic Research %D 2018 %T Association between effort-reward imbalance and self-reported diabetes mellitus in older U.S. workers %A Mutambudzi, Miriam %A Johannes Siegrist %A Meyer, John D. %A Li, Jian %K Diabetes %K Psychosocial %K Self-reported health %X Objective Studies assessing the effects of work stress on health in older adults in the U.S. labor force are scarce. We examined the longitudinal association between work stress as measured by effort-reward imbalance (ERI) and incident diabetes over a 7-year period in U.S. working adults aged 50 years and older. Methods We used longitudinal data from the 2006–2012 waves of the Health and Retirement Study (n = 1932). Cox proportional hazard regression was used to examine whether ERI significantly predicted diabetes incidence in older adults who were diabetes-free at baseline. Results High stress level at work (ERI ratio > 1.0) was found in participants who worked 55 h or more a week (37.3%), had no insurance coverage (35.9%), and those working in blue collar jobs (34.4%). Participants with high ERI had a significantly higher risk of diabetes (HR = 1.33, 95%CI = 1.04–1.69) relative to those with low ERI, after adjustment for known predictors of adult-onset diabetes. Conclusion Effort-reward imbalance was associated with increased risk of diabetes incidence after controlling for other known predictive factors, which suggests an independent non-mediated effect of work stressors. More research is required to better understand the effects of work stress in aging populations and how psychosocial disequilibrium in the work environment may impact susceptibility to chronic conditions, and in particular how change in self-assessed reward might vary toward the end of a working lifetime. %B Journal of Psychosomatic Research %V 104 %P 61-64 %G eng %U http://linkinghub.elsevier.com/retrieve/pii/S0022399917307298http://api.elsevier.com/content/article/PII:S0022399917307298?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S0022399917307298?httpAccept=text/plain %! Journal of Psychosomatic Research %R 10.1016/j.jpsychores.2017.11.008