Send to

Choose Destination
Am J Public Health. 2016 Aug;106(8):1449-56. doi: 10.2105/AJPH.2016.303264. Epub 2016 Jun 16.

Work-Family Trajectories and the Higher Cardiovascular Risk of American Women Relative to Women in 13 European Countries.

Author information

Karen van Hedel, Johan P. Mackenbach, and Frank J. van Lenthe are with the Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands. Iván Mejía-Guevara and Lisa F. Berkman are with the Harvard Center for Population and Development Studies, Harvard T. H. Chan School of Public Health, Cambridge, MA. Mauricio Avendaño is with the Department of Global Health and Social Medicine, King's College London, London, UK. Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA.



To investigate whether less-healthy work-family life histories contribute to the higher cardiovascular disease prevalence in older American compared with European women.


We used sequence analysis to identify distinct work-family typologies for women born between 1935 and 1956 in the United States and 13 European countries. Data came from the US Health and Retirement Study (1992-2006) and the Survey of Health, Aging, and Retirement in Europe (2004-2009).


Work-family typologies were similarly distributed in the United States and Europe. Being a lone working mother predicted a higher risk of heart disease, stroke, and smoking among American women, and smoking for European women. Lone working motherhood was more common and had a marginally stronger association with stroke in the United States than in Europe. Simulations indicated that the higher stroke risk among American women would only be marginally reduced if American women had experienced the same work-family trajectories as European women.


Combining work and lone motherhood was more common in the United States, but differences in work-family trajectories explained only a small fraction of the higher cardiovascular risk of American relative to European women.

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center