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PLoS One. 2018 Nov 27;13(11):e0207652. doi: 10.1371/journal.pone.0207652. eCollection 2018.

The association of employment status with ideal cardiovascular health factors and behaviors among Hispanic/Latino adults: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

Author information

1
Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America.
2
Department of Public Health Sciences, Loyola University Medical Center, Maywood, IL, United States of America.
3
Department of Neurosciences, University of California San Diego, San Diego, CA, United States of America.
4
Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
5
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America.
6
Division of Nephrology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America.
7
Graduate School of Public Health, San Diego State University, San Diego, CA, United States of America.
8
Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
9
Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, United States of America.

Abstract

BACKGROUND:

The American Heart Association's 2020 Impact Goals propose to improve cardiovascular health (CVH) and reduce deaths from cardiovascular diseases and stroke in the US. Targeted health promotion efforts in workplaces and communities are needed to achieve these population-level changes. The present study examined the sex-specific cross-sectional associations between employment status and ideal CVH among Hispanics/Latinos, and whether these associations were modified by age (i.e., younger adults [aged 18-44] compared to middle-aged and older adults [aged 45-74]).

METHODS:

This study included 4,797 males and 7,043 females (aged 18-74) from the Hispanic Community Health Study / Study of Latinos. Employment status was categorized as employed full-time (FT), employed part-time (PT), employed (FT or PT) and homemakers, homemakers only, and unemployed. CVH metrics, operationalized as 'ideal' versus 'less than ideal,' included health factors (i.e., blood pressure, cholesterol, and fasting glucose) and health behaviors (i.e., body mass index, smoking, physical activity [PA], and diet). A total CVH score was derived based on the seven CVH metrics, and dichotomized as ideal vs. less than ideal (score of 11-14 vs. 0-10). Survey-based generalized linear regression models with Gaussian binomial distribution were used to estimate adjusted prevalence differences (APDs) and their 95% confidence intervals (CIs) for the associations between employment status (with employed FT as referent) and ideal CVH (total score and each metric), adjusting for socio-demographic characteristics. Effect modification by age was examined.

RESULTS:

Among males, compared to their employed FT counterparts, those who were employed PT had a higher prevalence of ideal CVH score (APD = 6.8, 95% CI = 1.7, 11.8), ideal BMI (APD = 8.5, 95% CI = 3.0, 14.0), and ideal PA (APD = 4.8, 95% CI = 0.9, 8.7). Age modified the associations of employment type with ideal CVH score and ideal BMI, i.e., younger males who were employed PT had a higher prevalence of ideal CVH score and ideal BMI. Among females, employment status was not associated with ideal CVH score. Compared to females employed FT, females who were homemakers had a lower prevalence of ideal (non-) smoking (APD = -4.7, 95% CI = -8.5, -1.0) and ideal PA (APD = -7.9, 95% CI = -12.7, -3.0), and females who were unemployed had a lower prevalence of ideal PA (APD = -10.4, 95% CI = -16.7, -4.1). Age modified the associations of employment type with ideal fasting glucose and ideal PA, i.e., middle-aged and older females who were homemakers or unemployed had a lower prevalence of ideal fasting glucose and ideal PA.

CONCLUSIONS:

Hispanic/Latino males who were employed PT had the most favorable CVH profiles but these associations were mostly driven by better CVH (total score and metrics) among younger males. Hispanic/Latino females who were homemakers or unemployed had lower rates of ideal CVH metrics.

PMID:
30481192
PMCID:
PMC6258516
DOI:
10.1371/journal.pone.0207652
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