EMPLOYMENT PATTERNS AND THEIR EFFECT ON HEALTH OUTCOMES AMONG WOMEN WITH RHEUMATOID-ARTHRITIS FOLLOWED FOR 7 YEARS

Objective. To evaluate the effect of employment on health outcomes in a sample of women with rheumatoid arthritis (RA) and to test the hypot hesis that employment confers a health benefit to women. Methods. Seve n hundred sir;ty women with a diagnosis of RA were recruited from a na tional random sample of private rheumatology practices in 1988, and 41 6 remained in the study after 7 years of followup in 1991. Women were interviewed each year by telephone to collect data on demographic vari ables, health status, and employment status. Clinical data were provid ed by referring physicians.Results. Most women (175, 42%) were not emp loyed outside the home 1988-94, although 96 of those women (23% of the sample) had been employed previously. Twenty-seven percent (n = 112) were employed all 7 years and 31% (n = 129) had been employed between one and 6 years. Women who were employed had significantly better heal th outcomes measured by pain, disability, role functioning, and clinic al status compared to those who were never employed and those who had been employed before the study. Women who n ere previously employed, b ut not employed during the study period experienced the worst health o utcomes. This difference in health status, however, appeared before en try into this study. Conclusion, Employed women with RA had better hea lth status than women who were not employed outside the home. Previous ly employed women had worse health outcomes than both working women an d women who were never employed, suggesting that loss of employment is associated with worse health. Further research is needed to investiga te underlying factors contributing to worse health status among unempl oyed women and to better health among employed women.