Occupational hierarchy, economic sector, and mortality from cardiovasculardisease among men and women: Findings from the National Longitudinal Mortality Study

PURPOSE: Although socioeconomic position has been identified as a determina nt of cardiovascular disease among employed men and women in the U.S., the role of economic sector in shaping this relationship has yet to be examined . We sought to estimate the combined effects of economic sector-one of the three major sectors of the economy: finance, government and production-and socioeconomic position on cardiovascular mortality among employed men and w omen. METHODS: Approximately 375,000 men and women 25 years of age or more were i dentified from selected Current Population Surveys between 1979 and 1985. T hese persons were followed for cardiovascular mortality through use of the National Death Index for the years 1979 through 1989. RESULTS: In men, the lowest cardiovascular mortality was found for professi onals in the finance sector (76/100,000 person/years). The highest cardiova scular mortality was found among male nonprofessional workers in the produc tion sector (192/100,000 person years). A different pattern war observed am ong women. Professional women in the finance sector had the highest rates o f cardiovascular mortality (133/100,000 person years). For both men and wom en, the professional/non-professional gap in cardiovascular mortality was l ower in the government sector than in the production and finance sectors. T hese associations were strong even after adjustment for age, race and incom e. CONCLUSIONS: Characteristics of government, finance and production work dif ferentially influence the risk of cardiovascular disease mortality. Men, wo men, professionals and non-professionals experience this risk differently., Ann Epidemiol 2001;Il:194-201. (C) 2001 Elsevier Science Inc. All rights re served.