Friday, November 23, 2012


In the current global economic scene, this recent study by Dr Matthew Dupre of Duke's, North Carolina, carries much significance. When unemployment rate is 8.5% ( USA ), and 30% ( Spain ), and I forgot the number for Greece, it is a timely reminder that loss of job may have serious consequences. When loss of employment goes on too long, the unemployed soon become unemployable, and that brings even more issue to health. Not being an economist, I will not try and venture into discussing why people loss their jobs.
Dr Matthew Dupre and group from Duke's undertook a study called the Health and Retirement study ( HRS ), whose findings were published online in the 19th Nov 2012 issue of the archives of Internal Medicine. They enrolled 13,451 subjects aged 51-75 yrs who have no AMI on enrollment. He followed them up for 18 years, interviewing them every 2 yearly, on their job and employment. After 18 years, there were 1,061 AMIs in this group. 14% of those enrolled were unemployed at baseline. Over the 18 years, 70% loss their job at least once, and 35 % more had at some time spend some time unemployed. The study found that there was a clear correlation between loss of jobs and AMI rates.

 Risk of MI according to unemployment status and each incremental job loss

HR (95% CI)
Unemployment status 1.35 (1.10-1.66)
One job loss 1.22 (1.04-1.42)
Two job losses 1.27 (1.05-1.54)
Three job losses 1.52 (1.22-1.90)
Four job losses 1.63 (1.29-2.07)


This AMI risk seemed to be worse in the first year of losing their job.And the more times you lose your job, the higher the risk of MI.
It is interesting to speculate on why unemployment correlates with AMIs. I suppose the most obvious is increase stress, lack of sleep from worries, financial worries, loss of self esteem. With financial instability, comes poor diet and inability to sustain a healthy lifestyle.
In a funny way, this increase in AMI rates will increase healthcare cost, which will burden an already burdened financial system. Looks like the Southern European countries and USA  have a healthcare problem.
Even for those of us who are employed and looking at voluntary retirement, there is also a lesson here. It may be wise to plan your retirement well, and refrain from having nothing to do. Keep your mind and body as active as possible, and I do not mean watching VCD from morn till night. I always encourage my well to do senior patients to help society, by doing voluntary, social work, not for money, but to maintain good health which is wealth in a certain way.

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