Unemployment is associated with high cardiovascular event rate and increased all-cause mortality in middle-aged socially privileged individuals

  • Pierre MenetonEmail author
  • Emmanuelle Kesse-Guyot
  • Caroline Méjean
  • Léopold Fezeu
  • Pilar Galan
  • Serge Hercberg
  • Joël Ménard
Original Article



To assess prospectively the association between employment status and cardiovascular health outcomes in socially privileged individuals.


The incidence of fatal and non-fatal cardiovascular events and all-cause mortality rate were monitored during 12 years in a national sample of 5,852 French volunteers, aged 45–64 years, who were free of cardiovascular disease or other overt disease at baseline. The association between health outcomes and employment status was tested using Cox proportional modelling with adjustment for confounding factors.


Compared to randomly selected individuals, these volunteers were characterized by higher education level and socio-economic status and lower cardiovascular risk and mortality rate. A total of 242 cardiovascular events (3.5 events per 1,000 person-years) and 152 deaths from all causes (2.2 deaths per 1,000 person-years) occurred during follow-up. After adjustment for age and gender, both cardiovascular event risk [HR (95 % CI) 1.84 (1.15–2.83), p = 0.01] and all-cause mortality [2.79 (1.66–4.47), p = 0.0002] were increased in unemployed individuals compared to workers. These poor health outcomes were observed to the same extent after further adjustment for clinical, behavioural and socio-demographic characteristics of individuals at baseline [HR (95 % CI) 1.74 (1.07–2.72), p = 0.03 and 2.89 (1.70–4.69), p = 0.0002, respectively]. In contrast, neither cardiovascular event risk nor all-cause mortality was significantly increased in retired individuals compared to workers after adjustment for confounding factors.


These results support the existence of a link between unemployment and poor cardiovascular health and suggest that this link is not mediated by conventional risk factors in middle-aged socially privileged individuals.


Social status Cohort Cardiovascular event risk All-cause mortality Unemployment 



This study was funded by the Association Robert Debré pour la Recherche Médicale, the Institut National pour la Santé et la Recherche Médicale, the Conservatoire National des Arts et Métiers, the Institut National de la Recherche Agronomique and the Université Paris 13.

Conflict of interest

The authors declare that they have no conflict of interest relevant to this research.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Pierre Meneton
    • 1
    Email author
  • Emmanuelle Kesse-Guyot
    • 2
  • Caroline Méjean
    • 2
  • Léopold Fezeu
    • 2
  • Pilar Galan
    • 2
  • Serge Hercberg
    • 2
  • Joël Ménard
    • 3
  1. 1.INSERM U1142 LIMICS, UMR_S 1142 Sorbonne Universités, UPMC Université Paris 06Université Paris 13ParisFrance
  2. 2.UREN, INSERM U557, INRA U1125, CNAM, SMBH, Sorbonne Paris CitéUniversité Paris 13BobignyFrance
  3. 3.INSERM CIC9201Université Paris DescartesParisFrance

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