Annals of Behavioral Medicine

, Volume 36, Issue 2, pp 176–185

History of Unemployment Predicts Future Elevations in C-Reactive Protein among Male Participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

  • Denise Janicki-Deverts
  • Sheldon Cohen
  • Karen A. Matthews
  • Mark R. Cullen
Original Article



Unemployment is associated with risk of future morbidity and premature mortality.


To examine whether unemployment history predicts future C-reactive protein (CRP) levels in male participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study.


Unemployment, body mass index (BMI), and health behaviors were measured at 7, 10, and 15 years post-recruitment. CRP was measured at Years 7 and 15.


Having a history of unemployment at Year 10 was associated with higher CRP at Year 15, independent of age, race, BMI, Year 7 CRP, Year 15 unemployment, and average income across Years 10–15. Poor health practices and depressive symptoms explained 22% of the association, but Year 10 unemployment history remained a significant predictor. Findings did not differ across age, race, education, or income.


Discrete episodes of unemployment may have long-term implications for future CRP levels.


Unemployment C-reactive protein Socioeconomic status Health behaviors 


  1. 1.
    Jin RL, Shah CP, Svoboda TJ. The impact of unemployment on health: A review of the evidence. CMAJ. 1995; 153: 529–540.PubMedGoogle Scholar
  2. 2.
    Nylén L, Voss M, Floderus B. Mortality among women and men relative to unemployment, part time work, overtime work, and extra work: A study based on data from the Swedish twin registry. Occup Environ Med. 2001; 58: 52–57.PubMedCrossRefGoogle Scholar
  3. 3.
    Voss M, Nylen L, Floderus B, Diderichsen F, Terry PD. Unemployment and early cause-specific mortality: A study based on the Swedish twin registry. Am J Public Health. 2004; 94: 2155–2161.PubMedGoogle Scholar
  4. 4.
    McKee-Ryan FM, Song Z, Wanberg CR, Kinicki AJ. Psychological and physical well-being during unemployment: A meta-analytic study. J Appl Psychol. 2005; 90: 53–76.PubMedCrossRefGoogle Scholar
  5. 5.
    Hammarstrom A, Janlert U. Unemployment—An important predictor for future smoking: A 14-year follow-up study of school leavers. Scand J Public Health. 2003; 31: 229–232.PubMedCrossRefGoogle Scholar
  6. 6.
    Gallo WT, Bradley EH, Siegel M, Kasl SV. Health effects of involuntary job loss among older workers: Findings from the health and retirement survey. J Gerontol B Psychol Sci Soc Sci. 2000; 55: S131–S140.PubMedGoogle Scholar
  7. 7.
    Gallo WT, Teng HM, Falba TA, Kasl SV, Krumholz HM, Bradley EH. The impact of late career job loss on myocardial infarction and stroke: A 10 year follow up using the health and retirement survey. Occup Environ Med. 2006; 63: 683–687.PubMedCrossRefGoogle Scholar
  8. 8.
    Lynge E. Unemployment and cancer: A literature review. IARC Sci Publ. 1997; 138: 343–351.PubMedGoogle Scholar
  9. 9.
    Lynge E, Andersen O. Unemployment and cancer in Denmark, 1970–1975 and 1986–1990. IARC Sci Publ. 1997; 138: 353–359.PubMedGoogle Scholar
  10. 10.
    Bartley M. Unemployment and ill health: Understanding the relationship. J Epidemiol Community Health. 1994; 48: 333–337.PubMedCrossRefGoogle Scholar
  11. 11.
    Mathers CD, Schofield DJ. The health consequences of unemployment: The evidence. Med J Aust. 1998; 168: 178–182.PubMedGoogle Scholar
  12. 12.
    Roberts H, Pearson JCG, Madeley RJ, Hanford S, Magowan R. Unemployment and health: The quality of social support among residents in the Trent region of England. J Epidemiol Community Health. 1997; 51: 41–45.PubMedGoogle Scholar
  13. 13.
    Kessler RC, Turner JB, House JS. Effects of unemployment on health in a community survey: Main, modifying, and mediating effects. J Soc Issues. 1988; 44: 69–85.CrossRefGoogle Scholar
  14. 14.
    Feather NT, O’Brien GE. A longitudinal study of the effects of employment and unemployment on school-leavers. J Occup Psychol. 1986; 59: 121–144.Google Scholar
  15. 15.
    Cohen S, Janicki-Deverts D, Miller GE. Psychological stress and disease. JAMA. 2007; 298: 1685–1687.PubMedCrossRefGoogle Scholar
  16. 16.
    Bierhaus A, Wolf J, Andrassy M, Rohleder N, Humpert PM, Petrov D, Ferstl R, von Eynatten M, Wendt T, Rudofsky G, Joswig M, Morcos M, Schwaninger M, McEwen B, Kirschbaum C, Nawroth PP. A mechanism converting psychosocial stress into mononuclear cell activation. Proc Natl Acad Sci U S A. 2003; 100: 1920–1925.PubMedCrossRefGoogle Scholar
  17. 17.
    Kiecolt-Glaser JK, McGuire L, Robles TF, Glaser R. Emotions, morbidity, and mortality: New perspectives from psychoneuroimmunology. Annu Rev Psychol. 2002; 53: 83–107.PubMedCrossRefGoogle Scholar
  18. 18.
    Hamer M, Williams E, Vuonovirta R, Giacobazzi P, Gibson EL, Steptoe A. The effects of effort-reward imbalance on inflammatory and cardiovascular responses to mental stress. Psychosom Med. 2006; 68: 408–413.PubMedCrossRefGoogle Scholar
  19. 19.
    McDade TW, Hawkley LC, Cacioppo JT. Psychosocial and behavioral predictors of inflammation in middle-aged and older adults: The Chicago Health, Aging, and Social Relations Study. Psychosom Med. 2006; 68: 376–381.PubMedCrossRefGoogle Scholar
  20. 20.
    Suarez EC, Krishnan RR, Lewis JG. The relation of severity of depressive symptoms to monocyte-associated proinflammatory cytokines and chemokines in apparently healthy men. Psychosom Med. 2003; 65: 362–368.PubMedCrossRefGoogle Scholar
  21. 21.
    Danesh J, Whincup P, Walker M. Low-grade inflammation and coronary heart disease: Prospective study and updated meta-analyses. BMJ. 2000; 321: 199–204.PubMedCrossRefGoogle Scholar
  22. 22.
    Dziedzic T. Systemic inflammatory markers and risk of dementia. Am J Alzheimer Dis Dement. 2006; 21: 258–262.CrossRefGoogle Scholar
  23. 23.
    Ross R. Mechanisms of disease: Atherosclerosis—An inflammatory disease. NEJM. 1999; 340: 115–126.PubMedCrossRefGoogle Scholar
  24. 24.
    Pickup JC, Crook MA. Is type II diabetes mellitus a disease of the innate immune system? Diabetologia. 1998; 41: 1241–1248.PubMedCrossRefGoogle Scholar
  25. 25.
    Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA. 2001; 286: 327–334.PubMedCrossRefGoogle Scholar
  26. 26.
    Cutter GR, Burke GL, Dyer AR, Friedman GD, Hilner JE, Hughes GH, Hulley SB, Jacobs DRJ, Liu K, Monolio TA, Oberman A, Perkins LL, Savage PJ, Serwitz JR, Sidney S, Wagenknecht LE. Cardiovascular risk factors in young adults: The CARDIA baseline monograph. Control Clin Trials. 1991; 12: 1s–77s.PubMedCrossRefGoogle Scholar
  27. 27.
    Friedman GD, Cutter GR, Donahue RP, Hughes GH, Hulley SB, Jacobs DRJ, Liu K, Savage PJ. CARDIA: Study design, recruitment, and some characteristics of the examined subjects. J Clin Epidemiol. 1988; 41: 1105–1116.PubMedCrossRefGoogle Scholar
  28. 28.
    Buhmann B, Rainwater L, Schmaus G, Smeeding TM. Equivalence scales, well-being, inequality, and poverty: Sensitivity estimates across ten countries using the Luxembourg Income Study (LIS) database. Rev Income Wealth. 1988; 34: 115–142.CrossRefGoogle Scholar
  29. 29.
    Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Measurement. 1977; 1: 385–401.CrossRefGoogle Scholar
  30. 30.
    Bromberger JT, Matthews KA. A “feminine” model of vulnerability to depressive symptoms: A longitudinal investigation of middle-aged women. J Pers Soc Psychol. 1996; 70: 591–598.PubMedCrossRefGoogle Scholar
  31. 31.
    Cohen S, Schwartz JE, Epel ES, Kirschbaum C, Sidney S, Seeman T. Socioeconomic status, race, and diurnal cortisol decline in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Psychosom Med. 2006; 68: 41–50.PubMedCrossRefGoogle Scholar
  32. 32.
    The University of Alabama at Birmingham DoPM. Coronary Artery Risk Development in Young Adults (CARDIA) Study. Available at: Accessibility verified March 15, 2006.
  33. 33.
    Jacobs DR, Hahn L, Haskell WL, Pirie P, Sidney S. Validity and reliability of a short physical activity history: CARDIA and the Minnesota Heart Health Program. J Cardiopulm Rehabil. 1989; 9: 448–459.CrossRefGoogle Scholar
  34. 34.
    Shine B, de Beer FC, Pepys M. Solid phase radio-immunoassays for C-reactive protein. Clin Chem Acta. 1981; 117: 13–23.CrossRefGoogle Scholar
  35. 35.
    U.S. Census Bureau. Educational attainment: 2000. Available at: Accessibility verified March 5, 2007.
  36. 36.
    U.S. Census Bureau. Household income: 1999. Available at: Accessibility verified March 5, 2007.
  37. 37.
    Rohde LE, Hennekens CH, Ridker PM. Survey of C-reactive protein and cardiovascular risk factors in apparently healthy men. Am J Cardiol. 1999; 84.Google Scholar
  38. 38.
    Schnorpfeil P, Noll A, Schulze R, Ehlert U, Frey K, Fischer JE. Allostatic load and work conditions. Soc Sci Med. 2003; 57: 647–656.PubMedCrossRefGoogle Scholar
  39. 39.
    Ranjit N, Diez-Roux AV, Shea S, Cushman M, Seeman T, Jackson SA, Ni H. Psychosocial factors and inflammation in the multi-ethnic study of atherosclerosis. Arch Intern Med. 2007; 167: 174–181.PubMedCrossRefGoogle Scholar
  40. 40.
    Miller GE, Cohen S, Ritchey AK. Chronic psychological stress and the regulation of pro-inflammatory cytokines: A glucocorticoid-resistance model. Health Psychol. 2002; 21: 531–541.PubMedCrossRefGoogle Scholar
  41. 41.
    Cassidy T, Wright L. Graduate employment status and health: A longitudinal analysis of the transition from student. Soc Psychol of Educ. 2008; 11: 181–191.CrossRefGoogle Scholar
  42. 42.
    Block G, Dietrich M, Norkus E, Jensen C, Benowitz NL, Morrow JD, Hudes M, Packer L. Intraindividual variability of plasma antioxidants, markers of oxidative stress, C-reactive protein, cotinine, and other biomarkers. Epidemiology. 2006; 17: 404–412.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2008

Authors and Affiliations

  • Denise Janicki-Deverts
    • 1
  • Sheldon Cohen
    • 1
  • Karen A. Matthews
    • 2
  • Mark R. Cullen
    • 3
  1. 1.Department of PsychologyCarnegie Mellon UniversityPittsburghUSA
  2. 2.Department of PsychiatryUniversity of PittsburghPittsburghUSA
  3. 3.Department of Internal MedicineYale University School of MedicineNew HavenUSA

Personalised recommendations