Self-Employment, Working Hours, and Hypertension by Race/Ethnicity in the USA

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. 2022 Sep 6.


doi: 10.1007/s40615-022-01400-9.


Online ahead of print.

Affiliations

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Caryn N Bell et al.


J Racial Ethn Health Disparities.


.

Abstract

There is a large literature on work-related characteristics and hypertension, but studies on self-employment, longer working hours, and hypertension are mixed. Assessments of self-employment should be extended to account for people with part-time self-employment (i.e., employees also earning income from self-employment). The aim of this study was to determine the association of different types of self-employment with hypertension among adults by race/ethnicity and to assess whether longer working hours moderated these associations. Using data from the 2007-2018 National Health and Nutrition Examination Survey, measured hypertension (blood pressure ≥ 140/90 mm Hg) was assessed and employment categories included employees, part-time self-employment (i.e., employee with self-employment income), or full-time self-employment. Modified Poisson regressions and multiplicative interaction terms were used. Having full-time self-employment was associated with lower relative risk (RR) of hypertension compared to employees among Black (RR = 0.77, 95% confidence interval (CI) = 0.61-0.96) and White men (RR = 0.77, 0.65-0.93) compared to employees. Full-time self-employment was associated with higher risk of hypertension (RR = 1.36, 95% CI = 1.01-1.82) compared to employees among Hispanic women, while part-time self-employment was associated with lower risk (RR = 0.69, 95% CI = 0.48-0.98). Among White women, part-time self-employment was associated with higher relative risk of hypertension (RR = 1.27, 95% CI = 1.05-1.53) compared to employees. There were significant interactions between employment categories and longer working hours among Hispanic women as well as Black women and men. The results suggest that self-employment categories and longer working hours impact hypertension by race/ethnicity and sex. Because the number of full-time and part-time self-employed adults has increased, the health of this particular subgroup of workers should be further addressed.


Keywords:

Hypertension; Race/ethnicity; Self-employment; Work.

References

    1. Fryar CD, Ostchega Y, Hales CM, Zhang G, Kruszon-Moran D. Hypertension prevalence and control among adults: United States, 2015–2016. 2017. Contract No.: NCHS Data Brief No. 289. Available from: https://www.cdc.gov/nchs/data/databriefs/db289.pdf .

    1. Aggarwal R, Chiu N, Wadhera RK, Moran AE, Raber I, Shen C, et al. Racial/ethnic disparities in hypertension prevalence, awareness, treatment, cand control in the United States, 2013 to 2018. Hypertension. 2021;78:1719–26.



      PubMed



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    1. Commodore-Mensah Y, Turkson-Ocran RA, Foti K, Cooper LA, Himmelfarb CD. Associations Between social determinants and hypertension, stage 2 hypertension, and Controlled blood pressure among men and women in the United States. Am J Hypertens. 2020;34(7):707–17.



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    1. Kaur H, Luckhaupt SE, Li J, Alterman T, Calvert GM. Workplace psychosocial factors associated with hypertension in the U.S. Workforce: a cross-sectional study based on the 2010 National Health Interview Survey. Am J Ind Med. 2014;57(9):1011–21.



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    1. Yamasaki F, Schwartz JE, Gerber LM, Warren K, Pickering TG. Impact of shift work and race/ethnicity on the diurnal rhythm of blood pressure and catecholamines. Hypertension. 1998;32(3):417–23.



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