Gendered exposures: exploring the role of paid and unpaid work throughout life in US women's cardiovascular health

The paper explores how paid and unpaid labor history over the life course influence women's cardiovascular disease. U.S. women comprise about 50% of the paid workforce and perform the majority of unpaid labor. However, the influence of women's work on their health is under-researched. Our sample was drawn from the Women's Health Initiative Observational Study, a cohort of post-menopausal women in the U.S. aged 50-79 at recruitment. Women were categorized into five groups according to paid labor history: worked in paid jobs consistently throughout adult life; left the workforce early; entered the workforce later; discontinuous work history; never worked outside the home. Live birth history (none, at least one, missing) served as a proxy for unpaid labor in prime age. Cox proportional hazard models were used to estimate the hazard ratio of CVD associated with different paid work histories. We then assessed the effect of unpaid labor on the relation between paid labor and CVD. Paid labor participation was not associated with CVD risk among women without unpaid labor after adjusting for age, education, and birth cohort. Among those with unpaid demands, leaving the workforce early or having discontinuous work history was protective. In this U.S. sample, the association between paid work participation history and CVD risk depends on the presence of unpaid labor. Our results demonstrate the necessity of including work - paid and unpaid - in consideration of women's health.