Cross-sectional and longitudinal associations between high density lipoprotein cholesterol and women's employment

This study examined the association between women's employment and high density lipoprotein (HDL) cholesterol. Subjects were 1.998 women aged 25-64 years who were sampled by the first MONICA Augsburg Survey (Monitoring of Trends and Determinants in Cardiovascular Disease). The women were sampled from the population of Augsburg, Federal Republic of Germany, in 1984-1985, were followed up for 3 years, and were reexamined in 1987-1988. In cross-sectional analysis (1984-1985), the mean HDL cholesterol level of employed women was 3.4 mg/dl higher than that of full-time homemakers (p less than 0.001). After adjustment for age, body mass, cigarette smoking, consumption of coffee and alcohol, use of sex hormones, leisure-time physical activity, and reproductive history, this difference decreased to 2.1 mg/dl and remained statistically significant (p less than 0.01). As was predicted from the cross-sectional findings, the mean HDL cholesterol levels of women who gave up employment and became full-time homemakers during the follow-up period decreased by 3.04 mg/dl (p less than 0.01), whereas homemakers who became employed showed no significant change in HDL cholesterol levels. The change in mean HDL cholesterol of employed women who had become homemakers could be explained in part by changes in alcohol consumption and in number of pregnancies. The authors conclude that giving up employment is related to life-style changes that are associated with a decrease in HDL cholesterol levels. Furthermore, the findings suggest that employment may exert a beneficial influence on coronary risk in women that is consistent with a positive association between employment and HDL cholesterol.