The Cardiometabolic Effects of Work and Family Stress
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CitationO'Donnell, Emily Martin. 2015. The Cardiometabolic Effects of Work and Family Stress. Doctoral dissertation, Harvard T.H. Chan School of Public Health.
AbstractWork and family stress is increasingly pervasive in today’s workforce, and studies reveal that it may be related to worse employee cardiovascular health. However, it is unclear whether the combined stress from work and home relate to individual cardiometabolic risk factors over time and whether the workplace influences these risk factors. Further, no research has examined if these demands are associated with higher levels of inflammation in the body, which are meaningful indicators of cardiovascular disease (CVD). This dissertation seeks to address these gaps in the literature. We draw upon data from 1,524 predominantly female, ethnically and racially diverse extended-care employees who provide biological as well as self-reported data on a variety of sociodemographic, health and work and family variables at four study waves (baseline, 6 months, 12 months and 18 months). Specifically, Chapter 1 examines the observational effects of work and family conflict, conceptualized to represent perceived stress, on five cardiovascular risk factors (blood pressure, glycosylated hemoglobin, cholesterol, body mass index and cigarette consumption) used to establish a cardiometabolic risk score (CRS) over the 18 month study period. Chapter 2 investigates the effects of a workplace intervention designed to increase flexibility, schedule control and workplace support on employee markers of inflammation from baseline to 12 months as part of a prospective, randomized field experiment. Chapter 3 assesses manager- and worksite-level influences on the aforementioned CRS and behavioral and biological variables representing CVD risk, all measured at the employee-level at baseline. We employ multilevel level modeling techniques to account for the nesting of employees within manager workgroups and worksites as well as multiple measures per employee where appropriate. Overall, we find that work and family conflict may relate to certain measures of cardiometabolic risk, such as BMI and cholesterol. Additionally, employees who work within the same worksite may have more similar cholesterol levels than employees working at different worksites. We do not find evidence that this particular workplace intervention lead to changes in employee levels of inflammation over time. Given the public health burden of CVD, we recommend that future research continue to examine the effects of work and family stressors on cardiovascular outcomes in a variety of settings.
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