Dissertations and Theses
Date of Degree
6-1-2025
Document Type
Dissertation
Degree Name
Doctor of Public Health (DPH)
Department
Environmental, Occupational, and Geospatial Health Sciences
Advisor(s)
Catherine M. Schooling
Committee Members
Catherine M. Schooling, Ph.D.
Ghada Soliman, Ph.D.
Tran Huynh, Ph.D.
Subject Categories
Public Health
Keywords
Occupational stress, heart disease, diabetes, sex, negative confounding, blue-collar/ white-collar
Abstract
ABSTRACT
Occupational Stress: Lifestyle and Health in Blue- and White-Collar Workers in the United States
by
Carice Craffey
Advisor: Catherine M. Schooling, Ph.D.
Background: Heart disease and diabetes are leading causes of death in the United States and globally, particularly heart disease in men. Employment conditions can contribute to illness and death. Occupational or job stress (OS) is a potential contributor to heart disease and diabetes, but its conceptualization and role for men and women remain unclear. To address this gap, I conceptualized OS, then examined the role of OS in heart disease and diabetes.
Methods: I used a literature review to conceptualize OS, then I took advantage of the United States Health and Retirement Study (HRS) to assess longitudinally the role of OS in heart disease and diabetes overall, by sex and by job type (blue- or white-collar) using logistic regression adjusted for confounders.
Results: Of the 34,504 people included in the HRS from 2002 to 2018, of those with a measure of OS and potential confounders, 15,119 had incident heart disease and 14,666 had incident diabetes. OS was more common in people with white-collar jobs. Adjusted for age, sex, ethnicity, race, education, physical activity, self-rated health and job type (blue- and white-collar) OS was unrelated to both heart disease (odds ratio (OR) 0.98, 95% confidence interval (CI) 0.89 to 1.08) and diabetes (OR 1.05, 95% CI 0.96 to 1.16) with similar estimates for men and women and by job type, although OS was associated with diabetes in women (OR 1.14, 95% CI 1.01 to 1.30).
Conclusion: OS was not clearly associated with heart disease or diabetes, possibly because of negative confounding by job type, given OS was higher in people with white-collar jobs. Further research using methods less open to confounding, such as instrumental variable analysis, would be helpful. In addition, other targets of intervention should be sought to reduce the higher rates of heart disease in men than women, further investigation of whether OS increases diabetes in women should be conducted.
Recommended Citation
Craffey, Carice T., "Occupational Stress: Lifestyle and Health in Blue- and White-collar Workers in the United States" (2025). CUNY Academic Works.
https://academicworks.cuny.edu/sph_etds/114
