Work Stress and Coronary Heart Disease - Nursing Assignment Help

Assignment Task:

Task:

Aims To determine the biological and behavioural factors linking work stress with coronary heart disease (CHD).
Methods
and results

A total of 10 308 London-based male and female civil servants aged 35–55 at phase 1 (1985–88) of the Whitehall II study were studied. Exposures included work stress (assessed at phases 1 and 2), and outcomes included behavioural risk factors (phase 3), the metabolic syndrome (phase 3), heart rate variability, morning rise in cortisol (phase 7), and incident CHD (phases 2–7) on the basis of CHD death, non-fatal myocardial infarction, or definite angina. Chronic work stress was associated with CHD and this association was stronger among participants aged under 50 (RR 1.68, 95% CI 1.17–2.42). There were similar associations between work stress and low physical activity, poor diet, the metabolic syndrome, its components, and lower heart rate variability. Cross-sectionally, work stress was associated with a higher morning rise in cortisol. Around 32% of the effect of work stress on CHD was attributable to its effect on health behaviours and the metabolic syndrome.

Conclusion Work stress may be an important determinant of CHD among working-age populations, which is mediated through indirect effects on health behaviours and direct effects on neuroendocrine stress pathways.

Keywords Work stress † Autonomic nervous system † Myocardial infarction † Angina † Coronary heart disease Psychosocial

Do Socioeconomic Disadvantages Persist Into Old Age? Self-Reported Morbidity in a 29-Year Follow-Up of the Whitehall Study

There is a small but growing body of evi-dence from the United Kingdom that socioeco- nomic differentials in mortality persist into old age1–3 and may even be widening.4,5 Although rate ratios tend to be smaller for older people than for younger people in the United Kingdom and the United States,4–6 absolute differentials can still be large.5 There is little equivalent information on self-reported morbidity. Analyses of cross- sectional studies show that self-reported health and disability, respiratory function, and blood pressure are all worse among older people in disadvantaged socioeconomic groups.7,8Analy- ses of the Office for National Statistics Lon- gitudinal Study in England and Wales showed that adverse socioeconomic circumstances were associated with self-reported limiting long- term illness after a 20-year follow-up period among survivors.9

Employment grade and coronary heart disease in British civil servants

SUMMARY The relationship between grade of employment, coronary risk factors, and coronary heart disease (CHD) mortality has been investigated in a longitudinal study of 17 530 civil servants working in London. After seven and a half years of follow-up there was a clear inverse relationship between grade of employment and CHD mortality. Men in the lowest grade (messengers) had 3-6 times the CHD mortality of men in the highest employment grade (administrators). Men in the lower employment grades were shorter, heavier for their height, had higher blood pressure, higher
plasma glucose, smoked more, and reported less leisure-time physical activity than men in the higher grades.

Context:
This assignment covers learning topics from Module 2.1 and 2.2

PUBH6005: Epidemiology Assignment
This assessment is aimed at consolidating the students understanding of Module 2 content By prescribing this assessment, students are able to reflect on their understanding of study design, sampling and population risk

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