Self-employed women report a lower risk of developing high blood pressure, obesity, and diabetes compared to women who have a salary or work for wages, according to a new study led by UCLA Health researchers.
Study authors Dr. Kimberly Narain and medical student Sedina Dzodzomenyo aimed to research cardiovascular disease risk in women through the lens of work structure in part because social hierarchies and social roles play a significant part in determining health status. The investigators were interested in cardiovascular diseases in particular because it’s the leading cause of death among women, and stress has been associated with high blood pressure, which can pose a risk for heart attack and stroke. Previous studies suggest that some types of work can increase stress for women.
To conduct the study, published in BMC Women’s Health, the researchers analyzed survey data collected from 2016 to 2018 from the University of Michigan Health and Retirement Study (HRS). The data came from 4,624 women who were either self-employed, working for wages, or salaried employees. The authors studied the relationship between work structure and the participants’ self-reported responses about risk factors for cardiovascular diseases.
The researchers found that self-employed women had a 43% lower risk of reporting high blood pressure, a 34% lower risk of reporting obesity, and a 30% lower risk of reporting diabetes compared to women who work for a salary or wages. Self-employed women were also more likely to report exercise and a lower body mass index. Interestingly, these results were not explained by differences in access to health care, implying that factors outside of health care are responsible for the relationship between self-employment and cardiovascular risk.
Narain said there is an array of reasons why self-employment may lead to better cardiovascular health. “Self-employed women may have more flexibility in terms of setting their schedule, more control, more autonomy, and less exposure to gender-based discrimination in the work setting,” Narain said. She added that self-employed women may also face less stress balancing raising a family and working compared to those in a traditional work setting. Women who work for a salary or wages may also be perceived as less capable than men, particularly women with children who might not advance as quickly in their careers, potentially causing stress-induced cardiovascular issues, according to Narain.
Building upon this observational study, Narain said the next steps are to research the specific ways that traditional work settings may cause cardiovascular disease in women. Given the potential health benefits of self-employment, Narain also said federal support should be allocated to women entrepreneurs and organization leaders should implement the health-promoting aspects of self-employment into traditional work environments. “What sort of aspects of entrepreneurship are beneficial for health that can be transferred into traditional workplaces, so people can derive that benefit, flexibility, and autonomy of a good social environment? These can be retention and recruitment strategies as well as workplace wellness strategies.”
Funding: the Leichtman-Levine-TEM Summer Mentorship in Women's Health Research at the Iris Cantor-UCLA Women's Health Center.