Billy Joel sang, "Working too hard can give you a heart attack, ack, ack, ack, ack, ack." But here's something you oughta know by now: It turns out that losing your job can give you a heart attack, too.
A new Duke University study published in The Archives of Internal Medicine found that being unemployed, experiencing multiple job losses and even going for a short period without work was tied to a greater chance of heart attack for people between the ages of 51 and 75.
(MORE: Stress and Its Adverse Effect on the Human Heart)
The risk of a cardiac event was a stunning 35 percent higher among the unemployed than those who hadn't experienced job loss, after adjusting for other factors, like hypertension and cholesterol, according to the study's author, Matthew E. Dupre, an assistant professor of medicine at Duke, and his colleagues. That risk was "particularly elevated" during the first 12 months of unemployment.
Job Losses: On a Par With Smoking
What's more, the odds of suffering a heart attack among those who lost multiple jobs were on a par with smoking. The study — the first to examine the cumulative effect of unemployment on heart health — found the more jobs someone had lost, the higher his or her risk.
Losing a job once upped the chance of a heart attack by 22 percent; losing one twice, 27 percent; three bouts of unemployment, 52 percent. Those who had been shown the door four or more times had a 63 percent higher risk for heart attack.
Dupre was pretty surprised by the findings. "We knew from prior research that unemployment would be associated with increased risks for a heart attack," he told me. "However, we didn't expect that the effects would be as large and robust as this."
It's unclear precisely why job loss and heart attacks are so correlated, but Dupre has some ideas. "We suspect that a combination of elevated stress, diminished health maintenance and the loss of resources are important contributing factors," he said.
Divorced Women’s Declining Health
The study reminded me of new findings about women's health post-divorce that my Next Avenue colleague Kerry Hannon just wrote about. The University of Michigan report found that many women who lose their health insurance after getting divorced then endure a nasty downward spiral in health. Without insurance, women forgo checkups, medications and other preventive care to save money. Dupre is essentially saying that unemployment over 50 may lead men and women to let their health go.
(MORE: Gender Differences and Heart Disease)
I view the results of the Duke study as a clarion call to anyone who is out of work as well as to everyone in their 50s, 60s and 70s who is employed (since the ax may well fall someday): If you lose your job, you must safeguard your heart health.
Advice for the Unemployed
For advice on how to help prevent a heart attack when you're unemployed, I turned to Dupre and Melanie Greenberg, a psychologist in Marin County, Calif., who wrote an excellent article in Psychology Today, "Preserving Mental Health During Unemployment."
"There should be an awareness by those who have lost their jobs that the stress and adjustment related to unemployment may have serious health consequences," Dupre said. "Additional vigilance in staying healthy and knowing the signs and symptoms of a heart attack are critical during times of heightened stress."
Chest pain or discomfort is the most common symptom; the pain sometimes feels like indigestion or heartburn. But women are less likely than men to feel chest pain during a heart attack.
Time to See Your Doctor
Dupre added that if you lose your job, you should tell your doctor so he or she can be alert for telltale signs or symptoms. Get your LDL cholesterol and blood pressure levels checked, since both can trigger heart disease. Ask your physician about ways to improve your diet and fitness. A checkup is particularly important if you've had a history of unemployment, since the study shows that you're at an especially high risk of a heart attack.
Greenberg called the study's findings "striking," although she noted that other factors happening just before unemployment — like stress leading up to the job loss — could also be contributing factors.
"It's also possible that some personality trait, such as hostility, raises the risk of being fired and causes chronic physiological stress," which could be the root cause of both job loss and heart disease, she added.
The Stress of a Job Loss
Greenberg said that losing your job is "an acute and chronic stressor — it can set a cascade of other negative events into action, such as putting a strain on your marriage." Repeated job losses can "wear a person out physiologically," she said.
And, Greenberg said, the stress brought on by unemployment can lead you to feel helpless and hopeless, which could lead to depression, an independent risk factor for heart disease. "You can't relax because you don't know when the next shoe is going to drop," she said.
4 Tips for Heart Health
The psychologist, who has expertise in stress management and what’s known as "mindfulness" (learning how to accept the uncontrollability and changing nature of life), offered four recommendations to help ward off a heart attack during unemployment:
1. Adopt a "mindful perspective." That means living in the moment and not regretting the past or worrying about the future.
2. Focus on the positive aspects of your life. Losing your job can be a wrenching experience, but try to force yourself to appreciate what's good about your life, like your relationship with your family and friends.
3. Try mindfulness meditation. Sit up straight and create slow, rhythmic waves of breath. Meditation consultant Jeff Cannon, profiled in a Next Avenue article, recommended starting with five to 10 minutes a day of mindfulness meditation and eventually building up to an hour or more.
4. If you've lost your job repeatedly, analyze the cause. You may see a pattern that suggests it's time to make a meaningful change in your work life.
The layoffs could be telling you that your industry is in a constant state of downsizing and that it's time for you to switch careers. Alternatively, it could be something about your work personality that has led to repeated job losses — a gruffness that alienates colleagues or an inability to handle office politics effectively. "Get feedback from your former colleagues," Greenberg suggested.
(MORE: Positive Steps to Take After Losing a Job)
You just might realize that you'd be better off working for yourself or for a different type of employer.
One Last Piece of Advice
Greenberg's advice is smart and I'd add one more tip: Don't beat yourself up.
As Sallie Krawcheck, the former head of wealth management at Citigroup and Bank of America who's now in contention to run the Securities and Exchange Commission recently wrote on her LinkedIn blog: "If you haven't been fired at least once, you're not trying hard enough."