Economic stress in the short and long term and the onset of ischemic heart disease

Tina Hannemann, Lund University
Jonas Helgertz, Lund University

Cardiovascular diseases are today the main causes of death in developed countries, accounting for more than 40 percent of all deaths. The main motivation for the study is the link repeatedly found in empirical research between income and Ischemic Heart Disease (IHD), typically explained as the result of a stress related effect originating from a poorer labor market performance. Previous studies have already emphasized the importance of a lagged measurement of income. Otherwise, due to sickness absence and recuperation following an IHD event income, measured during the same year as the IHD event, would have high probability of being affected by the event itself. This study exploits a longitudinal dataset consisting of about 50,000 Swedish men and women during the years 1992-2001, and examines the short and long effect of income on the risk of experiencing their first IHD event using logistic random effect regression. The focus on the onset of IHD is cancelling out the effect from the degenerative nature of the disease, which is increasing the risk for another IHD event massively after an initial event. More specifically, the study examines whether the individual’s absolute or relative income deprivation is more important. In the paper, relative deprivation is measured as the share of the individual’s earnings compared to what they should earn, given their gender, age and educational level and type. The study is taking advantage of a large dataset and a very precise as well as long-term measurement of absolute and relative income. The study finds no strong indications that a significant difference exist between the risk of experiencing the first IHD event between the highest and lowest category of earners.