Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
Department of Health Studies, American University, Washington, DC, USA.
J Racial Ethn Health Disparities. 2023 Oct;10(5):2207-2217. doi: 10.1007/s40615-022-01400-9. Epub 2022 Sep 6.
There is a large literature on work-related characteristics and hypertension, but studies on self-employment, longer working hours, and hypertension are mixed. Assessments of self-employment should be extended to account for people with part-time self-employment (i.e., employees also earning income from self-employment). The aim of this study was to determine the association of different types of self-employment with hypertension among adults by race/ethnicity and to assess whether longer working hours moderated these associations. Using data from the 2007-2018 National Health and Nutrition Examination Survey, measured hypertension (blood pressure ≥ 140/90 mm Hg) was assessed and employment categories included employees, part-time self-employment (i.e., employee with self-employment income), or full-time self-employment. Modified Poisson regressions and multiplicative interaction terms were used. Having full-time self-employment was associated with lower relative risk (RR) of hypertension compared to employees among Black (RR = 0.77, 95% confidence interval (CI) = 0.61-0.96) and White men (RR = 0.77, 0.65-0.93) compared to employees. Full-time self-employment was associated with higher risk of hypertension (RR = 1.36, 95% CI = 1.01-1.82) compared to employees among Hispanic women, while part-time self-employment was associated with lower risk (RR = 0.69, 95% CI = 0.48-0.98). Among White women, part-time self-employment was associated with higher relative risk of hypertension (RR = 1.27, 95% CI = 1.05-1.53) compared to employees. There were significant interactions between employment categories and longer working hours among Hispanic women as well as Black women and men. The results suggest that self-employment categories and longer working hours impact hypertension by race/ethnicity and sex. Because the number of full-time and part-time self-employed adults has increased, the health of this particular subgroup of workers should be further addressed.
关于与工作相关的特征和高血压，已有大量文献，但关于自营职业、工作时间延长与高血压的研究结果不一。对自营职业的评估应扩展到包括兼职自营职业者（即也从自营职业中获得收入的雇员）。本研究的目的是按种族/民族评估不同类型的自营职业与成年人高血压之间的关联，并评估工作时间延长是否会调节这些关联。本研究使用了 2007-2018 年全国健康和营养检查调查的数据，评估了高血压（血压≥140/90mmHg），并将就业类别分为雇员、兼职自营职业（即有自营职业收入的雇员）或全职自营职业。采用修正泊松回归和乘法交互项。与雇员相比，黑人和白人男性中的全职自营职业与高血压的相对风险（RR）较低（RR=0.77，95%置信区间（CI）=0.61-0.96），而黑人和白人男性中的全职自营职业与高血压的相对风险（RR=0.77，0.65-0.93）相比，与雇员相比，高血压的风险更高（RR=1.36，95%CI=1.01-1.82），而兼职自营职业与高血压的风险较低（RR=0.69，95%CI=0.48-0.98）。与雇员相比，白种女性的兼职自营职业与高血压的相对风险较高（RR=1.27，95%CI=1.05-1.53）。在西班牙裔女性以及黑人和男性女性中，就业类别与工作时间延长之间存在显著的交互作用。结果表明，自营职业类别和工作时间延长会因种族/民族和性别而异影响高血压。由于全职和兼职自营职业者的数量有所增加，应进一步关注这一特定工人群体的健康问题。
