Mortality of Men versus Women in Comparable High-level Jobs: 15-Year Experience in the Federal Women's Study

• Published in: American journal of epidemiology 2001-08, Vol.154 (3), p.221-229
• Main Authors: Detre, Katherine M., Kip, Kevin E., Feinleib, Manning, Matthews, Karen A., Belle, Steven
• Format: Article
• Language: English
• Subjects: Administrative Personnel - statistics & numerical data; Administrative Personnel - trends; Adult; Age Distribution; Aged; Analysis. Health state; Biological and medical sciences; cardiovascular disease; Cause of Death; chronic obstructive pulmonary disease; Cohort Studies; COPD; CVD; Epidemiology; European Continental Ancestry Group; Female; follow-up studies; General aspects; General Schedule; Government Agencies - organization & administration; Government Agencies - statistics & numerical data; Government Agencies - trends; Heart Diseases - mortality; Humans; Male; Medical sciences; men; Middle Aged; mortality; Mortality - trends; Multivariate Analysis; National Death Index; NDI; Neoplasms - mortality; occupations; Occupations - statistics & numerical data; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sex Distribution; Sex Factors; sex ratio; SMR; standardized mortality ratio; United States - epidemiology; women
• ISSN: 0002-9262; 1476-6256; 0002-9262
• DOI: 10.1093/aje/154.3.221

The authors investigated exposure to high-level occupations in relation to the well-known survival advantage of women compared with men of the same age. Women in the federal workforce in positions of General Schedule 14 and above in 1979–1993 (n = 4,727) were each matched with three men (n = 14,181) by age, General Schedule level, and supervisory role. Fifteen-year mortality rates were compared between men and women and against expected 15-year mortality from the US general population. Despite similar job demands, women experienced markedly lower 15-year mortality than did men. However, men in these positions had nearly 50% lower mortality compared with age-matched men in the general population; the comparable reduction for women was 38%. The simultaneous substantial, but unequal by gender, improvement in mortality resulted in a reduced male/female mortality ratio, from 1.67 in the general population to 1.40. The reduced male/female mortality ratio was especially prominent for cancer and was not evident for heart disease mortality. Survival was nominally higher in non-White than in White participants. In summary, high-level employment is associated with substantially reduced mortality in both men and women. The relative improvement in survival is greater in men despite a comparable reduction in risk of heart disease mortality by gender.