Workplace status and risk of hypertension among hourly and salaried aluminum manufacturing employees

• Published in: Social science & medicine (1982) 2009-01, Vol.68 (2), p.304-313
• Main Authors: Clougherty, Jane Ellen, Eisen, Ellen A., Slade, Martin D., Kawachi, Ichiro, Cullen, Mark R.
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aluminum; Aluminum industry; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood pressure; Cardiology. Vascular system; Contracts; Employees; Employment - classification; Employment - economics; Extraction and Processing Industry; Female; Health; Humans; Hypertension; Hypertension - economics; Hypertension - epidemiology; Hypertension - ethnology; Hypertension Manufacturing employment Occupational status Job grade Propensity scores Salaried vs. hourly workers USA; Income; Job grade; Male; Manufacturing; Manufacturing employment; Manufacturing Industries; Medical sciences; Middle Aged; Miscellaneous; Occupational Diseases - economics; Occupational Diseases - epidemiology; Occupational Diseases - ethnology; Occupational health; Occupational medicine; Occupational status; Propensity scores; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression analysis; Risk; Risk Factors; Salaried vs. hourly workers; Salaries and Fringe Benefits; Sex Factors; Stress; Stress, Psychological - economics; Stress, Psychological - epidemiology; Stress, Psychological - ethnology; U.S.A; United States - epidemiology; USA; Work environment; Workers
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2008.10.014

An inverse relationship between workplace status and morbidity is well established; higher job status has been associated with reduced risks of heart disease, hypertension, and injury. Most research on job status, however, has focused on salaried populations, and it remains unclear whether job status operates similarly among hourly workers. Our objectives were to examine whether hourly status itself influences risk of hypertension after adjustment for socioeconomic confounders, and to explore the role of fine-scale job grade on hypertension incidence within hourly and salaried groups. We examined data for 14,999 aluminum manufacturing employees in 11 plants across the U.S., using logistic regression with adjustment for age, sex, race/ethnicity and other individual characteristics. Propensity score restriction was used to identify comparable groups of hourly and salaried employees, reducing confounding by sociodemographic characteristics. Job grade (coded 1 through 30, within hourly and salaried groups) was examined as a more refined measure of job status. Hourly status was associated with an increased risk of hypertension, after propensity restriction and adjustment for confounders. The observed effect of hourly status was stronger among women, although the propensity-restricted cohort was disproportionately male (96%). Among salaried workers, higher job grade was not consistently associated with decreased risk; among hourly employees, however, there was a significant trend, with higher job grades more protective against hypertension. Increasing the stringency of hypertension case criteria also increased the risk of severe or persistent hypertension for hourly employees.