Self-employed Hispanic women report less high blood pressure, obesity, diabetes, poor health and binge drinking compared to Hispanic women working for salary or wages, new research suggests.
The findings, published in the peer-reviewed journal Ethnicity & Disease, suggest that work structure may be related to cardiovascular disease (CVD) risk among this group, said Dr. Kimberly Narain, assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA and the study’s senior author.
“Hispanic women experience a disproportionate burden of heart disease compared to non-Hispanic women,” said Narain, who is also director of Health Services and Health Optimization Research for the Iris Cantor-UCLA Women’s Health Center. “This is the first study to link the structure of work with risks for heart disease among this group of women.”
The researchers examined 2003-2022 data from the Behavioral Risk Factor Surveillance System to examine the association between self-employment, cardiovascular disease risk factors and health outcomes for Hispanic women. The data included 165,600 Hispanic working women. Of those, about 21,000, or 13%, were self-employed rather than working for wages or a salary.
Overall, the researchers found that self-employed women were less likely to report CVD-associated health problems. They were also about 11% more likely to report exercising compared with their non-self-employed counterparts.
Specifically, they found that they had:
- 1.7 percentage point lower chance of reporting diabetes (roughly 23% decline)
- 3.3 percentage point lower chance of reporting hypertension (roughly 17% decline)
- 5.9 percentage point lower chance of reporting obesity (roughly 15% decline)
- 2.0 percentage point lower chance of reporting binge drinking (roughly 2% decline)
- 2.5 percentage point lower chance of reporting poor or fair overall health (roughly 13% decline)
The relationship between heart disease risks and the structure of work among Hispanic women was not driven by access to healthcare or differences in income, Narain said.
“In fact, the decrease in high blood pressure linked to self-employment was nearly as large as the decrease in high blood pressure linked to being in the highest income group,” she said.
The study has some limitations. Among them, the researchers relied on self-reported outcomes, which might be less reliable among ethnic and racial minorities and those from a lower socioeconomic background, the researchers write. In addition, the researchers’ definition of “poor mental health” does not entirely match the accepted definition in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. They also did not have data allowing them to examine the specific types of occupations held by the women.
The study design also cannot prove any causal relationships between self-employment and CVD risk, which is a subject that the researchers will explore. “The next step in the research is to conduct studies that are able to better assess if the structure of work is a cause of higher heart disease risks among Hispanic women,” Narain said.
Study co-authors are Lisette Collins, who led the research, and Dr. Frederick Ferguson of UCLA.
Grants from The Iris Cantor-UCLA Women’s Health Center-Leichtman-Levine-TEM program and the UCLA National Clinician Scholars Program supported this research.
