Abstract
Background
Cardiovascular diseases (CVD) were related to financial stress. Little was known about the effects of financial crisis on cardiovascular health by occupations. This study examined CVD hospitalisations before and during the 2008 financial crisis among five occupational groups in Taiwan.
Methods
Data were collected from the Taiwan Survey on Hypertension, Hyperglycemia and Hyperlipidaemia 2007, including 4,673 participants aged 20 and above, categorized into five types of occupations, i.e., professional & manager (PM), office clerk & administrative staff (OA), skilled work (SW), unskilled worker (UW) and non-worker (NW). We abstracted their CVD hospitalisation records in the three years before (September 2005 to August 2008) and during the 2008 financial crisis (September 2008 to August 2011) from the National Health Insurance Research Database. Using incidence rate ratios (IRRs), we compared CVD hospitalisation of the first, second, third year from September 2008 to the three-year average before September 2008 for five occupational groups. Random effect negative binomial models were performed to estimate IRRs.
Results
After adjusting for covariates including age, sex, education, smoking, alcohol drinking, exercise and body mass index, there was an increase of CVD hospitalisation incidence for NW in the first year of the financial crisis (IRR=1.46, 95% Confidence Interval [95% CI]=1.19-1.77); in the second year, SW had a raised risk of CVD hospitalisation (IRR= 2.71, 95% CI = 1.59-4.60). For all occupational groups, the incidence rates of CVD hospitalisation reached the peak in the third year (PM: IRR=2.68, 95% CI = 1.05-6.83; OA: IRR=2.70, 95% CI = 1.18-6.19; SW: IRR=5.13, 95% CI = 2.89-9.09; UW: IRR=2.12, 95% CI = 1.02-4.41; NW: IRR=1.85, 95% CI = 1.18-2.67).
Conclusions
CVD hospitalisation of all occupations were affected by the financial crisis; when non-workers were the early victims, skilled workers may be the most vulnerable in the 2008 financial crisis.
Key messages
This study investigated the effects of the 2008 financial crisis on cardiovascular disease hospitalization by five occupational types in Taiwan. All occupations, particularly skilled workers, were affected by the financial crisis.