Women and work: an investigation of the association between health and employment status in middle-aged women.

Considerable controversy has appeared in recent epidemiological literature on the association between unemployment and health. Other recent research suggests that there is an association between women's employment status and their physical and mental health. Although the nature of this association has still to be specified, it is of increasing importance given the dramatic rise in work force participation in the last few decades. This paper analyzes the results of the first large U.S. epidemiological study of the menopause in over two decades, comprising a random sample (n = 8114, response rate = 77%) from the general population of women aged 45-54 in Massachusetts. Women who were employed for pay (69%), full time homemakers (24%) and women who were unemployed themselves (5%) or living with an unemployed spouse (2%) were included in this analysis of data from the cross-sectional phase of the study. Comparisons between a variety of measures and employment status are reported, as are the intervening effects of sociodemographic variables and social support measures. The importance of the 'healthy worker effect', especially for homemakers, is analyzed. Finally, a small subsample of recently unemployed women from the first round of the longitudinal phase of the study is analyzed to demonstrate additional information to be gained through a longitudinal design.