Work-life imbalance increases risk of cardiovascular disease

Achieving a healthy work-life balance is becoming increasingly difficult. Longer work hours, expectations of being “on” all the time, and blurred boundaries between work and personal life mean that workers around the world are experiencing the effects of stress at work that spill over into the home sphere. This negative transference has been shown to have adverse effects on mental health, family relationships, work productivity and job satisfaction.

In Singapore, where worker stress levels are higher than the global average, more Singaporeans are feeling mentally and/or physically exhausted at the end of the day. An "epidemic" of work-life imbalance is raising concerns about the impact on physical health.

“Until now, most studies on the effects of work-life imbalance have relied on self-reports of subjective health, such as headaches, poor sleep, loss of appetite, fatigue,” said Associate Professor André Hartanto.

"Although subjective health readings show that people suffer from stress and negative work-to-life transference, physiological changes in the body, especially changes in the heart, are sometimes overlooked because some symptoms are silent and asymptomatic."

"This is concerning because the leading cause of death in the world is cardiovascular disease. According to the World Health Organization (WHO), 17.9 million people die from cardiovascular disease every year.

“That’s why we decided to conduct a study to specifically examine the effects of negative work-family spillover on biomarkers of cardiovascular risk,” continued Professor Hartanto.

Professor Hartanto published the article “Negative work-to-family stress transfer and increased biomarkers of cardiovascular risk in middle-aged and older adults” in the Journal of Psychosomatic Research.

The work was carried out in collaboration with some of his former undergraduate students from Singapore Management University (SMU), including K.T.A. Sandiesvara Kasturiratna, Meilan Hu, Shu Feng Diong and Verity W. K. Lua. Sandieswar is currently a first-year doctoral student at SMU, continuing to work with Professor Hartanto. Verity also recently began her doctorate in psychology at Stanford University.

Data for the study were taken from the National Midlife Development Survey of the United States (MIDUS) II and the MIDUS Refresher Biomarker Project.

The MIDUS II biomarker project ran from 2004 to 2009, and the MIDUS Refresher biomarker project ran from 2012 to 2016.

The sample consisted of 1,179 employed or self-employed adults. The sample was predominantly Caucasian, representing 89% of the total. The average age of the sample was 52.64 years, and the gender ratio was almost 50:50.

Study participants worked an average of 41 hours per week.

A four-item scale was developed and validated to measure negative work-to-family spillover and was completed by participants.

During data collection, participants spent an overnight stay at a clinical research center and underwent a physical examination, including a fasting blood sample for analysis of biomarkers of cardiovascular risk.

The five biomarkers included high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, interleukin-6, and C-reactive protein.

These biomarkers have been shown to be indicators of cholesterol levels (HDL, LDL), hardening of the arteries (triglycerides) and/or heart inflammation (interleukin-6 and C-reactive protein). All of these markers have been identified as initial markers of cardiovascular disease.

The results showed that negative work-to-family transfer was significantly predicted by two biomarkers - higher triglycerides, which can lead to hardening of the arteries, and lower HDL levels, which can increase cholesterol levels. The results remained robust even after adjusting for a variety of control variables, such as demographics, medications, health status, and health-related behavioral factors.

This suggests that the transfer of stress from work to family life may cause physiological changes that contribute to cardiovascular disease. The results also showed a correlation between negative work-family spillover and inflammatory biomarkers such as interleukin-6 and C-reactive protein.

Professor Hartanto's research is a call for organizations to pay attention to work-life balance, as stress in the workplace can spill over into the home, affecting not only mental health and family relationships, but also physical health.