Careful what you wish for. You're more likely to die from a heart attack when the economy is strong and unemployment is low, new research shows.

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An uptick in the nation's economy corresponds to an increased number of fatal heart attacks, according to a recent study by University of North Carolina-Greensboro economist Christopher Ruhm. The study, which tracked heart attacks against economic activity from 1979 to 1998, found that when unemployment drops by 1 percent, the number of heart-attack fatalities grows by 1.3 percent. Why? A go-go economy generally means people are working more — and have less time to take care of themselves.

Perhaps more worrisome, the most at-risk population is younger workers aged 20 to 44. “This is a group that’s more heavily involved in the workforce and may be more affected by changes,” Ruhm says. Older workers, it seems, may have more experience managing stress, or may feel more secure in their positions as they see the light at the end of the tunnel through higher accumulated salary and vacation days, or retirement.

Although past research has tied workplace stress to heart disease and overall poor health, it’s not just longer hours that contribute to the increased number of heart attacks, according to Ruhm. A number of factors are at play — more pollutants in the air from busier factories, more traffic on the roadways, more fast food and unhealthy diets, and busy employees blowing off steam with more alcohol, cigarettes, and even drugs.

Taken as a whole, these small factors add up — Ruhm’s study estimates that an annual 1 percent drop in unemployment is correlated to more than 2,500 fatal heart attacks. “We’re happier when the economy is better,” Ruhm says, “but it doesn’t mean we’re healthier.”

Some human-resources experts cite the failure of small and midsize businesses — which represent the majority of employers — to create effective workplace wellness programs that encourage workers to stay healthy, and then track the actual success of such programs. “Companies will come up with t-shirts and mugs [to promote fitness], and people lose interest after a few years,” says Ken Holtyn, president of Holtyn and Associates Health Promotion Consultants, based in Kalamazoo, Mich. “You cannot do a high-quality, effective program on a shoestring. If you’re spending $10,000 on each individual in your health plan, you should be investing 5 percent to 10 percent of that in wellness.”

Holtyn, a member of the Centers for Disease Control's Advisory Panel for Worksite Health Productivity, says that employees are a lot like the companies they work for — they care about their bottom lines as much as their waistlines. “The best incentive we’ve found is money,” Holtyn says. That doesn’t mean paying employees a per-mile rate on the treadmill, but it’s close.

Companies can build fitness and wellness programs into their benefits package, rewarding employees who stay healthy with reduced health-insurance premiums or more vacation days.
The key is measurable results. Holtyn's company assesses employee health using biometrics — like weight, blood pressure, cholesterol levels — and identifies targets for employees to meet.

When companies find success and can prove to insurers that they have a healthy, low health-risk workforce, they can negotiate health-care discounts and pass those savings along to employees. In return, companies see fewer sick days and happier employees. And when crunch time brings long hours and demanding clients, their workforce will be ready. “When times gets tough, companies that have these programs in place do well,” enabling employees to better handle the stress, Holtyn says.

Melvyn Rubenfire, director of preventative cardiology at the University of Michigan and an expert on executive health and company health management, agrees that companies need to make a better commitment to keeping their workers healthy. Managers have to “take a serious interest in their employees’ health,” says Rubenfire, adding that “when the economy revs up or goes down, the executive’s responsibility to his employees’ [health] goes up.”

He calls stress “a major problem” for heart health, and that can rise as a booming economy demands more hours from workers. For managers, that means not only keeping an eye on demanding new projects, but also looking after those working for them with an equal degree of care. With a fit, healthy workforce and good workplace health culture, those good times don’t have to be heartbreaking.

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