Research Roundup: You’re Fired, Call An Ambulance; Black Smokers; the Insulin-Resistant Race

Being Fired Near Retirement Doubles Risk of Heart Attack and Stroke:

To fire someone just before they’re set to retire can be considered heartless for more reasons than you’d think. Involuntary job loss near retirement more than doubles the risk of heart attack and stroke, researchers at Yale School of Medicine report in a national study published in Occupational and Environmental Medicine.

“With longer follow-up and heart attack and stroke events, we were able to better assess the association between employment separation and the medical outcomes,” says Dr. William T. Gallo, the lead author of the study and associate research scientist in the Department of Epidemiology and Public Health at Yale School of Medicine.

Starting with a sample of employed individuals, the researchers identified 582 workers who were either laid off or left jobless because of a business closing. The study compared their risk of heart attack and stroke to a group that included 3,719 workers who remained employed. In considering the effect of job loss, the researchers also took into account other risk factors such as smoking, high blood pressure, obesity and depression.

“Job loss is associated with a range of stressful outcomes, including loss of pay and non-wage benefits, limited access to medical care, and severance of identification and work-based social support,” says Gallo. “Older individuals could be at increased risk for stress after being let go from work. We know that workers over 50 may have difficulty finding new positions, which frequently offer lower compensation than the pre-separation job did. This can obviously affect their later pension amount.”

African Americans Have Enhanced Brain Response to Smoking Cues:

New research may explain why Black smokers are less successful than Whites at quitting the habit. Black smokers show greater brain activations in response to smoking cues, such as individuals smoking, than White smokers, according to researchers at the University of Minnesota. The study, published in the journal Addiction Biology measured increased brain activity in regions associated with emotion and reward.

“Cigarette craving is an important challenge that smokers face when trying to quit smoking, and those with more intense cravings are more likely to relapse back to smoking,” says Dr. Kolawole Okuyemi, director of the Program on Health Disparities Research in the Medical School and associate professor in the Department of Family Medicine and Community Health.

“This study further sheds light on possible reasons for lower success rates in smoking cessation in African-Americans,” says Dr. Jasjit S. Ahluwalia, co-author and executive director of the Office of Clinical Research in the university’s Academic Health Center. “These findings add to the body of knowledge about differences in African American smokers — notably that metabolism of nicotine tends to be slower in African American smokers than in other populations.”

Race Factors In Insulin Resistance:

Black women — even if their weight is normal — may be at increased risk for insulin resistance, a condition associated with diabetes, high blood pressure and heart vessel disease, according to new research by Wake Forest University School of Medicine.

“It is well known that obesity is a contributor to insulin resistance,” says Dr. Jorge Calles-Escandon, an associate professor of endocrinology. “Our research suggests that race may also be an important factor. Almost half of lean, Black women had insulin resistance — double the rate in Hispanic or Caucasian women.”

The goal of the study was to see how obesity relates to insulin resistance in three ethnic groups: Black, Caucasian and Hispanic. Insulin resistance is when the body does not effectively use the hormone insulin to process glucose, forcing the pancreas to produce more insulin. Researchers analyzed data from the Insulin Resistance Atherosclerosis Study (IRAS), designed to assess relationships between insulin resistance and cardiovascular disease in a large multi-ethnic population.

The analysis revealed that 47 percent of Black women of normal weight had insulin resistance, compared to less than 20 percent of the Hispanic or White women.

“If the results hold true, Black women may need to be evaluated and treated for insulin resistance and cardiovascular disease even at weight not considered obese by current standards,” says Calles-Escandon.

He says additional research is needed to explore how obesity relates to insulin resistance in men, as well as whether the women with insulin resistance have a higher percentage of body fat, or body fat that is distributed differently, from the White or Hispanic women.

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