Keywords: Self- employment, Hispanic women’s cardiovascular health

Background: Relative to most other racial and ethnic subgroups of women, Hispanic women experience more heart disease-related morbidity and mortality. Elements of work structure such as the level of autonomy and flexibility may influence heart disease risk directly through impacting psychosocial stress and indirectly by influencing health-related behaviors (e.g. exercise). Hispanic women are over-represented in jobs with low autonomy and flexibility. Self-employment has been associated with a more favorable heart disease risk profile among women, relative to work for salary or wages, however, few studies have explored the relationship between work structure and risk factors for heart disease among Hispanic women. 

Objective: Examine the association between self-employment, heart disease risk factors and health-related behaviors among working Hispanic women.

Methods: Using data from the Behavioral Risk Factor Surveillance System (2003-2022) and linear probability models (linear regression applied to dichotomous outcomes), we conducted a weighted pooled cross-sectional analysis to explore the association between self-employment, and several outcomes including risk factors for heart disease (hypertension, obesity and diabetes), poor-health and health-related behaviors (smoking, binge drinking and exercise) among Hispanic women. Self- employment was coded as “1” and working for wages/ salary was coded as “0”. Statistical models were adjusted for demographics, language, socioeconomic status, family structure (number of minor children, marital status) and insurance coverage as well as state and year-fixed effects.

Results: Relative to working for wages or salary, self-employment was associated with a statistically significant (p-value <.05) 1.6, 3.2, 6.0, 2.4 and 1.7 percentage-point decline in the probability of reporting diabetes, hypertension, obesity, poor health and binge drinking, respectively as well as an 8.5 percentage-point increase in the probability of reporting any exercise.

Conclusions: Among Hispanic women, self-employment was associated with fewer heart disease risk factors and a more favorable health profile, relative to work for wages or salary.