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Occupation and Coronary Disease: Schooling as a Confounder

J. Paul Leigh
JAMA. 1988;259(10):1496-1497. doi:10.1001/jama.1988.03720100018018.
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To the Editor.  —Buring et al1 recently reported an interesting correlation between occupational status and heart disease. White-collar workers were found to have a statistically significant 30% decreased risk of fatal coronary heart disease compared with blue-collar workers once the effects of other coronary risk factors were considered. The additional risk and controlling factors considered included age, gender, neighborhood, Jewish religion, relative weight, exercise level, and medical history variables. The evidence of Buring et al is potentially useful since it could be used to target groups for medical interventions as well as to point directions for future researchers who are interested in investigating the psychosocial and job-specific correlates of heart disease. One correlate that future researchers should investigate is years of schooling, which was unfortunately omitted by Buring et al. Schooling has been found to be strongly correlated with many diseases and measures of overall health as well as


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