Intersectional impacts of sex and gender on employment outcomes in patients with atrial fibrillation: a systematic review and meta-analysis
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Date
2025
Authors
Okeowo-Grant, Maryam A.
University of Lethbridge. Dhillon School of Business
Journal Title
Journal ISSN
Volume Title
Publisher
Lethbridge, Alta. : University of Lethbridge, Dhillon School of Business
Abstract
Abstract
Background
More than 33 million people worldwide suffer from Atrial Fibrillation (AF) (Chugh et al., 2014; Goren et al., 2013). The objective of this systematic review and meta-analysis was to explore the research question: How does sex and gender impact employment outcomes in adult patients with atrial fibrillation?
Methods
A systematic search was conducted in accordance with the PRISMA 2020 guidelines using keywords and MeSH terms related to atrial fibrillation, employment, sex and gender. Studies were included if they presented sex or gender-specific outcomes or employment outcomes for adults with AF. Data was presented in forest plots and using I² statistics.
Data Synthesis and Analysis
A fixed-effects meta-analysis was conducted using R software. Results were expressed as Odds Ratios (ORs) and 95% confidence intervals (95% CIs). The I² statistic was used to assess statistical heterogeneity. Forest plots were generated to represent effect sizes and heterogeneity visually
Results
A total of twenty studies met the inclusion criteria for qualitative synthesis, and eight were included in the quantitative meta-analysis. Pooled data indicated that males with atrial fibrillation (AF) had 24% lower odds of unemployment compared to females (OR = 0.76, 95% CI: 0.65–0.86). Unemployment was associated with a 44% increased risk of AF (OR = 1.44, 95% CI: 1.29–1.59). Shift work was linked to an 11% higher risk of incident AF (OR = 1.11, 95% CI: 1.05–2.17), although heterogeneity was substantial (I² = 90.59%). Many studies conflated sex and gender.
Conclusions
The findings from this study suggest that structural inequities tied to sex and gender exacerbate employment challenges and health risks for AF patients. Policies that provide flexible scheduling, caregiving support, and equitable labour conditions may reduce the socioeconomic and cardiovascular burdens associated with AF.
Description
Keywords
employment outcomes , employees with atrial fibrillation , sex and gender , unemployment and AF