Mortality Risks of U.S. Healthcare Workers.

Abstract

Physicians and nurses have lower annual mortality rates than the general population. One explanation for the low mortality rates of these healthcare workers emphasizes their specialized medical knowledge and greater access to healthcare while a second emphasizes their generally higher level of education. This study evaluated the extent to which general educational level accounts for the lower all-cause mortality rates of U.S. healthcare than non-healthcare workers. It also compared cause-specific mortality risks of healthcare and non-healthcare workers. A nationally representative sample of healthcare workers (n=176,000) and non-healthcare workers (n=1,662,000) from the 2008 American Community Survey (n=3,310,000) was followed through 2019 for mortality. Cox models estimated hazard ratios of all-cause and cause-specific mortality for 6 healthcare worker groups. Analyses were performed in 2024. Age- and sex-standardized all-cause death rates per 100,000 were lower for healthcare (370.7; 95% CI=361.5, 379.9) than non-healthcare (442.2; 95% CI=439.2, 445.2) workers (p<0.001). However, this difference was not evident after additionally adjusting for level of education (aHR=1.00; 0.97, 1.02). In fully adjusted models, hazards of mortality were lower for healthcare than non-healthcare workers for cardiovascular disease (aHR=0.94; 0.89, 0.99) and lung cancer (aHR=0.89; 0.81, 0.98), but higher for pancreatic cancer (aHR=1.21; 1.05, 1.39) and external causes of death (aHR=1.20; 1.10, 1.30). Higher educational attainment accounted for the longer life expectancy of U.S. healthcare workers than other workers. Nevertheless, healthcare work relative to non-healthcare work was associated with lower hazards of deaths due to cardiovascular diseases and lung cancer, but higher hazards of deaths due to external causes.