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Work-life imbalance increases cardiovascular disease risk
Last reviewed: 02.07.2025
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Achieving a healthy work-life balance is becoming increasingly difficult. Longer working hours, the expectation of being “on” all the time, and blurred boundaries between work and personal life mean that workers around the world are experiencing the effects of stress at work that spill over into the home sphere. This negative carryover has been shown to have adverse effects on mental health, family relationships, productivity, and job satisfaction.
In Singapore, where worker stress levels are higher than the global average, more Singaporeans are feeling mentally and/or physically exhausted by the end of the day. The "epidemic" of work-life imbalance is raising concerns about the impact on physical health.
"Until now, most studies on the effects of work-life imbalance have relied on self-reports of subjective health, such as headaches, poor sleep, loss of appetite, fatigue," said Associate Professor Andre Hartanto.
"Although subjective health indicators show that people suffer from stress and negative work-life transfer, physiological changes in the body, especially changes in the heart, are sometimes overlooked because some symptoms are silent and asymptomatic."
"This is worrying because cardiovascular disease is the leading cause of death worldwide. According to the World Health Organization (WHO), 17.9 million people die from cardiovascular disease every year.
"This is why we decided to conduct a study to specifically examine the effects of negative work-family stress on cardiovascular risk biomarkers," Professor Hartanto continued.
Professor Hartanto published the article, "Negative stress spillover from work to family and elevated cardiovascular risk biomarkers in middle-aged and older adults," in the Journal of Psychosomatic Research.
The work was carried out in collaboration with some of his former undergraduate students from Singapore Management University (SMU), including K. T. A. Sandeeswar Kasturiratna, Meilan Hu, Shu Fen Diong and Verity W. K. Lua. Sandeeswar is currently a first-year PhD student at SMU, continuing to work with Professor Hartanto. Verity has also recently started her PhD in psychology at Stanford University.
Data for the study were taken from the National Survey of Midlife Development (MIDUS) II and the MIDUS Refresher Biomarkers Project.
The MIDUS II biomarker project ran from 2004 to 2009, and the MIDUS Refresher biomarker project ran from 2012 to 2016.
The sample consisted of 1,179 employed or self-employed adults. The sample was predominantly Caucasian, representing 89% of the total. The average age of the sample was 52.64 years, and the gender ratio was nearly 50:50.
Study participants worked an average of 41 hours per week.
To measure negative work-to-family transfer, a four-item scale was developed and validated for participants to complete.
During data collection, participants spent the night at a clinical research center and underwent a physical examination, including a fasting blood sample for analysis of cardiovascular risk biomarkers.
The five biomarkers included high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, interleukin-6, and C-reactive protein.
These biomarkers have been shown to be indicators of cholesterol levels (HDL, LDL), hardening of the arteries (triglycerides), and/or inflammation of the heart (interleukin-6 and C-reactive protein). All of these markers have been identified as early markers of cardiovascular disease.
The results showed that negative work-family transference significantly predicted two biomarkers—higher triglycerides, which can lead to hardening of the arteries, and lower HDL levels, which can raise cholesterol levels. The results remained robust even after adjusting for a variety of control variables, such as demographics, medications, health status, and health-related behaviors.
This suggests that stress spillover from work to family life may cause physiological changes that contribute to cardiovascular disease. The results also showed a correlation between negative work-family spillover and inflammatory biomarkers such as interleukin-6 and C-reactive protein.
Professor Hartanto's research is a call for organisations to pay attention to work-life balance, as workplace stress can spill over into the home, impacting not only mental health and family relationships but also physical health.