# Where we work correlates with whether we receive cardiorespiratory preventive care services: Health and Retirement Study 2003–2018

## TL;DR

Workers in industrial and general service jobs are less likely to receive preventive care for heart and respiratory health compared to those in management or science roles.

## Contribution

This study reveals occupational disparities in preventive care utilization for cardiorespiratory health among American workers.

## Key findings

- Industrial and general services workers had lower rates of cholesterol screening and influenza vaccination compared to management/science workers.
- Physical job strain and job instability were associated with reduced preventive care uptake.
- Those outside the labor force also showed lower preventive care utilization.

## Abstract

Uncontrolled dyslipidemia contributes to cardiovascular diseases, the leading cause of death among American workers, while influenza leads to significant absenteeism and presenteeism. Despite the potential productivity loss due to cardiorespiratory illness, few studies have examined occupational disparities in preventive care utilization. This study aimed to assess the influence of occupation and job characteristics on cholesterol screening and influenza vaccination utilization.

Data from the Health and Retirement Study (HRS) 2003–2018 were analyzed, representing past and current workers (N = 7,022). Occupation was coded based on the U.S. Census 1980 and 2000 and configured into five groups: management/science, social services, general services, health services, and industrial workforce. Participants who never reported job information were included in the sensitivity analysis. Job characteristics, including psychological and physical strains at work, ergonomic risk, lifting of heavy loads, and job stability, were based on self-reported questions. The influences of job category and job characteristics on cholesterol screening and influenza vaccination utilization were examined using multivariable logistic regression, multinomial logit model, and multinomial probit models.

Industrial workers and general services workers were less likely to receive cholesterol screenings and influenza vaccinations than management and science workers after controlling for social-demographic and health statuses. Frequent job-related heavy lifting and lower job-related mental strain were linked to lower cholesterol screening rates. Higher job-related physical strain and job instability were associated with reduced influenza vaccination uptake. Those outside the labor force were also less likely to undergo periodic cholesterol screening and influenza vaccination.

This study demonstrated an underutilization of preventive care services among industrial and general services workers, as well as those outside the labor force. Our findings underscore the need to promote access to preventive care services while addressing cardiovascular disease awareness and vaccination hesitancy in these populations.

The online version contains supplementary material available at 10.1186/s12889-025-24748-z.