Department of Health Services, University of Washington School of Public Health and Community Medicine, Seattle, USA.
Am J Health Promot. 2010 May-Jun;24(5):315-23. doi: 10.4278/ajhp.080603-QUAN-77.
To examine the prevalence of health behaviors, including clinical preventive services and lifestyle risk behaviors, among insured workers and to determine whether disparities in health behaviors based on demographic factors exist among this group.
Cross-sectional analysis of 2004-2005 Behavioral Risk Factor Surveillance System data.
United States.
. A representative sample of noninstitutionalized employed and insured adults aged 18 to 64 years (139,738 in 2004 and 159,755 in 2005).
Self-reported clinical preventive services utilization and lifestyle-related behaviors, as well as multiple logistic regression analyses assessing the independent effects of demographic and access variables on health behaviors.
Among insured workers, rates of not using recommended clinical preventive services ranged from 8.5% (cervical cancer screening) to 73.9% (influenza vaccination). Rates for engaging in lifestyle-related risks ranged from 5.5% (heavy drinking) to 77.1% (inadequate fruit-vegetable consumption). In multivariate analyses, lower income, lower education, cost as a barrier to health care, and no health care provider were associated with significantly decreased clinical preventive services utilization (p < .01). Lower education and no health care provider were associated with lifestyle-related risks (p < .01).
Working insured adults are not meeting recommendations for health behaviors. Significant disparities in health behaviors related to socioeconomic status exist among this group. Employers and insurers should consider these poor health behaviors and disparities when designing insurance benefits addressing clinical preventive services utilization and workplace health promotion programs addressing lifestyle-related behaviors.
调查参保职工健康行为（包括临床预防服务和生活方式风险行为）的流行情况，并确定该人群是否存在基于人口统计学因素的健康行为差异。
2004-2005 年行为危险因素监测系统数据的横断面分析。
美国。
18-64 岁非住院就业且参保的成年人的代表性样本（2004 年 139738 人，2005 年 159755 人）。
自我报告的临床预防服务利用情况和与生活方式相关的行为，以及多变量逻辑回归分析，评估人口统计学和获得因素对健康行为的独立影响。
在参保职工中，不使用推荐的临床预防服务的比例从 8.5%（宫颈癌筛查）到 73.9%（流感疫苗接种）不等。生活方式相关风险的比例从 5.5%（大量饮酒）到 77.1%（水果-蔬菜摄入不足）不等。在多变量分析中，收入较低、教育程度较低、医疗费用是获得医疗服务的障碍以及没有医疗服务提供者与临床预防服务利用率显著下降相关（p<0.01）。教育程度较低和没有医疗服务提供者与生活方式相关风险相关（p<0.01）。
有工作的参保成年人不符合健康行为的建议。该人群中存在与社会经济地位相关的健康行为显著差异。雇主和保险公司在设计涵盖临床预防服务利用率的保险福利和解决与生活方式相关行为的工作场所健康促进计划时，应考虑这些不良健康行为和差异。
