BACKGROUND: The American Heart Association established seven ideal cardiovascular health behaviors or modifiable factors to improve cardiovascular disease (CVD) outcomes. These cardiovascular health metrics (CHMs) are 1) not smoking, 2) being physically active, 3) having normal blood pressure, 4) having normal blood glucose, 5) being of normal weight, 6) having normal cholesterol levels, and 7) eating a healthy diet (2). Meeting six or all seven CHM is associated with a lower risk of all-cause CVD and ischemic heart disease mortalities compared with persons who meet none or only one CHM. Fewer than 2% of U.S. adults meet all seven of the CHMs. Cardiovascular morbidity and mortality account for an estimated annual $120 billion dollars in lost productivity in the workplace; thus, workplaces are viable settings for effective health promotion programs. The study objectives were to evaluate cardiovascular health status among workers and determine if an association between occupation and CHM score exists.
METHODS: We analyzed data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS) industry and occupation module, which was implemented in 21 states. Currently-employed participant responses to the occupation question were coded using Bureau of Census (2002) occupation codes; these were grouped for analysis into 22 Standard Occupational Classification System (SOC) major groups. Responses for each of the seven CHM were scored as ‘0’ for not ideal or ‘1’ for meeting the ideal of that individual metric and summed for a score 0–7. For the purposes of this study, the CHM score was dichotomized into two groups: 0–2 and 3–7. CHM scores were analyzed by occupation group, adjusted for the sociodemographic variables including age, sex, race/ethnicity, and education level using weighted logistic regression models in SUDAAN.
RESULTS: Among all occupational groups, community and social services employees (14.6%), transportation and material moving employees (14.3%), and architecture and engineering employees (11.6%) had the highest adjusted prevalence of meeting two or fewer CHMs. Transportation and material moving employees also had the highest prevalence of “not ideal” (“0” [i.e., no CHMs met]) scores for three of the seven CHMs: physical activity (54.1%), blood pressure (31.9%), and weight (body mass index [BMI]; 75.5%).
CONCLUSIONS: Significant disparities in cardiovascular health status exist among U.S. occupational groups even after adjusting for relevant sociodemographic characteristics. The results of this study can be used by state organizations and employers to target cardiovascular disease prevention programs and improve workplace health promotion programs.