Chronic disease risk factors among multiethnic blue-and white-collar workers in Hawaii

Abstract

Blue-collar workers (BCW) are reported to have a higher prevalence of obesity and hypertension, compared to white-collar workers (WCW). Learning factors related to high prevalence of diseases among BCW is needed to effectively address them in worksite health promotion efforts. The purpose of this three-paper dissertation is to identify factors related to the high prevalence of obesity and hypertension among BCW. Chapter one provides an overview on literature reporting sociodemographic, behavioral, health, and job characteristics of BCW. Chapter two presents findings from the first study, reporting on associations between occupational types and obesity among subscribers of a health plan in Hawaiʻi who completed the Succeed questionnaire. The association between being a BCW and obesity was attenuated by ethnicity, with an inverse association seen after controlling for education. Ethnic minorities and those with low education levels should be targeted in obesity reduction efforts. Chapter three presents findings from the second study, which estimated associations between occupational types and hypertension, among Kohala Health Research Project participants. Being a BCW was not associated with hypertension, after controlling for obesity and ethnicity. Efforts to decrease hypertension among workers should focus on reducing obesity and should target ethnic groups at higher risk. Chapter four reports on the final study, which identified supports and barriers to healthy eating and physical activity among workers of a health care organization in Hawaiʻi. WCW cited onsite availability of health and fitness opportunities as supportive, while lack of the same and job demands were barriers to healthy behaviors. BCW saw their ability to bring home lunch and their jobs as supportive of healthy behaviors, and that not having enough time to eat and illness/injury were barriers. Differing influences to health, among BCW and WCW, should be considered when developing a worksite wellness program. Taken together, the three studies suggest that high prevalence of obesity and hypertension among BCW may be associated with their ethnic minority status and lower educational levels, rather than their blue-collar jobs per se. Findings from these studies can help inform development of worksite health promotion programs relevant to both WCW and BCW.