title: The effectiveness of using the workplace to identify and address modifiable health risk factors in deprived populations.
abstract: OBJECTIVE
  To establish whether a programme of targeted health screening, with referral to appropriate interventions, offered to an employed but socioeconomically deprived group was effective in overcoming barriers to uptake of such services and improving a range of surrogate health markers for participants.
  
  
  METHODS
  Low-paid local government employees from socially and economically deprived areas in North-East England were invited to attend a free health check. Health checks were conducted within working hours and close to their worksite, and included assessment of a range of lifestyle and health-related risk factors, including those associated with cardiovascular disease (CVD). A range of additional interventions were offered where indicated. Participants were invited to repeat screening approximately 9 months later.
  
  
  RESULTS
  635 (20% response rate) employees in the target age group (≥40 years) attended the first check. Most health risk markers improved in those (N=427) attending both health checks, as did the mean CVD risk score (t=2.86, p=0.004). 269 referrals were made to the intervention programmes.
  
  
  CONCLUSIONS
  This workplace programme had a positive impact on cardiovascular health, but attendance rates were low. These findings suggest that workplace health screening activities may have the potential to improve health in a group often considered hard to reach by other routes, but do not offer a straightforward solution in overcoming barriers to access for such subgroups within the working population.
authors.affiliation: Occupational Health Service, Sunderland City Council, Sunderland, UK.
authors.forename: Syed Zakir
authors.initials: SZ
authors.lastname: Abbas
authors.affiliation: Department of Anthropology, Durham University, Durham, UK.
authors.forename: Tessa M
authors.initials: TM
authors.lastname: Pollard
authors.affiliation: Occupational Health Service, Durham County Council, Durham, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Wynn
authors.affiliation: Centre for Public Policy and Health, School of Medicine, Pharmacy & Health, Wolfson Research Institute, Durham University,  Durham, UK.
authors.forename: Alyson
authors.initials: A
authors.lastname: Learmonth
authors.affiliation: Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Kerry
authors.initials: K
authors.lastname: Joyce
authors.affiliation: Department of Geography, Durham University, Durham, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Bambra
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D004651:Employment; D004739:England; D005260:Female; D006076:Government; D006262:Health; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D008019:Life Style; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012017:Referral and Consultation; D012307:Risk Factors; D012923:Social Class; D014937:Work; D017132:Workplace
keywords: cardiovascular risk; deprivation; health check; health inequalities; workplace