Having health insurance doesn't mean workers will take advantage of immunizations, cancer screenings, and other preventive health services, a new study finds.

"Employment and insurance do not guarantee better health outcomes," says lead study author M. Courtney Hughes, who led a team of researchers at the University of Washington School of Public Health, in Seattle, in the study.

The study, which appears in the May-June issue of the American Journal of Health Promotion, uses data on nearly 160,000 participants in a Centers for Disease Control and Prevention telephone survey of adults under 65.

Hughes and colleagues found evidence that a significant number of working, insured adults didn't meet national recommendations for health behaviors.

For example, 74 percent of insured workers didn't get influenza vaccines, and 49 percent failed to undergo preventive screenings for colon cancer, the data showed. In addition, 77 percent of workers reported that they didn't eat the recommended number of fruits and vegetables daily, and 49 percent failed to get enough physical activity.

"Even among adults who are working and insured—two status factors which past research has shown are associated with better health behaviors and outcomes—disparities in health behaviors persist due to income, education, and access to care," says Hughes.

Lower household incomes and education levels influence workers' health behaviors, the study found. Workers with lower incomes and less education were least likely to get cancer and cholesterol screenings, and less-educated employees reported the highest smoking rates.

Even among a population that in theory has access to care, use of some preventive services, especially colorectal cancer screening and influenza vaccinations, "is very poor," says Stephenie Lemon, an epidemiologist at the University of Massachusetts Medical School who specializes in work-site health promotion research. She had no affiliation with the study.