The bottom line:
- Night and rotating shifts can make heart health harder to manage by disrupting sleep, medication routines, preventive care, and regular blood pressure checks.
- For Taft-Hartley funds, the challenge may be whether heart health programs fit the realities of members’ work and schedules, not whether members are motivated to engage.
- Members are more likely to use heart health support when it works around demanding schedules, is easy to use between visits, and does not add unnecessary complexity for the fund team.
A member finishes a 12-hour overnight shift and gets home as the rest of the neighborhood starts its day. They eat whatever is easiest, try to sleep while the world outside keeps moving, and prepare to do it again that night.
A routine doctor’s appointment is hard to schedule. Medication timing can change from one week to the next. Blood pressure may be checked only once a year, even as work, sleep, stress, and daily routines keep shifting.
For many union members, this is normal life.
Hospital staff, police officers, firefighters, truck drivers, machine operators, cargo workers, and other essential workers keep critical services running outside traditional business hours. An estimated 17.7% of the U.S. labor force, or about 29 million workers, works outside the hours of 6 a.m. and 6 p.m.
What fund administrators may not see is how those schedules can shape cardiovascular risk.
Night and rotating shifts do more than make people tired. They can disrupt sleep, meal timing, medication routines, preventive care, and the body’s natural rhythms. Over time, those pressures may make it harder for members to manage high blood pressure and other heart health risks before they become more serious.
For Taft-Hartley funds, that creates a challenge that is easy to underestimate. Risk may be building between annual checkups while members continue working and feel well enough to keep going.
Shift work can make cardiovascular risk harder to manage
Research published in the peer-reviewed Cardiovascular Journal of Africa found that shift work may be associated with increased cardiovascular disease (CVD) risk because of disrupted circadian rhythms, lifestyle changes, and psychosocial stress.1
That language can sound clinical. In a member’s life, it can look much more familiar.
It may mean eating at inconsistent times because the work schedule changes every week. It may mean missing blood pressure medication because “morning” and “night” no longer follow a predictable routine. It may mean delaying a physical because the clinic is open while the member is sleeping or working.
Chronic fatigue can also become so familiar that changes in health are easy to overlook.
A separate study published in the European Heart Journal found that people who regularly or permanently worked night shifts had a 12% higher risk of atrial fibrillation, or A-fib, than daytime workers. That association increased to 18% after 10 or more years of night-shift work and to 22% among people who averaged 3 to 8 night shifts per month for at least 10 years.2
This does not mean every night-shift worker will develop heart disease. It does mean that irregular schedules can make cardiovascular risk harder to manage, especially when combined with physical work, long hours, job-related stress, and limited access to routine care.
High blood pressure may be the clearest warning sign, and one of the easiest to miss
High blood pressure often has no obvious symptoms. A member can feel fine, work a full shift, and still have rising cardiovascular risk.
A 2017 study published in the Annals of Occupational and Environmental Medicine found that shift workers had a greater likelihood of hypertension than daytime workers, with risk increasing the longer people worked shifts continuously.3 A separate 2019 study published in the Journal of the American Heart Association concluded that shift workers with short sleep duration may also be at increased risk for hypertension.4
The problem is that many members may not check their blood pressure often enough to see what is changing.
An annual physical captures one moment. It may not show what happens after several consecutive night shifts, during a period of overtime, or when sleep and medication routines become inconsistent.
That leaves a blind spot for both the member and the fund. By the time rising risk appears in claims, the fund may already be managing emergency department visits, hospitalizations, or more advanced cardiovascular disease.
Women working rotating night shifts may face added risk
The effects of shift work may also differ across member populations.
A study published in JAMA found that women who worked rotating night shifts for more than 10 years had a 15% to 18% higher risk of coronary heart disease than women who did not work rotating night shifts.5
For funds covering women in healthcare, public safety, manufacturing, transportation, hospitality, and other around-the-clock industries, this is an important reminder. Cardiovascular risk can be shaped by the job, the schedule, and the member’s broader health profile.
A general wellness message is unlikely to address that complexity. Members need support that works with the realities of their schedules.
The issue with existing health programs may be fit, not motivation
Fund administrators have historically relied on standard wellness initiatives to close these gaps, but these one-size-fits-all strategies often go unused. When members do not engage with a health program, it is easy to assume they are not interested.
But consider what many traditional programs ask them to do:
• Attend an appointment during the day
• Take a coaching call at a scheduled time
• Travel to a specific location
• Complete another task after a long shift
• Maintain the same routine while their work schedule changes
For a member coming off an overnight shift, those requirements can turn a well-intentioned program into one more thing they cannot realistically fit into the day
That does not mean the member does not care about their health. The support may simply not fit the way they live and work.
For fund administrators, that distinction should shape how heart health benefits are evaluated. The strongest program is not necessarily the one with the most features. It is the one members can realistically use when their schedules are irregular, demanding, and difficult to predict.
What fund administrators can do
Funds cannot eliminate night shifts or redesign every workplace schedule. They can, however, reduce some of the barriers that make heart health harder to manage.
Make support available outside business hours. A program built around daytime appointments and scheduled calls will be harder for shift-based populations to use.
Help members see what is happening between annual visits. At-home blood pressure tracking can give members a broader view of how their numbers change across workdays, nights, and time off.
Support more consistent medication routines. Rotating schedules can make it difficult to remember whether a dose was taken. Reminders and tracking tools may help members stay aware of their routines and identify gaps.
Consider the burden on the fund team. A member-friendly program should also be practical to launch, communicate, and evaluate. Fund administrators need clear visibility into engagement and outcomes without taking on unnecessary administrative complexity.
The right approach should make heart health easier for members and manageable for the fund.
Heart health support should work around the member
Hello Heart is a digital heart health solution that helps people track their blood pressure, understand their readings, and receive wellness coaching based on clinical guidelines and peer-reviewed literature.
Members receive access to the Hello Heart app and an FDA-cleared blood pressure monitor. Together, they help members:
• Track blood pressure and other heart health information
• Understand readings and progress over time
• Receive personalized digital coaching
• Manage medication information and reminders
• Create reports they can choose to share with their clinicians
For members working nights or rotating schedules, that flexibility matters.
They can take a reading before a shift, after work, or on a day off. They can review their progress without waiting for an appointment or trying to fit heart health into traditional office hours.
This does not remove the cardiovascular risks associated with shift work. It gives members a more practical way to understand and manage their heart health between visits.
The takeaway for Taft-Hartley funds
Night and rotating shifts are part of how many union members earn a living. The cardiovascular risks connected to those schedules deserve more attention from fund leaders.
Telling members to sleep more, reduce stress, or schedule more appointments does not address the constraints they face. Fund administrators can make a more meaningful difference by offering support that fits the job, the shift, and the member’s daily routine.
When members can understand their numbers and take action earlier, funds have a better opportunity to address risk before it becomes a more serious and costly health event.
See how Hello Heart supports heart health for labor members.
