US flight attendant healthcare avoidance behavior

Flight attendants (FAs) must meet air carrier fitness-for-duty standards to perform their safety-critical roles. Those unable to work due to illness may face occupational and financial consequences that could contribute to healthcare avoidance. We conducted an anonymous, cross-sectional, internet-based survey of U.S. flight attendants. Respondents reporting at least one of four predefined healthcare avoidance behaviors were classified as engaging in healthcare avoidance. Findings were compared to a previously published sample of U.S. pilots (n = 3,765). A total of 6,318 aviation personnel were analyzed. Among 2,553 flight attendants, 66.24% reported healthcare avoidance compared to 56.12% of pilots (p < 0.01). After adjusting for age and sex, flight attendants demonstrated higher odds of healthcare avoidance compared to pilots (OR: 1.56; 95% CI: 1.35-1.80; p < 0.01). Healthcare avoidance appears prevalent among U.S. flight attendants and warrants further investigation.