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Precarious employment is one of the social determinants of health. In 2010, 34.4% of Japanese workers fell into this employment category. The purpose of our study was to assess whether the use of annual health check-ups varied by worker contract type.Using 2007 nationally representative survey data, we compared the annual health check-up compliance of permanently employed full-time workers versus that of precariously employed workers (hourly, dispatched, and fixed-term workers).Dispatched workers and hourly workers received health check-ups less often compared with permanent workers. Hourly young male workers received health check-ups five times less frequently than permanent workers. The percentage of workers who consulted a physician after receiving advice to do so did not differ by employment types, except in older men.In Japan, workers with precarious employment, most notably hourly and dispatched workers, had a lower rate of health check-ups compared with full-time workers in permanent positions. Am. J. Ind. Med. 55:884–892, 2012. © 2012 Wiley Periodicals, Inc.