A majority of Americans say they're stressed at work. And it's clear the burden of stress has negative effects on health, including an increase in heart disease, liver disease and gastrointestinal problems.

Still, though it's been known for years that periodically disengaging from one's everyday routine can reduce stress, most Americans don't take advantage of their days off. A recent poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health finds about half of Americans who work 50-plus hours a week say they don't take all or most of the vacation they've earned.

And among respondents who actually take vacations, "30 percent say they do a significant amount of work while on vacation," says Robert Blendon, a professor and health policy analyst at the Harvard T.H. Chan School of Public Health who directed the survey. "So they're taking their stress along with them wherever they go."

Take 27-year-old Julie Hagopian, for example. She lives in Alexandria, Va., works in digital marketing for a large educational company, and says she adores her job. But it consumes at least 60 hours of her time each week, she says, and includes plenty of stress. The biggest problem, Hagopian says: There's no "off switch."

"I'm on call all the time — to moderate, create content, curate everything," she says. "So, generally speaking, even when on vacation, I'm checking email and moderating social feeds."

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When it comes to taking the classic one to two weeks of vacation — forget it, she says. That would require burdening her colleagues with her workload, and they already have too much to do.

So, instead, she takes a few days here and there, but always stays connected via phone calls or online.

For 33-year-old Adam Rowan, who lives in Dolores, Colo., staying "connected" isn't a big issue, he says, because he just doesn't take vacation. Ever.

"It's just not my thing," he says with a chuckle, "which probably sounds strange. But I'd prefer to be at work, getting things done."

Rowan works in information technology for a large outdoor retail company. Because many of his colleagues in IT got their start in their early 20s, Rowan says he feels like he has a lot of catching up to do. He skips vacation to keep learning more, he says — "just to get a foot in the game."

In our poll, 35 percent of people who work 50 or more hours a week say they also skip vacations because they want to get ahead at work. Like Hagopian, 42 percent say there wouldn't be enough people to pick up their workload if they took days off. And many, like Hagopian and Rowan, say their office doesn't have many people with the same expertise who could serve as backup.

"If I leave and something breaks and somebody who doesn't know how to fix it tries to fix it, it could get a lot worse," Rowan says.

Rowan is hardly alone in his dedication to the job. Today, Americans take far less vacation time than they did a few decades ago, says psychologist Matthew J. Grawitch of Saint Louis University, who studies stress in the workplace. Research shows that, on average, Americans now take 16.2 days of vacation a year, compared with nearly three weeks of vacation in 2000.

That's an unfortunate trend, he says; not only can time off help alleviate stress, it can also be personally rejuvenating and motivate people to be more productive once they return to the job.

Recent research suggests employee health and well-being improve even during short vacations. That has led scientists studying workplace stress to urge people to take shorter vacations throughout the year if they feel they can't manage a week or two all at once.

At least some employers concur. Diane Domeyer, executive director of The Creative Group, a staffing firm, recently surveyed more than 400 advertising and marketing executives and found that 39 percent say they believe their employees would be more productive if they took more time off.

But Grawitch says it's one thing for employers to recognize the value of vacation and another to make it happen.

"It has to involve thinking through how to restructure work, utilize technology more effectively, [and] to coordinate vacation times so work is still being accomplished — and not by the person who is on vacation," Grawitch says.

Of course, that can require more investment in staffing from employers. Domeyer says an increasing number of companies are choosing to make that sort of investment because they recognize the relatively high cost of burnout — either in the form of lower productivity or in the loss of employees.

If you're one of those people who go on vacation and just can't disconnect completely, Domeyer suggests you resist the temptation to answer email immediately. A too-quick response suggests you are available to do work, she says.

Instead consider using a "delayed delivery" function in your emailed responses, she suggests. That gets the note off your plate, but doesn't deliver it until the day you return — from vacation.

Copyright 2016 NPR. To see more, visit http://www.npr.org/.

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Overworked Americans Aren't Taking The Vacation They've Earned