Informal employment and health status in Central America

BMC Public Health

Research Article

Lucía Artazcoz¹  José Miguel Martínez²  Fernando G. Benavides²  María López-Ruiz³  Marianela Rojas⁴ 

[1] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;Agència de Salut Pública de Barcelona, Barcelona, Spain;Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain;CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;Center for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Spain;IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain;CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;Center for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Spain;IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain;Facultad Latinoamericana de Ciencias Sociales, Salamanca, Spain;Center for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Spain;Programa Salud, Trabajo y Ambiente en América Central (SALTRA), Universidad Nacional, Heredia, Costa Rica;

关键词: Informal employment;    Health inequalities;    Central America;    Occupational health;    Mental health;    Self-perceived health;    Social security coverage;   

DOI  :  10.1186/s12889-015-2030-9

 received in 2015-01-08, accepted in 2015-07-07,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundInformal employment is assumed to be an important but seldom studied social determinant of health, affecting a large number of workers around the world. Although informal employment arrangements constitute a permanent, structural pillar of many labor markets in low- and middle-income countries, studies about its relationship with health status are still scarce. In Central America more than 60 % of non-agricultural workers have informal employment. Therefore, we aimed to assess differences in self-perceived and mental health status of Central Americans with different patterns of informal and formal employment.MethodsEmployment profiles were created by combining employment relations (employees, self-employed, employers), social security coverage (yes/no) and type of contract -only for employees- (written, oral, none), in a cross-sectional study of 8,823 non-agricultural workers based on the I Central American Survey of Working Conditions and Health of 2011. Using logistic regression models, adjusted odds ratios (aOR) by country, age and occupation, of poor self-perceived and mental health were calculated by sex. Different models were first fitted separately for the three dimensions of employment conditions, then for employment profiles as independent variables.ResultsPoor self-perceived health was reported by 34 % of women and 27 % of men, and 30 % of women and 26 % of men reported poor mental health. Lack of social security coverage was associated with poor self-perceived health (women, aOR: 1.38, 95 % CI: 1.13-1.67; men, aOR: 1.36, 95 % CI: 1.13-1.63). Almost all employment profiles with no social security coverage were significantly associated with poor self-perceived and poor mental health in both sexes.ConclusionsOur results show that informal employment is a significant factor in social health inequalities among Central American workers, which could be diminished by policies aimed at increasing social security coverage.

【 授权许可】

CC BY   
© López-Ruiz et al. 2015