Informal employment and health status in Central America

Abstract

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.

Work and health in Latin America: results from the working conditions surveys of Colombia, Argentina, Chile, Central America and Uruguay

“…Thus, it excluded most of the informally employed, accounting for almost half of the working population in the Region 36. It should be noted that informal employment is linked to poor employment conditions (eg, temporary employment and long working hours) and hazardous exposures 37 38. Moreover, we also excluded workers aged under 18,39 as well as workers engaged in agriculture, who are also usually exposed to worse working and employment conditions.…”

Effect of age and social connection on perceived anxiety over radiation exposure among decontamination workers in Fukushima Prefecture, Japan

“…Regarding working conditions, the presence of a written contract contributed to decreased anxiety. A previous study reported that employees with informal contracts Studied about work method, safety management, and protection from radiation exposure, during training f Watched a video about work method, safety management, and protection from radiation exposure, during training g Checked the physical condition daily before work h Materials for work method, safety management, and protection from radiation exposure were given for selfstudy i Materials were not given for self-study j Checking dose rate of working areas and keeping out of high-dose areas k Monitoring the total amount of daily external dosage by portable indicator ( oral or no contract ) had significantly poorer mental health than those with formal (written) contracts 20) . Workers with written contracts may work in companies that provide adequate occupational management for their employees; thus, the presence of a written contract may contribute to decreased anxiety over radiation exposure.…”

Effect of informal employment on the relationship between psychosocial work risk factors and musculoskeletal pain in Central American workers

“…Following previous work,48 participants were coded as formal or informal workers according to their social security coverage (yes/no, respectively). Also, to control for potential confounders, the following variables were considered in the analyses: gender (male as reference), age (<30, 30–50 (reference), >50 years), occupation (manual vs non-manual (reference)), hours worked per week (<40, 40–48 (reference) and >48 hours) and ergonomic working conditions (ie, handling heavy loads, carrying out repetitive movements, performing extreme forces and working in uncomfortable postures).…”

“…These factors may lead to MSP by inducing muscle tension and deteriorating work-related biomechanics 45–47. And informal work often combines less favourable ergonomic and psychosocial conditions 48. The existing psychosocial work models, however, were developed in and for high-income economies with stable employment conditions and strong social protection networks,44 49 where work for survival is not such a determining aspect as it may be in LMICs and for informal workers.…”