See the published version of this preprint at International Journal for Equity in Health.
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Research
Michael Silva-Peñaherrera
Center of research in Occupational Health (CiSAL), Universitat Pompeu Fabra
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5133-181X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Latin America and the Caribbean (LAC) is the world’s most inequitable region in terms of wealth distribution. The full scale of social inequalities in health has been hidden by the lack of reliable data. This study aimed to measure and compare health inequalities in the working population within and between 15 countries of LAC.
Methods: A sample of 180 163 workers aged 18 years and older was drawn from the most recent national surveys of working conditions or health in 15 LAC countries. Poor self-perceived health (P-SPH) was used as a health indicator, and age, education level, and occupational category as inequality stratifiers. We calculated four measures: absolute and relative population-attributable risks, the Kuznets and weighted Keppel indexes.
Results: P-SPH prevalence ranged from 9% in men from Uruguay to 50% in women from Nicaragua. It was higher in women than in men in most countries. A clear gradient was shown, in which young people in non-manual skilled jobs and high education had the lowest prevalence. Nearly 45% of cases that reported P-SPH among men and 35% among women could be avoided if all the groups received a higher level of education. Also, approximately 42% of P-SPH reported by men and 31% by women could be avoided if they all shared the working and employment conditions of non-manual skilled jobs.
Conclusions: Wide health inequalities were found between occupational and educational groups in LAC. However, country borders appear to be an even more important stratifier in the production of health inequalities. Urgent interventions to improve worker’s health are needed in countries where prevalence of poor self-perceived health is high. Strengthening occupational health surveillance system in LAC countries should become a priority, in order to track the interventions to reduce occupational health inequity.
Keywords
Health inequalities, occupational health; self-perceived health, inequity
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CURRENT STATUS: Published
View the published article at International Journal for Equity in Health.
Version 3
Posted 20 May, 2020
No community comments so far
Editorial decision: Accept
On 21 Jun, 2020
Review #1 received
Received 07 Jun, 2020
Reviewer #1 agreed
On 14 May, 2020
Editor assigned
On 11 May, 2020
Reviewers invited
Invitations sent on 11 May, 2020
Submission checks complete
On 10 May, 2020
Editor invited
On 10 May, 2020
No comments provided
Editorial decision: Major Revision
On 14 Apr, 2020
Review #1 received
Received 18 Mar, 2020
Reviewers invited
Invitations sent on 03 Mar, 2020
Reviewer #1 agreed
On 03 Mar, 2020
Editor assigned
On 02 Mar, 2020
Submission checks complete
On 01 Mar, 2020
Editor invited
On 01 Mar, 2020
No comments provided
Editorial decision: Major Revision
On 02 Feb, 2020
Review #2 received
Received 23 Jan, 2020
Review #1 received
Received 18 Jan, 2020
Reviewer #2 agreed
On 02 Jan, 2020
Reviewer #1 agreed
On 21 Dec, 2019
Reviewers invited
Invitations sent on 19 Dec, 2019
Submission checks complete
On 15 Dec, 2019
Editor invited
On 15 Dec, 2019
Editor assigned
On 15 Dec, 2019
First submitted
On 11 Dec, 2019
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
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See the published version of this preprint at International Journal for Equity in Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Michael Silva-Peñaherrera
Center of research in Occupational Health (CiSAL), Universitat Pompeu Fabra
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5133-181X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at International Journal for Equity in Health.
Version 3
Posted 20 May, 2020
No community comments so far
Editorial decision: Accept
On 21 Jun, 2020
Review #1 received
Received 07 Jun, 2020
Reviewer #1 agreed
On 14 May, 2020
Editor assigned
On 11 May, 2020
Reviewers invited
Invitations sent on 11 May, 2020
Submission checks complete
On 10 May, 2020
Editor invited
On 10 May, 2020
No comments provided
Editorial decision: Major Revision
On 14 Apr, 2020
Review #1 received
Received 18 Mar, 2020
Reviewers invited
Invitations sent on 03 Mar, 2020
Reviewer #1 agreed
On 03 Mar, 2020
Editor assigned
On 02 Mar, 2020
Submission checks complete
On 01 Mar, 2020
Editor invited
On 01 Mar, 2020
No comments provided
Editorial decision: Major Revision
On 02 Feb, 2020
Review #2 received
Received 23 Jan, 2020
Review #1 received
Received 18 Jan, 2020
Reviewer #2 agreed
On 02 Jan, 2020
Reviewer #1 agreed
On 21 Dec, 2019
Reviewers invited
Invitations sent on 19 Dec, 2019
Submission checks complete
On 15 Dec, 2019
Editor invited
On 15 Dec, 2019
Editor assigned
On 15 Dec, 2019
First submitted
On 11 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at International Journal for Equity in Health.
Background: Latin America and the Caribbean (LAC) is the world’s most inequitable region in terms of wealth distribution. The full scale of social inequalities in health has been hidden by the lack of reliable data. This study aimed to measure and compare health inequalities in the working population within and between 15 countries of LAC.
Methods: A sample of 180 163 workers aged 18 years and older was drawn from the most recent national surveys of working conditions or health in 15 LAC countries. Poor self-perceived health (P-SPH) was used as a health indicator, and age, education level, and occupational category as inequality stratifiers. We calculated four measures: absolute and relative population-attributable risks, the Kuznets and weighted Keppel indexes.
Results: P-SPH prevalence ranged from 9% in men from Uruguay to 50% in women from Nicaragua. It was higher in women than in men in most countries. A clear gradient was shown, in which young people in non-manual skilled jobs and high education had the lowest prevalence. Nearly 45% of cases that reported P-SPH among men and 35% among women could be avoided if all the groups received a higher level of education. Also, approximately 42% of P-SPH reported by men and 31% by women could be avoided if they all shared the working and employment conditions of non-manual skilled jobs.
Conclusions: Wide health inequalities were found between occupational and educational groups in LAC. However, country borders appear to be an even more important stratifier in the production of health inequalities. Urgent interventions to improve worker’s health are needed in countries where prevalence of poor self-perceived health is high. Strengthening occupational health surveillance system in LAC countries should become a priority, in order to track the interventions to reduce occupational health inequity.
Figure 1
Figure 2
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