Epidemiology and Surveillance Section, National Institute for Occupational Health, National Health Laboratory Service, Johannesburg 2000, South Africa.
Faculty of Health Sciences, School of Public Health, University of Witwatersrand, Johannesburg 2000, South Africa.
Int J Environ Res Public Health. 2020 Mar 27;17(7):2252. doi: 10.3390/ijerph17072252.
Waste pickers are exposed to various environmental health hazards, and self-rated health (SRH) could influence their medical care access. This study investigated the association between illness, clinic visits and SRH, and assessed if SRH can increase clinic visits. A cross-sectional study was conducted. SRH was defined as "very good", "good", "fair", and "poor". The illnesses were mental health, infectious, and chronic diseases. Medical care access included clinic visits in the previous 12 months. An ordinal logistic regression model was fitted to assess the association. There were 361 participants, 265 (73.41%) were males. Median age was 31 years, (interquartile range (IQR): 27-39). SRH: poor (29.89%), fair (15.92%), good (43.30%) very good (10.89%). Ever smoked (adjusted odds ratio (AOR): 1.72; 95% confidence interval (CI): 1.11-2.66), mental health (AOR: 1.87; 95% CI: 1.22-2.84), chronic (AOR: 2.34; 95% CI:1.47-3.68) and infectious (AOR: 2.07; 95% CI: 1.77-3.63) diseases were significantly associated with increased odds of reporting poor health. Clinic visit was not associated with SRH. From 99 (31%) individuals who rated their health as poor and ill, 40% visited a clinic ( = 0.0606). Acute and chronic illnesses were associated with poor SRH but this did not increase clinic visits. Provision of mobile clinic services at the landfill sites could increase access to medical care.
拾荒者暴露于各种环境卫生危害之中，自感健康（SRH）可能会影响他们获得医疗服务的机会。本研究旨在调查疾病、就诊与 SRH 之间的关联，并评估 SRH 是否能增加就诊。本研究采用了横断面研究设计。SRH 定义为“非常好”、“好”、“一般”和“差”。疾病包括心理健康、传染病和慢性病。医疗服务获取包括过去 12 个月内的就诊情况。采用有序逻辑回归模型来评估相关性。共纳入了 361 名参与者，其中 265 名（73.41%）为男性。参与者的中位年龄为 31 岁（四分位距（IQR）：27-39）。SRH：差（29.89%）、一般（15.92%）、好（43.30%）、非常好（10.89%）。曾吸烟（调整后的优势比（AOR）：1.72；95%置信区间（CI）：1.11-2.66）、心理健康问题（AOR：1.87；95% CI：1.22-2.84）、慢性病（AOR：2.34；95% CI：1.47-3.68）和传染病（AOR：2.07；95% CI：1.77-3.63）与较差的健康自评结果显著相关。就诊与 SRH 无关。在 99 名（31%）自感健康状况不佳且患病的个体中，有 40%（ = 0.0606）就诊过。急性和慢性病与较差的 SRH 相关，但并未增加就诊。在垃圾填埋场提供流动诊所服务可能会增加医疗服务的可及性。
