Michael Silva-Peñaherrera, David Gimeno Ruiz de Porras, George L. Delclos, Maria Lopez-Ruiz, and Fernando G. Benavides are with the Center for Research in Occupational Health, Universitat Pompeu Fabra, Hospital del Mar Medical Research Institute, Network of Biomedical Research Center in Epidemiology and Public Health, Barcelona, Spain. D. Gimeno Ruiz de Porras and G. L. Delclos are also with the Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston, School of Public Health, Houston. Marianela Rojas Garbanzo is with the Health, Work and Environment Program in Central America within the Regional Institute for Studies of Toxic Substances, Universidad Nacional, Heredia, Costa Rica. Pamela Merino-Salazar is with the Universidad Internacional SEK, Quito, Ecuador.
Am J Public Health. 2021 Jul;111(7):1338-1347. doi: 10.2105/AJPH.2021.306276. Epub 2021 Jun 10.
To analyze changes in occupational health inequity between 2011 and 2018 among workers in Central America. Data were collected by face-to-face interviews at the workers' homes for the 2 Central America Working Conditions Surveys (n = 12 024 in 2011 and n = 9030 in 2018). We estimated health inequity gaps by means of absolute and relative population attributable risks and the weighted Keppel index. We stratified all analyses by gender. Between 2011 and 2018, the proportion of workers reporting poor self-perceived health decreased both in women (from 32% to 29%) and men (from 33% to 30%). However, the health inequity gaps remained wide in the 4 stratifiers. Measured by the Keppel index, health inequity gaps between countries increased from 22% to 39% in women and from 20% to 29% in men. While health improved between 2011 and 2018, health inequity gaps remained wide. Wider health inequity gaps were observed between countries than by gender, age, occupation, or education. This first benchmark of occupational health inequities in Central America could be useful when developing and evaluating the impact of public policies on work.
分析 2011 年至 2018 年期间中美洲工人职业健康不平等的变化。通过面对面访谈在工人家中收集了 2 次中美洲工作条件调查的数据(2011 年 n=12024,2018 年 n=9030)。我们通过绝对和相对人群归因风险以及加权 Keppel 指数来估计健康不平等差距。所有分析均按性别分层。2011 年至 2018 年间,报告自我感觉健康状况不佳的工人比例在女性(从 32%降至 29%)和男性(从 33%降至 30%)中均有所下降。然而,在 4 个分层中,健康不平等差距仍然很大。用 Keppel 指数衡量,女性的健康不平等差距从 22%增加到 39%,男性从 20%增加到 29%。尽管 2011 年至 2018 年间健康状况有所改善,但健康不平等差距仍然很大。国家之间的健康不平等差距大于性别、年龄、职业或教育。这是中美洲首次对职业健康不平等进行基准分析,在制定和评估公共政策对工作的影响时可能会很有用。