Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China.
Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China.
Int J Equity Health. 2024 Nov 29;23(1):257. doi: 10.1186/s12939-024-02342-w.
There are growing global concerns about informal waste pickers and their health issues. This cross-sectional study drew on the structural violence theory to examine the mental health situation of informal waste pickers in Hong Kong and identified the determinants of depression and anxiety in them ranging from individual to societal and governmental levels.
The data from the largest territory-wide study of informal waste pickers in 2023 was analysed. Descriptive statistics and logistic regressions were used to investigate the association between mental health and socioeconomic variables, including demographic background, governmental measures against informal waste pickers, other negative experiences related to safety and public discrimination, and supportive resources. The symptoms of depression and anxiety were assessed using the Patient Health Questionnaire (PHQ) and General Anxiety Disorder (GAD).
The results showed that physical strain/illness and chronic illness caused by long-term scavenging works (for depression adjusted OR 3.33, 95% CI [1.75, 6.31]; for anxiety adjusted OR 5.01, 95% CI [2.45, 10.24]), recycling or personal property stolen (for depression adjusted OR 2.04, 95% CI [1.23, 3.36]; for anxiety adjusted OR 2.72, 95% CI [1.62, 4.56]), being treated rudely by citizens (for depression adjusted OR 2.16, 95% CI [1.32, 3.55]); for anxiety (adjusted OR 2.85, 95% CI [1.74, 4.67]) are the critical risk factors of informal waste pickers' mental health. While higher intention to continue scavenging work if financial conditions permit is the critical protective factor for depression (adjusted OR 0.46, 95% CI [0.24, 0.88]) and anxiety (adjusted OR 0.43, 95% CI [0.22, 0.86]), compared to lower intention to continue scavenging work if financial conditions permit in the multivariate model.
This study discloses the close relationship between informal waste pickers' long-term physical strain/illness and mental health and identifies the governmental measures, other negative experiences related to safety issues and public discrimination as risk factors for informal waste pickers' mental health. Providing outreach, tailored medical services, increasing the unit price of recycling, developing specific recycling zones and establishing membership-based organisations help alleviate the challenges of precarious employment and enhance the well-being of the informal waste pickers.
全球对非正规拾荒者及其健康问题的担忧日益加剧。本横断面研究借鉴结构暴力理论，考察了香港非正规拾荒者的心理健康状况，并确定了导致他们抑郁和焦虑的决定因素，这些因素涉及个人、社会和政府层面。
对 2023 年最大规模的非正规拾荒者全港性研究的数据进行了分析。采用描述性统计和逻辑回归方法，调查了心理健康与社会经济变量之间的关系，这些变量包括人口统计学背景、针对非正规拾荒者的政府措施、与安全和公众歧视有关的其他负面经历以及支持性资源。使用患者健康问卷（PHQ）和广泛性焦虑症（GAD）评估抑郁和焦虑症状。
结果表明，长期拾荒工作导致的身体劳损/疾病和慢性病（抑郁调整后的 OR3.33，95%CI[1.75，6.31]；焦虑调整后的 OR5.01，95%CI[2.45，10.24]）、回收物或个人财产被盗（抑郁调整后的 OR2.04，95%CI[1.23，3.36]；焦虑调整后的 OR2.72，95%CI[1.62，4.56]）、受到市民的粗鲁对待（抑郁调整后的 OR2.16，95%CI[1.32，3.55]；焦虑调整后的 OR2.85，95%CI[1.74，4.67]）是非正规拾荒者心理健康的关键危险因素。而如果经济条件允许，继续拾荒工作的意愿较高是抑郁（调整后的 OR0.46，95%CI[0.24，0.88]）和焦虑（调整后的 OR0.43，95%CI[0.22，0.86]）的关键保护因素，与如果经济条件允许，继续拾荒工作的意愿较低相比，这在多变量模型中是如此。
本研究揭示了非正规拾荒者长期身体劳损/疾病与心理健康之间的密切关系，并确定了政府措施、与安全问题和公众歧视有关的其他负面经历是影响非正规拾荒者心理健康的危险因素。提供外展服务、量身定制的医疗服务、提高回收物的单价、开发特定的回收区和建立会员制组织有助于缓解不稳定就业带来的挑战，提高非正规拾荒者的幸福感。
