Health Services Use and Health Outcomes among Informal Economy Workers Compared with Formal Economy Workers: A Systematic Review and Meta-Analysis.
Health Services Use and Health Outcomes among Informal Economy Workers Compared with Formal Economy Workers: A Systematic Review and Meta-Analysis.
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DOI：
10.3390/ijerph18063189
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发表时间：
2021-03-19
影响因子：
--
通讯作者：
Singh T
中科院分区：
文献类型：
--
作者：
Naicker N;Pega F;Rees D;Kgalamono S;Singh T
背景资料：全球约有20亿工人从事非正规经济。与正规经济中的工人相比，这些工人往往被边缘化，从职业健康和安全条例、劳动法、社会保护和/或医疗保健中获得的好处很少，甚至没有。因此，与正规劳动者相比，非正规经济劳动者的职业健康风险可能更高。我们的目标是系统地审查和荟萃分析关于非正规经济工人与正规经济工人在卫生服务使用和健康结果方面的相对差异(或不平等)的证据。方法：计算机检索PubMed和EMBASE数据库，检索词为PubMed和EMbase，检索词为1999-2020。符合条件的人口是非正规经济工人。参照者是正规的经济工作者。符合条件的结果是一般和职业卫生服务的使用、致命和非致命的职业伤害、艾滋病毒、结核病、肌肉骨骼疾病、抑郁症、噪音导致的听力损失和呼吸道感染。两位作者独立筛选记录，提取数据，用ROB-SPEO评估偏倚风险，并按等级评估证据质量。采用随机效应进行逆方差Meta分析。结果：纳入了12项研究，共有来自世界卫生组织四个地区(非洲、美洲、东地中海和西太平洋)的7个国家的1,637,297名参与者。与正规经济劳动者相比，非正规经济劳动者较少使用任何医疗服务(优势比0.89，95%可信区间0.85-0.94，四项研究，195,667名参与者，1289%，证据质量低)，而更有可能患有抑郁症(优势比5.02，95%可信区间2.72-9.27，三项研究，26260名参与者，128.7%，证据质量低)。我们对其他结果非常不确定(证据质量非常低)。结论：非正规经济工作者可能比正规经济工作者更少使用任何医疗服务，而更有可能患有抑郁症。对于其他合格结果的相对差异，证据尚不确定。有必要进行进一步的研究，以加强目前的证据，并需要进一步的研究来改善人口健康和减少工人之间的健康不平等。
Background: There are approximately two billion workers in the informal economy globally. Compared to workers in the formal economy, these workers are often marginalised with minimal or no benefits from occupational health and safety regulations, labour laws, social protection and/or health care. Thus, informal economy workers may have higher occupational health risks compared to their formal counterparts. Our objective was to systematically review and meta-analyse evidence on relative differences (or inequalities) in health services use and health outcomes among informal economy workers, compared with formal economy workers. Methods: We searched PubMed and EMBASE in March 2020 for studies published in 1999–2020. The eligible population was informal economy workers. The comparator was formal economy workers. The eligible outcomes were general and occupational health services use, fatal and non-fatal occupational injuries, HIV, tuberculosis, musculoskeletal disorders, depression, noise-induced hearing loss and respiratory infections. Two authors independently screened records, extracted data, assessed risk of bias with RoB-SPEO, and assessed quality of evidence with GRADE. Inverse variance meta-analyses were conducted with random effects. Results: Twelve studies with 1,637,297 participants from seven countries in four WHO regions (Africa, Americas, Eastern Mediterranean and Western Pacific) were included. Compared with formal economy workers, informal economy workers were found to be less likely to use any health services (odds ratio 0.89, 95% confidence interval 0.85–0.94, four studies, 195,667 participants, I2 89%, low quality of evidence) and more likely to have depression (odds ratio 5.02, 95% confidence interval 2.72–9.27, three studies, 26,260 participants, I2 87%, low quality of evidence). We are very uncertain about the other outcomes (very-low quality of evidence). Conclusion: Informal economy workers may be less likely than formal economy workers to use any health services and more likely to have depression. The evidence is uncertain for relative differences in the other eligible outcomes. Further research is warranted to strengthen the current body of evidence and needed to improve population health and reduce health inequalities among workers.
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DOI：
10.1201/9780203971284.ch10
发表时间：
2003-01-01
期刊：
SOCIO-ECONOMIC IMPACTS OF ARTISANAL AND SMALL-SCALE MINING IN DEVELOPING COUNTRIES
影响因子：
--
作者：
Jennings, NS
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Jennings, NS
DOI：
10.1590/s0102-311x2013000700013
发表时间：
2013-07-01
期刊：
Cadernos de Saúde Pública
影响因子：
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作者：
Miquilin, Isabella de Oliveira Campos;Marín-León, Letícia;Corrêa Filho, Heleno Rodrigues
通讯作者：
Corrêa Filho, Heleno Rodrigues
影响因子：
2.6
作者：
Abaerei, Admas Abera;Ncayiyana, Jabulani;Levin, Jonathan
通讯作者：
Levin, Jonathan
DOI：
10.1590/s1413-81232011001000017
发表时间：
2011-09-01
期刊：
Ciência & Saúde Coletiva
影响因子：
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作者：
Giatti, Luana;Barreto, Sandhi Maria
通讯作者：
Barreto, Sandhi Maria
影响因子：
4.5
作者：
Calys-Tagoe BNL;Clarke E;Robins T;Basu N
通讯作者：
Basu N