Illness, Self-Rated Health and Access to Medical Care among Waste Pickers in Landfill Sites in Johannesburg, South Africa

Abstract

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 (p = 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.

Ten-Year Risk of Fatal Cardiovascular Disease and its Association with Metabolic Risk Factors Among Waste Pickers in South Africa

“…Also, waste pickers might have no or rare access to healthcare, as reported previously [31]. Furthermore, another study reported that 37% of the waste pickers did not consult a doctor in more than a year and 8% never measured their blood pressure including other health measurements [29].…”

Ten-year risk of fatal cardiovascular disease and its association with metabolic risk factors among waste pickers in South Africa

“…The waste pickers could be affected the worst given their level of poverty and stress, as they strive on daily basis to earn a living. Also, waste pickers might have no or rare access to healthcare, as reported previously [ 36 ]. Furthermore, another study reported that 37% of the waste pickers did not consult a doctor in more than a year and 8% never measured their blood pressure including other health measurements [ 34 ].…”

Occupational Health Risk of Waste Pickers: A Case Study of Northern Region of South Africa

“…The study result found that, about 50% of the respondents rated their health condition as good. The finding can be related to a study which reported that 43% of the waste pickers surveyed in Johannesburg reported their health status as good [ 45 ]. Conversely, another study has reported more than 50% of the participants indicating their health condition as average [ 54 ].…”

“…Supported by the findings from the study are several related community health surveys that investigate a wide range of health complications related to environmental exposure to a landfill [ 44 ]. Increased occurrences of associated symptoms between waste picking and landfill such as illnesses, self-rated health, and clinic visit have been reported [ 45 ]. Reported study has also revealed the relationship between waste picking and mental health disorders [ 24 ].…”

“…The use of appropriate and recommended PPE are essential components in safeguarding their occupational health. Often, waste pickers collect worn or old shoes and clothes from landfill sites and use it as PPE [ 45 ]. Health impact of waste pickers may be susceptibly enhanced by inappropriate use of PPE [ 30 ].…”