Chronic diseases and trauma among low-income workers of Karachi, Pakistan
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20151050Keywords:
Low income workers, Chronic diseases, Physical traumaAbstract
Background: The self-efficacy of individuals is influenced by experiences in the community, the workplace, and in broader civil society, all of which exert a collective influence on attitudes and behaviors. The low-income population is more likely to suffer from many chronic health problems and trauma. This study was done to assess the prevalence of chronic diseases and workplace physical trauma among low-income workers in Karachi, Pakistan.
Methods:A descriptive cross sectional study was conducted in Karachi, Pakistan. Trained interviewers used a structured questionnaire to interview 707 workers and collected information on socio-demographic characteristics, chronic health problems and physical trauma among them. The data were analysed using SPSS version 18.
Results: Majority (72%) of the participants were aged between 15 and 35 years. More than one-third (35.1%) were educated up to secondary level only. Half of the participants (50.8%) had a household comprising 6-10 people, while 34.8% of the respondents were the only breadwinners in their family. Two fifths (39.5%) reported a household income between Rs11000 and Rs 20000 per month. A significant number (21%) of workers reported being diagnosed with a chronic disease including Diabetes Mellitus, Asthma, Hepatitis, Arthritis, Hypertension, Hyperlipidemia, Hypothyroidism, Epilepsy, Chronic obstructive pulmonary disorder, whereas three fourths (75%) reported physical trauma history at their work place during the past year, while majority (95.2%) of them looked apparently healthy.
Conclusions:These chronic health conditions not only affect their productivity but play a vicious role in poverty and poor health cycle. The findings of the present study cannot be generalized due to the limited sample. Still, the study supports the notion that factors such as low socioeconomic status may lead to the poor management of physical trauma and course of chronic diseases. Future research should direct attention toward workers' health and working conditions to improve the effectiveness of the interventions to reduce the disparities in provision of health services for the low-income workers.
Metrics
References
Clark D, Nothwehr F. Exercise self-efficacy and its correlates among socioeconomically disadvantaged older adults. Health Education Behaviour. 1999;25(4):535-46.
Lin CC, Rogot E, Johnson NJ, Sorlie PD, Arias E. A further study of life expectancy by socioeconomic factors in the National Longitudinal Mortality Study. Ethn Dis. 2003;13(2):240–7.
Singh GK, Siahpush M. Widening socioeconomic inequalities in US life expectancy, 1980-2000. Int J Epidemiol. 2006;35(4):969–79.
Braveman P, Egerter S, Williams DR The social determinants of health: coming of age. Annu Rev Public Health. 2011a;32:381-98.
Braveman P, Kumanyika S, Fielding J, Laveist T, Borrell L, Manderscheid R, Troutman A. Health Disparities and Health Equity: The Issue Is Justice. Am J Public Health. 2011b May 6. [Epub ahead of print]
Diez Roux A, Chambless L, Merkin S, Arnett D, Eigenbrodt M, Nieto F, et al. Socioeconomic disadvantage and change in blood pressure associated with aging. Circulation. 2002;106:703-10.
Diez-Roux AV, Link BG, Northridge ME.A multilevel analysis of income inequality and cardiovascular disease risk factors. Soc Sci Med. 2000 Mar;50(5):673-87. Calles-Escandón J, Hunter JC, Langdon SE, Gómez EM, Duren-Winfield VT, Woods KF. La Clínica Del Pueblo: a model of collaboration between a private media broadcasting corporation and an academic medical center for health education for North Carolina Latinos. J Immigr Minor Health. 2009;11(6):513-9
Kanervisto M, Vasankari T, Laitinen T, Heliövaara M, Jousilahti P, Saarelainen S. Low socioeconomic status is associated with chronic obstructive airway diseases. Respir Med. 2011 Aug;105(8):1140-6.
Kanjilal S, Gregg EW, Cheng YJ, Zhang P, Nelson DE, Mensah G, Beckles GL. Socioeconomic status and trends in disparities in 4 major risk factors for cardiovascular disease among US adults, 1971-2002. Arch Intern Med. 2006 Nov 27;166(21):2348-55.
Zwi AB, Forjuoh S, Murugusampillay S, Odero W, Watts C. Injuries in developing countries: policy response needed now. Transactions of the Royal Society of Tropical Medicine and Hygiene. 1996;90:593–5.
Wilkinson DPTC. A trauma management template for developing countries trauma care. Official Publication of International Trauma Anaesthesia and Critical Care Society 2000; 10: No. 2. Wilkinson D, McDougall R. Primary trauma care. Anaesthesia 2007; 62S1:61-4.
International Labor Organization. Safety and Health at Work. Available online: http://www.ilo.org/global/topics/safety-and-health-at-work/lang--en/index.htm. Accessed on 30 April 2015).
Boone-Heinonen J, Diez Roux AV, Kiefe CI, Lewis CE, Guilkey DK, Gordon-Larsen P. Neighbourhood socioeconomic status predictors of physical activity through young to middle adulthood: the CARDIA study. Soc Sci Med. 2011 Mar;72(5):641-9
Booth KM, Pinkston MM, Poston WS. 2005. Obesity and the built environment. J Am Diet Assoc.105:S110–17
Gordon-Larsen P, Nelson MC, Page P, Popkin BM. Inequality in the built environment underlies key health disparities in physical activity and obesity. Pediatrics. 2006;117:417–24
Giles-Corti B, Donovan RJ. 2002. The relative influence of individual, social and physical environment determinants of physical activity. Soc. Sci. Med. 54:1793–812.
Hutch DJ, Bouye KE, Skillen E, Lee C, Whitehead L, Rashid JR. Potential strategies to eliminate built environment disparities for disadvantaged and vulnerable communities. Am J Public Health. 2011 Apr;101(4):587-95 Institute for Work and Health (IWH). Immigrant workers safety. At Work, Issue 64:3-4, spring 2011: Institute for Work & Health, Toronto.
Mujahid MS, Diez Roux AV, Morenoff JD, Raghunathan TE, Cooper RS, Ni H, Shea S. Neighbourhood characteristics and hypertension. Epidemiology. 2008 Jul;19(4):590-8 National Institute of Environmental Health Science. (2009, July). Hazardous Materials Worker Health and Safety Training Request for Applications (RFA-ES-09-004). Research Triangle Park, NC. Noblet A, Lamontagne AD. The role of workplace health promotion in addressing job stress. Health Promot Int. 2006;21(4):346-53.
Woolf SH, Dekker MM, Byrne FR, Miller WD. Citizen-cantered health promotion: building collaborations to facilitate healthy living. Am J Prev Med. 2011 Jan;40 (1 Suppl 1):S38-47
Karin Heitzmann R. Sudharshan Canagarajah Paul B. Siegel, Guidelines for Assessing the Sources of Risk and Vulnerability, Social Protection Discussion Paper Series No. 0218, The World Bank, June 2002
Sorensen G, Landsbergis P, Hammer L, et al. Preventing chronic disease in the workplace: a workshop report and recommendations. Am J Public Health. 2011;101(Suppl 1):S196–207.
Rockefeller Institute. Health Vulnerabilities of informal workers. 2013. Available at: https://assets.rockefellerfoundation.org/app/uploads/20130528214745/Health-Vulnerabilities-of-Informal-Workers.pdf (Accessed February 10, 2015).
Benach J, Muntaner C, Santana V, Chairs F. Employment Conditions and Health Inequalities. Final report to the WHO Commission on Social Determinants of Health (CSDH) Employment Conditions Knowledge Network (EMCONET). Geneva: World Health Organization;2007.
R. Nugent, “Chronic diseases in developing countries: health and economic burdens,” Annals of the New York Academy of Sciences. 2008;1136:70–9.
Muhammad Hafeez, Poverty and Poor Health in Pakistan: Exploring the Effects of Privatizing Healthcare, Harvard International Review, June 15, 2014;35(4).
Available at: http://hir.harvard.edu/archives/5768, Retrieved June 30, 2015
"Population explosion: Put an embargo on industrialisation Karachi". Available at http://tribune.com.pk. 6 October 2013. Retrieved 17 January 2015.
"Largest cities and their mayors in 2011". Available at http://www.citymayors.com/statistics/largest-cities-mayors-1.html. Retrieved 5 February 2015.
"About Karachi". Karachi Chamber of Commerce and Industry. Available at http://www.kcci.com.pk/mykarachi/aboutkarachi.aspx. Retrieved 10 February 2014.
"Sindh population surges by 81.5 pc, households by 83.9 pc". Thenews.com.pk. 2 April 2012. Available at http://www.thenews.com.pk/Todays-News-13-13637-Sindh-population-surges-by-81.5-pc,-households-by-83.9-pc. Retrieved 21 April2013.
"Global city GDP rankings 2008-2025". PricewaterhouseCoopers. Available at http://www.ukmediacentre.pwc.com/content/detail.asp? Retrieved 12 February 2010.
National Institute of Population Studies (NIPS) [Pakistan] and ICF International. 2013. Pakistan Demographic and Health Survey 2012-13. Islamabad, Pakistan, and Calverton, Maryland, USA: NIPS and ICF International.
Robert Wood Johnson Foundation Commission to Build a Healthier America. Beyond health care: new directions to a healthier America [Internet]. Washington (DC): The Commission; 2009 Apr [cited 2015 Apr 21]. Available at: http://www.commissiononhealth.org/Report.aspx?Publication=64498, Accessed 15 Feb 2015.
Miranda JJ, Kinra S, Casas JP, et al. Non-communicable diseases in low- and middle-income countries: context, determinants and health policy. Trop Med Int Health 2008;13:1225–1234.
Steenland K, Halperin W, Hu S, Walker JT. Deaths due to injuries among employed adults: The effects of socioeconomic class. Epidemiol. 2003;14:74–9.
Suhrcke M, Rocco, M. Mckee, et al. 2007. Economic consequences of non-communicable diseases and injuries in the Russian federation. European Observatory on Health Systems and Policies, World Health Organization.
Downloads
Published
How to Cite
Issue
Section
