Household context and self-rated health: the effect of unemployment and informal work

Objective: This article investigates whether the presence of residents in precarious work situations influences the self-rated health of people living in the same household. Methods: The study is based on the National Household Survey (PNAD) carried out in 1998 (n = 85 384) and 2003 (n = 89 063) by the Brazilian Institute of Geography and Statistics. These samples included all individuals aged 15 years and over, who lived in large metropolitan regions of Brazil. The effects at individual and household levels were estimated by the generalised estimation equations (GEE). Results: At the individual level, poor self-rated health was inversely associated with schooling and positively associated with female sex, older age, informal work, unemployment and not economically active. Living in households with at least one informal or unemployed worker was positively associated with poor self-rated health, regardless of individual factors and socioeconomic characteristics of the household in 1998 ( informal work: OR 1.09; 95% CI 1.06 to 1.12; unemployment: OR 1.08; 95% CI 1.04 to 1.13), and in 2003 (informal work: OR 1.06; 95% CI 1.03 to 1.10; unemployment: OR 1.10; 95% CI 1.05 to 1.15). Conclusion: These results suggest that unemployment and/or informal work have a contextual impact on the self-rated health of household dwellers. They add to the hypothesis that adverse conditions in the labour market and their impact on the health of individuals and groups are relevant in understanding inequalities in health.