International Journal of Public Health

, Volume 62, Issue 2, pp 209–218 | Cite as

Informal employment, unpaid care work, and health status in Spanish-speaking Central American countries: a gender-based approach

  • María Lopez-RuizEmail author
  • Fernando G. Benavides
  • Alejandra Vives
  • Lucía Artazcoz
Original Article



To assess the relationship between paid work, family characteristics and health status in Central American workers; and to examine whether patterns of association differ by gender and informal or formal employment.


Cross-sectional study of 8680 non-agricultural workers, based on the First Central American Survey of Working Conditions and Health (2011). Main explicative variables were paid working hours, marital status, caring for children, and caring for people with functional diversity or ill. Using Poisson regression models, adjusted prevalence ratios of poor self-perceived and mental health were calculated by sex and social security coverage (proxy of informal employment).


A clear pattern of association was observed for women in informal employment who were previously married, had care responsibilities, long working hours, or part-time work for both self-perceived and mental health. No other patterns were found.


Our results show health inequalities related to unpaid care work and paid work that depend on the interaction between gender and informal employment. To reduce these inequalities suitable policies should consider both the labor (increasing social security coverage) and domestic spheres (co-responsibility of care).


Informal employment Gender Family characteristics Care Social factors Central America 



We acknowledge Edurne Jiménez and George L. Delclòs for their review of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the Parc de Salut MAR Ethical Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the survey.


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Copyright information

© Swiss School of Public Health (SSPH+) 2016

Authors and Affiliations

  1. 1.CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain
  2. 2.Center for Research in Occupational HealthUniversitat Pompeu FabraBarcelonaSpain
  3. 3.IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
  4. 4.Facultad Latinoamericana de Ciencias SocialesSalamancaSpain
  5. 5.Department of Public Health, School of MedicinePontificia Universidad Católica de Chile, CEDEUS (Conicyt/Fondap/15110020), ACCDiS (Conicyt/Fondap/15130011)Santiago de ChileChile
  6. 6.Agència de Salut Pública de BarcelonaBarcelonaSpain
  7. 7.Institute of Biomedical Research (IIB-Sant Pau)BarcelonaSpain

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