Health inequality and self-employment in South Korea

Abstract

Abstract Background Self-employed persons work for themselves as owners of a business rather than for an employer. Although self-employed persons have autonomy and flexibility, they are vulnerable to workplace health and safety hazards. However, there has been little interest in the health of self-employed persons, especially in small business owners. This study investigated the health status of small self-employed business owners compared to standard workers. Methods The third Korean Working Conditions Survey for a total of 32,630 workers aged 20-59 were analyzed. A small business was defined as self-employment with 0-4 workers. Standard employment included full-time employment with a permanent or one-year contract. Health outcomes included the presence of depressive symptom and 8 types of physical health; hearing problems, skin problems, backache, muscular pains (upper limbs), muscular pains (lower limbs), headaches/eye strain, injuries, and overall fatigue. Results Among 32,630 workers, 10,652 (32.64%) were small business self-employed. Compared with standard employed workers, small business self-employed had a 1.2-fold [adjusted OR (Odds Ratio) =1.20, 95%CI (Confidence Interval) 1.09-1.32] increased likelihood for depression after adjustment for potential covariates. Small business self-employed was at higher risk of work-related physical health problems: backache (OR = 1.16, 95%CI 1.06-1.26), muscular pains in upper limbs (OR = 1.19, 95%CI 1.12-1.27), and muscular pains in lower limbs (OR = 1.14, 95%CI 1.07-1.22). Conclusions Our study found health inequality of small business self-employed, showing higher odds for mental and physical health problems in small business self-employed than in standardly employed workers. Key messages The current study showed vulnerability of self-employed in small business to health problems. Our study would be helpful to build up better working environment for small business owners and improve occupational health inequalities in South Korea.