Illness, self-rated health and access to medical care among waste pickers in landfill sites in Johannesburg, South Africa

Felix Made, Vusi Ntlebi, Tahira Kootbodien, Kerry Wilson, Nonhlanhla Tlotleng, Angela Mathee, Mpume Ndaba, Spo Kgalamono, Nisha Naicker

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


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.

Original languageEnglish
Article number2252
JournalInternational Journal of Environmental Research and Public Health
Issue number7
Publication statusPublished - 1 Apr 2020
Externally publishedYes


  • Chronic diseases
  • Clinic visits
  • Infectious diseases
  • Mental illness
  • Self-rated health
  • Waste pickers

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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