Formal and informal work: work arrangements and their implications for mental healthAbstract
Introduction In contemporary capitalism, employment relationships without social protection have expanded. Formal and informal work coexist under distinct conditions.
Objective To describe the characteristics of formal and informal work and the mental health status of workers.
Methods A population-based cross-sectional study was conducted in the municipality of Feira de Santana, Bahia, Brazil. Data was collected through household interviews. Sociodemographic, occupational, and mental health characteristics were analyzed.
Results A total of 1,623 workers participated, including 513 formal workers (50.2% female) and 1,110 informal workers (53.6% female). Compared with formal workers, informal workers had lower income and education levels and longer working hours. They also reported a higher frequency of stressful situations, such as high psychological demand (45.5%) and excessive work commitment (49.3%), although they reported greater control over their work (68.3%). The prevalence of high effort exceeded 50.0% in both groups. The prevalence of common mental disorders was similar between groups; however, informal workers more frequently reported poor self-rated health.
Conclusion Informal workers face more precarious working conditions and self-reported health, whereas formal work also presents vulnerabilities. This scenario requires policies that promote dignified conditions for all, both formal and informal workers.
Keywords
Occupational Health; Psychosocial Factors; Precarious Employment; Mental Health
Resumo
Introdução No capitalismo contemporâneo, os vínculos empregatícios sem proteção social foram ampliados. Trabalhos formais e informais coexistem com condições distintas.
Objetivo Descrever características do trabalho formal e informal e a situação de saúde mental dos trabalhadores.
Métodos Estudo transversal de base populacional, realizado no município de Feira de Santana, Bahia. Os dados foram coletados por meio de entrevistas domiciliares. Foram analisadas características sociodemográficas, ocupacionais e de saúde mental.
Resultados Participaram 1.623 trabalhadores, 513 trabalhadores formais (50,2% do sexo feminino) e 1.110 informais (53,6% do sexo feminino). Em comparação aos trabalhadores formais, os informais apresentaram renda e escolaridade mais baixas e jornadas laborais mais prolongadas. Também apresentaram maior frequência de situações estressoras, como alta demanda psicológica (45,5%) e comprometimento excessivo com o trabalho (49,3%), embora tenham relatado maior controle sobre o trabalho (68,3%). A prevalência de alto esforço foi superior a 50,0% em ambos os grupos. As prevalências de transtornos mentais comuns foram semelhantes, contudo, trabalhadores informais apresentaram maior frequência de autoavaliação negativa da saúde.
Conclusão Trabalhadores informais enfrentam condições de trabalho e de saúde autorreferida mais precárias, mas o trabalho formal também apresenta vulnerabilidades. Esse cenário exige políticas que promovam condições dignas para todos, trabalhadores formais e informais.
Palavras-chave
Saúde do Trabalhador; Fatores Psicossociais; Trabalho Precário; Saúde Mental
Introduction
The Brazilian labor market, as in other countries, incorporates the coexistence of formal and informal work. A priori, these sectors may be seen as opposites, with formality offering guarantees of social and labor rights and informality without legal protection. However, both forms are part of the complex relations within the capitalist production process1. The economic structure of countries varies between complete informality and total formality2.
Informality includes a variety of worker segments: informal self-employed (employers in informal companies, own-account workers in informal companies, family workers, helpers in formal and informal companies, and members of informal production cooperatives) and informal wage earners (employees hired by formal and informal companies, without registration and without social protection; apprentices; homeworkers and domestic workers)2.
Informal work is mainly characterized by atypical work relationships, with various exploitative work practices, low incomes, long working hours, low qualifications, low social protection, insecurity about the future, high physical and mental demands, lack of guaranteed labor rights, precarious physical environment, unsafe working conditions and health risks, as well as situations of violence3,4. However, in Brazil, some of these characteristics can also be found within formal work contexts5.
The approximation of the characteristics and working conditions of the formal and informal sectors in the current context is partly driven by productive restructuring in the country, driven by changes in labor legislation. These changes were marked by the deregulation of social rights, flexibilization, outsourcing, and new forms of work management, which increased informal employment and extended precariousness to the formal sector3. As a result, working conditions unfavorable to workers’ health have emerged6.
Working conditions are structured based on the organization of work, the dynamics of the division of tasks and the interpersonal relationships established. The way they interact and are perceived by the worker constitutes the psychosocial factors at work. These risks are established from the interaction between the organization of work (reflecting the conception and management of work, including norms, assignments, tasks and work process); the physical environment (working conditions) and the social context (roles in the organization, culture, interpersonal relationships, career development, expectations, and personal situations)7.
Among the main models used to assess the psychosocial factors at work are the Demand-Control (DC) Model - comprising the dimensions: psychological demand, control over work, social support, and physical demand8,9- and the Effort-Reward Imbalance (ERI) Model, which involves the dimensions of effort, reward and excessive commitment to work10. These models, used simultaneously, make it possible to capture different dimensions of occupational stressors, offering a more comprehensive analysis of the situation11.
The DC Model envisages four work situations based on a combination of the dimensions of psychological demand and control over one’s work: low demand (low demand/high control), passive work (low demand/low control), active work (high demand/high control), and high demand (high demand/low control). Exposure to high demand and low control constitute a risk to physical and mental health. The social support dimension considers social relationships in the workplace. The presence of low social support increases the risk to health. The physical demand is also understood as a requirement of work activities, impacting on mental loads, and is a dimension to be measured, although it is not included in the model9.
The ERI model predicts that work-related benefits depend on reciprocity between efforts invested and rewards received. Lack of reciprocity triggers stress reactions which, when maintained, generate adverse health effects. It is an integrative model, combining extrinsic factors (work demands) and intrinsic factors (personal coping characteristics). Excessive commitment to work, a third dimension of the model, influences the perception of high effort and low reward, intensifying efforts and expectations of reward which, when not met, increase the possibility of negative effects on health10. Analysis of the psychosocial factors emphasized in these two models is useful in investigating the relationship between working environment conditions and repercussions on workers’ mental health.
Changes in the world of work have accentuated its precariousness5 and increased psychosocial risks, both in formal and informal work. Analyzing these types of work, exploring their differences and similarities, is fundamental to understanding the impact of labor transformations on workers’ health. The aim of this article is to describe working conditions and mental health, highlighting similarities and differences between formal and informal workers from a sample of the population in the city of Feira de Santana, Bahia.
Methods
Study design and context
This is a cross-sectional epidemiological study using data from workers who took part in a population-based household survey carried out in 2019, with a probabilistic sample of the urban population aged 15 years and over in the municipality of Feira de Santana.
This municipality has a population of 616,272 people, 26.9% of whom are employed (2022); a gross domestic product - GDP per capita of R$ 27,691.08 (2021) and a municipal human development index - MHDI of 0.712 (2010); an average monthly salary for formal workers of 1.9 minimum wages (2022) and a basic education development index (IDEB) - final years of elementary school of 3.6 (2019). Its territory is divided into five sub-districts, constituting census sectors with street groupings12.
Study size and participants
The sample size of the population survey was defined considering a detection power of 90%, 95% confidence interval, risk ratio of 1.38, and design effect - deff = 2, adding 20% due to losses. A minimum sample of 2,655 participants was obtained. Sampling was stratified by sub-districts, with two-stage cluster draws: the number of census tracts was obtained by simple probabilistic sampling and the number of streets by proportional probabilistic sampling, taking into account the number of households and people in the household, by sex and age (according to data from the Brazilian Institute of Geography and Statistics - IBGE). All the households in the streets drawn were included in the sample. All residents aged 15 or over were considered eligible. A total of 4,170 interviews were obtained. For this study, 1,623 subjects were selected who reported that they were working at the time of collection.
Data collection
Data collection took place in 2019, with interviewers hired for this purpose. Individual interviews were carried out in households, using a household identification form and a structured questionnaire in thematic blocks, applied by an interviewer.
Bias control
The period of data collection and typing was monitored by a coordination team, with the aim of organizing and controlling the quality of these stages. The process was checked weekly, and field supervision was carried out monthly. A random sample of 10% of the questionnaires was double entered. The hired interviewers were trained beforehand and the collection was standardized through a Conduct and Procedures Manual. To obtain the interviews, up to three visits were made to households.
Variables and measurement
The data was obtained from the answers to the questions that made up the questionnaire’s blocks on sociodemographic characteristics, professional work, psychosocial aspects of work, lifestyle habits and mental health.
The independent variable - formal and informal work - was defined based on data on formal employment, type of contract, and occupation. A formal worker was one who had a formal contract or was a civil servant in one or more jobs.
The dependent variables included sociodemographic characteristics: gender (male, female), race (black and non-black), age group (15-24; 25-39; 40-59; ≥ 60 years), education level (categorized as complete/incomplete), income (up to R$ 1,000.00; between R$ 1,001.00 and 3,000; above R$ 3,000.00), and residential structure (low, medium, high); work characteristics: occupation (asked “what is your occupation?”, with nine answer options), years of work (up to 2; 3-10; > 11), weekly working hours (up to 30 hours, 31-44, > 44), days worked in the week (up to 5; 6 or 7), location (asked “where do you work?”, with five answer options), occurrence of an accident at work in the last year (yes; no) and aspects of mental health: alcohol abuse, quality of life, perceived health, presence of common mental disorders (CMD), suicidal ideation and sleep disorders.
The suicidal ideation variable was obtained from the SRQ-20, item 17 - “have you had thoughts of ending your life?”. Residential structure was defined based on the sum of the scores of the questions about the rooms in the house, type of building, having household appliances, running water, electricity, telephone, and housekeeper, and the result was divided by the tertiles. Perceived health and quality of life were transformed into binary variables (good/bad), grouping the categories (very good/good and fair/bad/very bad).
The psychosocial factors at work were assessed using the Job Content Questionnaire - JCQ9, validated in Brazil by Araújo and Karasek13, containing 27 items and the Effort-Reward Imbalance Questionnaire - ERI-Q10, validated in Brazilian worker populations14, with 23 items (ERI), both on a Likert scale (scores from 1 to 4). The instrument scores were calculated according to the recommendations of Karasek15 and Siegrist et al.16. The description of the application of the models is given in the study by Araújo et al.11.
CMD was measured using the Self-Reporting Questionnaire-SRQ-2017. The cut-off point for CMD suspicion was 7 for women and 5 for men18. Detection of alcohol abuse followed the CAGE criteria19 and sleep quality was assessed using the Mini Sleep Questionnaire - MSQ20, treated as a binary categorical variable, grouping levels of difficulty sleeping (combining good quality/mild difficulty and moderate/severe difficulty). For description purposes, the JCQ and ERI-Q items were transformed into binary variables (grouping the disagree/strongly disagree and agree/strongly agree categories).
Data analysis
The database was entered into the Statistical Package for the Social Sciences (SPSS) software, version 24.0. Cleaning was carried out using conference and combination routines. Six workers were excluded due to not answering the questions about their work. The analyses were carried out using Stata software version 17.0, applying the procedures for complex samples (survey).
Missing data reached proportions of up to 10% for most variables21(Supplementary tables - Appendix A). It was decided to keep the cases with higher proportions of missing data, given the theoretical relevance of these variables to the proposed research.
Pearson’s chi-squared test with Rao-Scott correction was used to compare the distributions between the groups of formal and informal workers, with a significance level of 0.05. For the aspects relating to mental health, the respective confidence intervals (95%) were described, according to the formal and informal work modalities.
Ethical considerations
The study complied with the ethical requirements of Resolution 466/2012. Each individual selected was informed about the objectives of the study and those who agreed to take part signed the Informed Consent Form (ICF).
The study was carried out by the Epidemiology Center of the State University of Feira de Santana (NEPI-UEFS), approved by the Research Ethics Committee of the State University of Feira de Santana - CEP/UEFS, with Opinion no. 2.420.653 (CAAE: 74792617.4.0000.0053), on June 6, 2020. The project received approval and funding from the Bahia State Research Support Foundation (FAPESB/SESAB/CNPQ/MS PPSUS/BA - 028/2018). The data collected was recorded in an information system, forming a database stored under the custody of the team of researchers responsible, ensuring the confidentiality of the information.
Results
Among the 513 formal workers, the gender distribution was balanced: 50.2% were women and 49.8% were men; among the 1,110 informal workers, women were more frequent (53.6%). Black race (mixed race and Black individuals) prevailed among both formal (77.1%) and informal workers (81.8%). Among formal workers, those aged between 25 and 39 predominated (45.1%). Among informal workers, the predominant age group was 40 to 59 (59.3%) and there was a higher proportion of workers aged 60 and over (10.7%). In the group of formal workers, most workers had completed or incomplete secondary education (55.4%) and 30.8% had higher education, while among informal workers these proportions were 41.5% and 19.5%, respectively. Monthly family income of up to R$ 1,000.00 was more common among informal workers (57.7%), whereas 65.0% of formal workers were in the R$ 1,001.00 to R$ 3,000.00 income bracket. Medium-quality housing was more common among formal workers (55.6%). Low-quality homes were more common among informal workers (27.4%) (Table 1).
Among the informal, occupation was concentrated among self-employed workers (63.7%) and odd jobs (17.8%). Compared to formal workers, informal workers had a higher frequency of working more than 44 hours a week (30.6%), working between six and seven days a week (59.4%), using their own home as a workplace (34.5%) and having an accident at work (10.8%) (Table 2).
Considering the psychosocial factors at work, 45.5% of informal workers had high psychological demands (compared to 32.8% of formal workers). Among formal workers, 63.1% had low control over their work, while informal workers had 31.7%. The proportion of high-demand jobs was higher among formal workers (22.7%). Active work was more frequent among informal workers (34.2% compared to 10.1% among formal workers), while passive work was more frequent among formal workers (40.0% compared to 20.0% among informal workers). Low reward (42.6%) and overcommitment (49.3%) were proportionally higher among informal workers. High work effort and high physical demand were above 50.0% for both types of work (Table 3).
An average of 823 informal workers answered “not applicable” to the supervisor variables that make up the scores for the Social Support and Reward dimensions, which is considered lost data and makes it impossible to include these people in the calculation of the scores for these dimensions and ERI.
Among formal workers, the following situations were most frequent: not making decisions about work (64.4%), going through unwanted changes (50.0%), and having little chance of promotion (49.9%). Informal workers stood out for: excessive workload (56.5%), working during lunchtime or breaks (46.0%), longer working hours (30.5%), lack of support in difficult situations (25.5%), and feeling unstable at work (42.0%). More than 90% of formal and informal workers considered that they had a lot of responsibility at work. The perception that “work demands more and more”; “work hard and fast”, “work requires uncomfortable positions”, and “not having an adequate salary/income” was considered by more than 50% of formal and informal workers (Table 4).
Regarding mental health, the prevalence of alcohol abuse, negative perception of quality of life, and health status were higher among informal workers (15.2% and 30.4%, 32.0% respectively). However, the prevalence of common mental disorders was similar for formal workers (24.8%) and informal workers (25.0%). Suicidal ideation was reported by 2.8% of formal workers and 5.7% of informal workers (Table 5).
Discussion
The study revealed that informal workers in Feira de Santana-BA had lower incomes, lower levels of schooling, and longer working hours compared to formal workers. The former had a higher frequency of stressful situations, such as high psychological demand and overcommitment to work, although they reported greater control over their work. More than half of the workers in both groups reported high effort. The prevalence of common mental disorders was similar among workers in both groups. However, informal workers had a higher frequency of negative self-rated health.
One result that should be highlighted in this study was the high percentage of people working informally. This result was similar to a previous study carried out in the same city, with similar sampling procedures13.
Informal workers were more likely to work in more precarious occupations than formal workers. These results are consistent with other studies22,23. Another study of informal workers on the streets of downtown Feira de Santana showed similar characteristics24. Informal workers were the ones who reported the longest weekly working hours, indicating work overload. A similar result was identified by Carvalho and Aguiar25, in a content analysis of a qualitative study with street vendors in Feira de Santana (BA) and by Santos and Mesquita26 in a cross-sectional study with street vendors in São Luís (MA), in which 60% worked more than eight hours a day.
The presence of informal salaried, domestic, and cooperative workers shows a situation of illegality, marked by the absence of labor and social security rights, which represents greater vulnerability and precariousness. This scenario reflects the process of economic restructuring in recent decades, intensified by the labor reform (Law No.13,467 of June 13, 2017), which expanded the forms of contracting and increased the fragility of labor relations3.
The distribution of informal workers over different working hours suggests that it is a characteristic of this type of work, influenced by factors such as region, local culture, type of activity, place of performance, and other daily demands related to domestic work, intensity of workloads, sales point agreements, and times when there is a greater flow of people. Variation in informal working hours was also observed among workers in six Central American countries, whose weekly working hours ranged from 40 to more than 48 hours27. Accidents at work were more frequent among informal workers. However, in both groups, the low response suggests that occupational accidents are underreported in the country28. The lack of registration may be related to exclusion from the social security system, non-recognition by health care services, employers’ failure to report accidents at work (CAT) and the lack of a nexus on the part of the social security system. But the denial of the event by the worker themself29 shows a culture of naturalizing risk, aggravated by the precariousness of work, which turns accidents into random events, the fruit of chance.
Control over work proved to be an important differentiating factor between formal and informal workers. Informal workers reported a greater perception of high control over their work, indicating that the organization of informal work favors greater autonomy and the use of skills in tasks. This trend has been observed in other studies25,30,31, reinforcing the role of this psychosocial dimension. At the same time, high psychological demand also stood out among informal workers, mainly due to the excessive volume of work.
Formal workers were more likely to fall into low-demand and passive working conditions. Among informal workers, the active work situation stands out in relation to that of formal workers. Applying the DC model to these workers revealed a distribution without a predominance of quadrants, reflecting the heterogeneity of their occupations and, consequently, influencing the combinations between demand and control. According to Karasek8, the diversity of occupations has an impact on how the different levels of demand and control interact.
According to Karasek et al.9, a passive work situation predicts a demotivating, negative learning environment for low-status administrative and service employees. Low-demand jobs are occupied by workers with their own rhythms, such as electricians and mechanics. This pattern is in line with some of the occupations of formal workers in this study.
On the other hand, active work (with high psychological demand but also high control) predicts motivation and learning opportunities, and is commonly found among highly prestigious professionals9, which does not reflect the condition of these informal workers. However, this statement is based on different cultural and working contexts. In the case of informality, the possibility of deciding how to carry out tasks13 suggests an autonomy inherent to this type of work and indicates that control over one’s work is related to the way and possibilities of carrying it out, regardless of the prestige of the occupation.
Social support was poorly perceived among informal workers, especially regarding support from bosses, which is understandable given that many were self-employed or odd jobs. As for support from colleagues, these workers carried out their activities mainly on the streets or in their own homes, where interactions with colleagues are limited or confused with relationships with clients25,32. The low perception of social support among colleagues was also observed in the qualitative study by Morrone and Mendes30 which describes relationships between market traders characterized by disunity and individualism.
Regardless of the type of work, the perception of high effort was high. This effort was perceived mainly in the form of demands and high responsibility. Effort at work among informal workers was identified in different occupations, such as retail workers31 and market traders25. The condition of low reward was highlighted by the perception that income or salary was inadequate, for both formal and informal workers. Given the high level of effort required, low income contributes to the feeling of insufficient recognition10.
Excessive commitment to work was relevant among informal workers. This result is in line with the study by Taris et al.33, which identified difficulties in disconnecting from work among self-employed workers. This characteristic is associated with a motivational pattern that leads to excessive and limitless work in the pursuit of achievement. Even without commensurate rewards, workers tend to remain involved, underestimating the demands and overestimating their ability to cope34. The question is whether this commitment is disproportionate or whether, in reality, informality requires excessive dedication as a condition for making a living.
The high level of responsibility at work (the effort) combined with low pay (the reward gap) were central to the effort-reward imbalance between formal and informal workers. According to Siegrist10, the failure of reciprocity - i.e. the absence of retribution for efforts expended - can be maintained by extrinsic factors, such as the lack of alternatives, especially in more precarious contexts, or the expectation of future promotions.
Aspects of compromised mental health were more frequent among informal workers, in line with the conclusions of Bernardino and Andrade22. Low quality of health and suicidal ideation were more common among informal workers. Alcohol abuse was higher among informal workers, although at a lower frequency than that observed in the 2019 IBGE National Health Survey35. This discrepancy with the general population was addressed by Primo and Batista36, in a study of market traders, which showed a similar trend.
The equivalence of CMD in both types of work indicates that different occupational contexts may share similar trajectories in determining mental health. On the other hand, suicidal ideation, which is more prevalent among informal workers, requires attention in future studies. Cases of suicide among informal workers have already been reported in the literature37. The prevalence of CMD observed in this study was close to that found among adult Quilombolas in Bahia (29.6%)38 and in other categories of Brazilian workers39.
Considering that low income, intensification of work, lack of legal protection, poor health conditions, and weak employment relationships are aligned with the concept of precarious work1,6, the results of this study showed that indicators of precarious work were higher among informal workers. On the other hand, some characteristics related to work and mental health were also unfavorable for formal workers, suggesting that, in certain respects, both groups may share a similar condition of vulnerability.
The information obtained must be interpreted in the light of the limitations of this study. The cross-sectional study design allows for a one-off assessment, preventing us from knowing the dynamics of work and health that occur over time. Selection bias may be a limiting factor. Workers who identified themselves as working at the time of the interview were studied, but it is possible to lose individuals who did not recognize themselves as workers, especially if they belonged to a more unstable informal occupation. The measures, being self-reported, may have been influenced by recall bias, however, most of the questions referred to situations that were being experienced or happened at a time not far from the day of the interview. It is likely that educational level was a limiting factor and favored the occurrence of information bias.
As for the missing data, the methodological decision to keep them may imply bias, underestimating, or overestimating prevalence. The losses in the variables Workload and work accidents (among informal workers) and Family income (in both modalities) were considerable, which limits robust statistical inferences. For family income, the data was consistent with the average monthly salary of the population of Feira de Santana in 2022 (1.9 minimum wage)12, proving to be an approximate reference for reality at the time of the survey. The CAGE was only applied to people who reported drinking alcohol. Thus, the absence of a response did not represent missing data, but a conditional characteristic of the variable.
The apparent losses in the Social Support variable resulted from the “not applicable” option ticked by a significant number of participants in the items that make up this dimension, indicating that the situation is not pertinent to the context of these workers. A similar procedure occurred with the items relating to social relationships that make up the Reward dimension. The answer “not applicable” reflects specific situations, without this being considered missing data. However, although these significant absences are not losses to be attributed, there is still the possibility that they could lead to biased inferences.
The behavior of the dimensions that deal with social relationships at work among informal workers indicates that this is a phenomenon inherent to the characteristics of this type of work, and is an opportunity for further research aimed at understanding the functioning of these working relationships in psychosocial environments resulting from unique working conditions, as well as expanding knowledge about other sources of social support.
The data and methodology of the study did not make it possible to obtain more information about work organization, making it impossible to discuss the results in depth. The scarcity of national studies comparing formal and informal workers made comparisons difficult, making it necessary to resort to studies on specific occupations or those that used qualitative methodologies with informal workers.
Despite the limitations, the data analyzed comes from a population-based study with a diverse sample of workers from Feira de Santana-BA. Consolidated instruments were used to measure the outcomes of interest. Due to the complex sample design, appropriate statistical treatment was applied to analyze data of this nature. Thus, it is plausible to extend the results to similar groups of workers, considering that, even with limitations, it was possible to explore a significant amount of information about the working conditions and mental health of these individuals.
Conclusion
This study explored the work and mental health characteristics of workers in the formal and informal sectors in the city of Feira de Santana-BA. The results revealed that formal and informal workers differed in terms of work characteristics, perception of psychosocial factors, and some aspects of mental health, with more precarious working conditions and mental health among informal workers. Although formal workers have better working conditions and mental health, the unfavorable situations found among them also demand attention.
The findings of this study reflect the varied configurations of the reality of work: employment relationships, new and old ways of working, and the dynamics of relationships. Therefore, working conditions do not confirm the idea that formal and informal work are at opposite ends of the spectrum. We need to understand that both are part of a chain of interrelated processes that are part of a socio-economic system. Thus, any aspect related to these categories must be analyzed considering the complexity and multiplicity of the factors that intertwine them.
The end of informality in Brazil does not seem feasible in the next few years, considering that it has a long history and is already comfortably incorporated into our production model. However, the reality of informality encompasses forms of precariousness and inequalities in health and, although it is a challenge, this panorama needs intervention. Ideally, this type of work, like formal work, should be more protected by the State.
From the perspective of workers’ health, the National Workers’ Health Policy (PNSTT)40 prioritizes the most vulnerable groups, such as those in the informal sector. The reality of these workers demands that the PNSTT advances its effectiveness in the various instances of the SUS, ensuring that users are identified as workers and incorporating work as an important determinant of living conditions and health. The National Network for Comprehensive Workers’ Health Care (RENAST) requires greater effectiveness for this population practices of comprehensive workers’ health care with an emphasis on surveillance.
Viable solutions are needed, with the aim of promoting and legalizing employment relationships; providing opportunities for self-employment as an option and a chance to improve one’s life; and providing social support for the coexistence of informality in the traditional, self-supporting way. However, these solutions must be driven by a state policy, enabling and encouraging, above all, decent working conditions, capable of providing for the health and well-being of workers, whether formal or informal. It is therefore hoped that this study can contribute information to support the actions and measures needed to protect and promote workers’ health.
References
-
1 Druck G. Labor, precarization and resistances: old and new challenges. Cad CRH. 2011;24(SPE1):37-57. https://doi.org/10.1590/S0103-49792011000400004
» https://doi.org/10.1590/S0103-49792011000400004 - 2 Krein JD, Proni MW. Economia informal: aspectos conceituais e teóricos. Brasília, DF: OIT; 2010. (Série Trabalho Decente no Brasil;1)
- 3 Krein JD, Oliveira RV. Para além dos discursos: impactos efetivos da reforma nas formas de contratação. In: Krein JD, Oliveira RV, Filgueiras VA, organizadores. A Reforma trabalhista no Brasil: promessas e realidade. Campinas: Curt Nimuendajú; 2019. p. 81-125.
-
4 Ko Ko T, Dickson-Gomez J, Yasmeen G, Han WW, Quinn K, Beyer K, et al. Informal workplaces and their comparative effects on the health of street vendors and home-based garment workers in Yangon, Myanmar: a qualitative study. BMC Public Health. 2020 Apr;20(1):524. https://doi.org/10.1186/s12889-020-08624-6
» https://doi.org/10.1186/s12889-020-08624-6 -
5 Cabral IB, Silva PH, Souza DO. Precarização do trabalho e saúde do trabalhador: revisão e perspectivas. Trab Educ. 2022 Feb;30(3):51-65. https://doi.org/10.35699/2238-037X.2021.25729
» https://doi.org/10.35699/2238-037X.2021.25729 -
6 Fernandes RC. O construto multidimensional trabalho precário, o futuro do trabalho e a saúde de trabalhadoras(es). Cad Saude Publica. 2023 May;39(4):e00100522. https://doi.org/10.1590/0102-311xpt100522
» https://doi.org/10.1590/0102-311xpt100522 -
7 Organización Internacional del Trabajo. Factores psicosociales en el trabajo: naturaleza, incidencia y prevención. Informe del Comité Mixto OIT-OMS sobre Medicina del Trabajo, novena reunión, Ginebra, 18-24 de septiembre de 1984. Ginebra: Oficina Internacional del Trabajo; 1986. (Serie Seguridad, Higiene y Medicina del Trabajo; 56) [citado 10 jan 2025]. Disponível em: https://www.factorespsicosociales.com/wp-content/uploads/2019/02/FPS-OIT-OMS.pdf
» https://www.factorespsicosociales.com/wp-content/uploads/2019/02/FPS-OIT-OMS.pdf -
8 Karasek RA. Job demands, job decision latitude, and mental strain: implications for job redesign. Adm Sci Q. 1979 Jun;24(2):285-308. https://movingforwardnetwork.org/wp-content/uploads/2023/04/Karasek_Job-Demands-Job-Decision-Latitude-and-Mental-Strain-Implications-for-Job-Redesign_1979.pdf
» https://movingforwardnetwork.org/wp-content/uploads/2023/04/Karasek_Job-Demands-Job-Decision-Latitude-and-Mental-Strain-Implications-for-Job-Redesign_1979.pdf -
9 Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B. The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol. 1998 Oct;3(4):322-55. https://doi.org/10.1037/1076-8998.3.4.322
» https://doi.org/10.1037/1076-8998.3.4.322 -
10 Siegrist J. Effort-reward imbalance and health in a globalized economy SJWEH Supplements. 2008 [citado 10 set 2023];(6):163-8. Disponível em: https://www.sjweh.fi/article/1263
» https://www.sjweh.fi/article/1263 -
11 Araújo TM, Mattos AI, Almeida MM, Santos KO. Aspectos psicossociais do trabalho e transtornos mentais comuns entre trabalhadores da saúde: contribuições da análise de modelos combinados. Rev Bras Epidemiol. 2016;19(3):645-57. https://doi.org/10.1590/1980-5497201600030014
» https://doi.org/10.1590/1980-5497201600030014 -
12 Instituto Brasileiro de Geografia e Estatistica. Cidades e Estados. Feira de Santana Rio de Janeiro: Instituto Brasileiro de Geografia e Estatistica; 2020 [citado 15 jun 2023]. Disponível em: https://www.ibge.gov.br/cidades-e-estados/ba/feira-de-santana.html?
» https://www.ibge.gov.br/cidades-e-estados/ba/feira-de-santana.html? -
13 Araújo TM, Karasek R. Validity and reliability of the job content questionnaire in formal and informal jobs in Brazil. SJWEH Supplements. 2008 [citado 20 maio 2023;(6):52-9. Disponível em: https://www.sjweh.fi/show_abstract.php?abstract_id=1251
» https://www.sjweh.fi/show_abstract.php?abstract_id=1251 -
14 Chor D, Werneck GL, Faerstein E, Alves MG, Rotenberg L. The Brazilian version of the effort-reward imbalance questionnaire to assess job stress. Cad Saude Publica. 2008 Jan;24(1):219-24. https://doi.org/10.1590/S0102-311X2008000100022
» https://doi.org/10.1590/S0102-311X2008000100022 - 15 Karasek R. Job content questionnaire and user's guide. Lowell: Department of Work Environment, University of Massachusetts; 1985.
- 16 Siegrist J, Li J, Montano D. Psychometric properties of the Effort-Reward imbalance questionnaire. Dusseldorf: Department of Medical Sociology, Faculty of Medicine, Duesseldorf University; 2014.
- 17 Beusenberg M, Orley JH. A User's guide to the Self-Reporting Questionnaire (SRQ). World Health Organization (WHO/MNH/PSF/94.8. Unpublished). Genebra, 1994:1-84.
-
18 Santos KO, Araújo TM, Pinho PS, Silva AC. Avaliação de um instrumento de mensuração de morbidade psíquica: estudo de validação do Self-Reporting Questionnaire (SRQ-20). Rev Baiana Saude Publica. 2010 Sep;34(3):544-60. https://doi.org/10.22278/2318-2660.2010.v34.n3.a54
» https://doi.org/10.22278/2318-2660.2010.v34.n3.a54 -
19 Guimarães VV, Florindo AA, Stopa SR, César CL, Barros MB, Carandina L, et al. Consumo abusivo e dependência de álcool em população adulta no Estado de São Paulo, Brasil. Rev Bras Epidemiol. 2010 Jun;13(2):314-25. https://doi.org/10.1590/S1415-790X2010000200013
» https://doi.org/10.1590/S1415-790X2010000200013 -
20 Falavigna A, Bezerra MLS, Teles AR, Kleber FD, Velho MC, da Silva RC, et al. Consistency and reliability of the Brazilian Portuguese version of the Mini-Sleep Questionnaire in undergraduate students. Sleep Breath. 2011 Sep;15(3):351-5. https://doi.org/10.1007/s11325-010-0392-x
» https://doi.org/10.1007/s11325-010-0392-x - 21 Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL. Análise multivariada de dados. 6a ed. Porto Alegre: Bookman, 2009. Capítulo 2, Exame de seus dados; p. 50-9.
-
22 Bernardino DCAM, Andrade M. O trabalho informal e as repercussões para a saúde do trabalhador: uma revisão integrativa. Rev Enferm. 2015;4(7):149-58. http://dx.doi.org/10.12707/RIV14049
» http://dx.doi.org/10.12707/RIV14049 -
23 Xavier DG, Falcão JT, Torres CC. Caracterização da atividade laboral de trabalhadores informais em praia de Natal (RN) - Brasil. Cad Psicol Soc Trab. 2015;18(1):29-45. https://doi.org/10.11606/issn.1981-0490.v18i1p29-45
» https://doi.org/10.11606/issn.1981-0490.v18i1p29-45 -
24 Queiroz FA, Souza LN, Reis RB, Souza JG. Perfil socioeconômico dos trabalhadores de rua de uma metrópole nordestina. Research. Soc Dev. 2020 Nov;9(11):e2799119690. https://doi.org/10.33448/rsd-v9i11.9690
» https://doi.org/10.33448/rsd-v9i11.9690 -
25 Carvalho JD, Aguiar MG. Qualidade de vida e condições de trabalho de feirantes. Rev Saude Col UEFS. Dez. 2017;7(3):23. https://doi.org/10.13102/rscdauefs.v0i0.1943
» https://doi.org/10.13102/rscdauefs.v0i0.1943 - 26 Santos DR, Mesquita AA. Avaliação das condições de trabalho e sofrimento psíquico em camelos. Rev Psicol Saude. 2016;8(2):29-42.
-
27 Ruiz de Porras DG, Rojas Garbanzo M, Aragón A, Carmenate-Milián L, Benavides FG. Effect of informal employment on the relationship between psychosocial work risk factors and musculoskeletal pain in Central American workers. Occup Environ Med. 2017 Sep;74(9):645-51. https://doi.org/10.1136/oemed-2016-103881
» https://doi.org/10.1136/oemed-2016-103881 -
28 Barros DO, Oliveira LS, Bezerra JC, Sá EC. Work accidents registered in the Brazilian social security system between 2016 and 2020: a descriptive analysis. Rev Bras Med Trab. 2024 Nov;22(3):e20231215. https://doi.org/10.47626/1679-4435-2023-1215
» https://doi.org/10.47626/1679-4435-2023-1215 -
29 Cavalcante CA, Cossi MS, Costa RR, De Medeiros SM, De Menezes RM. Análise crítica dos acidentes de trabalho no Brasil. Rev Bras Cien Saude. 2015 Jul;13(44):100-9. https://doi.org/10.13037/ras.vol13n44.2681
» https://doi.org/10.13037/ras.vol13n44.2681 - 30 Morrone CF, Mendes AM. A ressignificação do sofrimento psíquico no trabalho informal. Rev Psicol Organ Trab. 2003 Dez;3(2):91-118.
-
31 Rios MA, Nery AA. Condições laborais e de saúde referidas por trabalhadores informais do comércio. Texto Contexto Enferm. 2015 Jun;24(2):390-8. https://doi.org/10.1590/0104-07072015000052014
» https://doi.org/10.1590/0104-07072015000052014 - 32 Torres TL, Bendassolli PF, Lima FC, Paulino DS, Fernandes AP. Representações sociais do trabalho informal para trabalhadores por conta própria. Rev Subjetividades. 2018;18(3):26-38.
-
33 Taris TW, Geurts SA, Schaufeli WB, Blonk RW, Lagerveld SE. All day and all of the night: the relative contribution of two dimensions of workaholism to well-being in self-employed workers. Work Stress. 2008 Apr;22(2):153-65. https://doi.org/10.1080/02678370701758074
» https://doi.org/10.1080/02678370701758074 -
34 Siegrist J, Li J. Associations of extrinsic and intrinsic components of work stress with health: a systematic review of evidence on the Effort-Reward Imbalance Model. Int J Environ Res Public Health. 2016 Apr;13(4):432. https://doi.org/10.3390/ijerph13040432
» https://doi.org/10.3390/ijerph13040432 - 35 Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional de Saúde 2019. Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística; 2024.
-
36 Primo SM, Batista L. Feiras livres, interseccionalidades e seus rebatimentos na saúde mental. ECOS. 2024 [citado 8 mar 2025];14(2). Disponível em: http://www.periodicoshumanas.uff.br/ecos/article/view/219-231
» http://www.periodicoshumanas.uff.br/ecos/article/view/219-231 -
37 Sena-Ferreira N, Pessoa VF, Boechat-Barros R, Figueiredo AE, Minayo MC. Fatores de risco relacionados com suicídios em Palmas (TO), Brasil, 2006-2009, investigados por meio de autópsia psicossocial. Cien Saude Colet. 2014 Jan;19(1):115-26. https://doi.org/10.1590/1413-81232014191.2229
» https://doi.org/10.1590/1413-81232014191.2229 - 38 Mussi R, Rocha S, Alves T. Transtornos mentais comuns em quilombolas baianos, nordeste brasileiro. Psicol Saude Doencas. 2019 Nov;20(3):698-710.
-
39 Coledam DH, Alves TA, Arruda GA, Ferraiol PF. Prevalence of common mental disorders among Brazilian workers: systematic review and meta-analysis. Cien Saude Colet. 2022 Feb;27(2):579-91. https://doi.org/10.1590/1413-81232022272.46012020 PMID:35137814
» https://doi.org/10.1590/1413-81232022272.46012020 -
40 Ministério da Saúde (BR). Portaria Nº 1.823, de 23 de agosto de 2012 [citado 3 jun 2025]. Institui a Política Nacional de Saúde do Trabalhador e da Trabalhadora. Disponível em: http://bibliotecadigital.gestao.gov.br/handle/123456789/980
» http://bibliotecadigital.gestao.gov.br/handle/123456789/980
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Information on academic work:
Article based on the doctoral thesis entitled “Aspectos psicossociais do trabalho e saúde mental entre trabalhadores formais e informais (Psychosocial aspects of work and mental health among formal and informal workers)”, which will be defended by the author Suerda Fortaleza de Souza at the Institute of Collective Health Studies of the Federal University of Rio de Janeiro.
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Data availability:
Unrestricted public sharing of the database is not possible, since the project approved by the Research Ethics Committee provided for its exclusive use for the intended purposes. Interested researchers can request access to the anonymized data from the contact author by providing justification and signing a confidentiality agreement, subject to further ethical review.
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Statement on the Use of Artificial Intelligence:
During the preparation of the article, the artificial intelligence tool ChatGPT (OpenAI), based on the GPT-5.2 model, was used exclusively for translation revision purposes. The authors declare that they have fully reviewed and validated all content.
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Presentation at a scientific event:
The authors inform that this study was partially presented at the Congress of the International Commission on Occupational Health (ICOH), at the University of Economics in Ho Chi Minh City, Vietnam, in December 2025.
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Funding:
Bahia State Research Foundation (FAPESB/SESAB/CNPQ/MS PPSUS/BA - process 028/2018).
Appendix 1
Missing data relating to the variables that make up work characteristics, according to formal and informal employment. Urban workers in Feira de Santana, BA, Brazil, 2019 (n = 1,613)
Edited by
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Editors responsible:
Ricardo Luiz Lorenzi https://orcid.org/0000-0002-7534-054X Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho - FundacentroLeila Posenato Garcia https://orcid.org/0000-0003-1146-2641 Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho - Fundacentro
Unrestricted public sharing of the database is not possible, since the project approved by the Research Ethics Committee provided for its exclusive use for the intended purposes. Interested researchers can request access to the anonymized data from the contact author by providing justification and signing a confidentiality agreement, subject to further ethical review.
