Illness, Healthcare Challenges and Causation of Chronic Disease: An Epidemiological Study of Construction Workers

Introduction

The social determinants produce butterfly effects in the domains of causation of diseases as well as healthcare outcomes. This study explores the disease causation and healthcare trajectories of the migrant people working in construction sector in urban spaces of western Uttar Pradesh (India). Construction sector workers largely work as casual workers and constitute a major disadvantaged group in India.

Methods

This is a cross-sectional study based on social epidemiological perspective. It uses semi-structured interview schedule and ethnographic observation. The multi-stage cluster sampling is used to identify the 300 samples.

Findings

Findings reveal that cases of injury among the workers is 35 percent. Eighty five percent female workers and 55 percent male workers are suffering from disease or illness like prolonged cough and shivering (16.7%); exhaustion (16%); fever (13%); respiratory problems (8%); headache and gastritis problems (6%) and others including tuberculosis, skin, slip disc problems, STDs etc.

The respondents preferred private practitioners for immediate pain relief without undergoing proper medical treatment in many cases. Government hospitals were used only occasionally. None had any health insurance. Lack of immunisation left the children susceptible to several diseases. Poor food, lack of potable water and use of tobacco products etc aggravated the health challenges.

Conclusions

The findings suggest that poor health outcome aggravates the already disadvantaged conditions of these workers. Lack of public health facilities and poor economic conditions compel many of them to get treatment from quacks and alternative systems of medicines. This often cause occurrence of chronic diseases. This paper explains how feminization of casual labour, informalization of work and poor public health facilities cause chronic disease among the disadvantaged groups. It proposes concepts of ‘illness doubt’ and ‘healthcare illusion’ to explain them. It concludes that the ecology of primary care practice is complicated and often confirm complexity theories.