Background:

The association between work and health has not been well explored in the context of economically developing countries, largely due to inadequate data.

Objectives:

The objective of this study was to identify the association between informal wage work and health in South Africa using a newly available data set that includes detailed information on both employment and health.

Methods:

To explore the relationship between formality, work, and health in South Africa, data from the first (2008) wave of the National Income Dynamic Study (NIDS) were analyzed. We constructed a “formality index” which represents work arrangements on a continuum of formality to informality allowing for a more nuanced analysis of the association between wage work and health.

Results:

We found that formality of employment was significantly associated with health in South Africa, but that the protective effect of formality in employment on health was largely derived from the higher levels of income earned through more formal types of employment. Nevertheless, we did find that the association between informality and poor health was significantly greater for women in wage employment than for males.