بررسي اپيدميولوژيك وضعيت سلامت اجتماعي نانوايان شهر اصفهان و عوامل مرتبط با آن

Investigating Social Health of Bakers and the Related Factors in Isfahan, Iran

خصوصيات هر شغل و پيامدهاي اقتصادي-اجتماعي آن در ارتباط با سلامت اجتماعي شاغلين است. سلامت‌اجتماعي در پِي شناسايي تاثير متقابل نحوه‌ي كنش اجتماعي بر بهزيستي افراد مي باشد. مطالعه حاضر با هدف بررسي وضعيت سلامت‌اجتماعي نانوايان و متغيرهاي مرتبط با آن صورت گرفته است. سلامت اجتماعي نانوا علاوه بر اينكه از جنبه سلامت فردي و شغلي و نوع تعامل با همكاران و ساير اقشار جامعه حائز اهميت است، از نقطه نظر بهداشت عمومي نيز شايان توجه مي باشد به گونه اي كه اگر فرد نانوا از بهزيستي اجتماعي مناسبي برخوردار نبوده و براي اجتماعش اهميت قائل نشود ممكن است سلامت نان بخش اعظمي از مردم دستخوش تغيير شده و نان توليدي از كيفيت لازم برخوردار نباشد. روش بررسي: اين مطالعه يك بررسي مقطعي-تحليلي بود كه در سال 1396 انجام پذيرفت. نمونه مورد مطالعه شامل 469 نفر نانواي شاغل در نانوايي‌هاي سنتي شهر اصفهان بود كه با روش نمونه‌گيري طبقه اي از مناطق پانزده‌گانه شهرداري اصفهان انتخاب گرديدند. داده‌هاي پژوهش به وسيله‌ي پرسشنامه سلامت اجتماعي بزرگسالان با مولفه­هاي تعامل اجتماعي، مسئوليت‌پذيري اجتماعي، وظيفه­شناسي، نگرش به جامعه، همدلي، روابط خانوادگي و مشاركت اجتماعي؛ و پرسشنامه اطلاعات دموگرافيك گردآوري شد، و با نرم افزار SPSS نسخه20 طي آزمون‌هاي همبستگي اسپيرمن و آناليز كوواريانس ناپارامتري، تجزيه و تحليل شد. يافته ها: ميانگين سني نانوايان مورد بررسي 9/39 سال (82/11±) و دامنه سابقه كار آنان بين يك تا 65 سال با ميانگين 3/18 (31/12±) بود. بازه‌ي نمره‌ي سلامت اجتماعي آن ها بين 18 تا 140 بود. حدود 3درصد از آنان وضعيت سلامت‌اجتماعي خيلي ضعيف، 36% ضعيف، 27درصد متوسط، 26% خوب و 7درصد خيلي خوب داشتند. سلامت اجتماعي اين نانوايان با سن و سابقه كار آنان رابطه‌اي مثبت و مستقيم داشت (p-value≤ 0.05). ميانگين نمره سلامت اجتماعي افراد متأهل بطور متوسط در حدود 7/9 واحد بيشتر از افراد مجرد بود. همچنين سلامت‌اجتماعي افراد با وضعيت درآمد متوسط نيز در مقايسه با درآمد پايين به اندازه 22/6 واحد بالاتر بود (p-value= 0.034). بحث و نتيجه گيري: وضعيت سلامت اجتماعي نانوايان سنتي شهر اصفهان ضعيف رو به متوسط بود. به نظر مي رسد اين به دليل معدود بودن تعداد كاركنان نانوايي ها و نيز زمان كاري متناوب و منتشر بين ساعات اوليه صبح تا پاسي از شب، و كاهش تعاملات سازنده اجتماعي آنان است. احتمالا نانوايان در قبال نقشي كه در جامعه بر عهده دارند مسئوليت پذيري درخوري نداشته و توان درك سايرين و همدلي با ديگران در آن ها دچار ضعف است. ممكن است اين افراد با خانواده و خويشاوندان خويش ارتباط صحيحي برقرار نكنند و در برنامه ها و فعاليت هاي بهبود دهنده اجتماع مشاركت نداشته باشند و خود را سهيم در جامعه ندانسته و دچار گسست از جامعه شوند. اين افراد ارزيابي ذهني نسبتا پاييني از وضعيت اجتماعي اقتصادي خود دارند. نانوايان ياد شده بايد در مولفه هاي تعامل اجتماعي، همدلي، وظيفه شناسي و نحوه ي نگرش به جامعه تقويت شوند. لازم است مداخلاتي چون باز‌طراحي محيط كاري به نحوي كه سطح تعامل نانوايان و مردم را همزمان با رعايت بهداشت مواد غذايي افزايش دهد و اجراي برنامه هاي افزايش دهنده ي فعاليت هاي اجتماعي نانوايان انجام شود. به علاوه بهبود فضاي كسب و كار آنان از طريق پيگيري‌هاي سياسي-اجتماعي جهت افزايش درآمد ايشان و كاهش اقدامات تعزيري-تنبيهي ارگان‌هاي دولتي، احتمالا باعث ارتقا سطح بهزيستي اجتماعي نانواها خواهد شد.

: Characteristics of any job and its socio-economic outcomes are related to the social health of the working population. Social health attempts to identify the mutual effects of social interaction on the individuals’ well-being. An individual’s positive or negative willingness to the society-benefiting environmental subjects with high sensitivity, care, and intelligence along with the ability to understand the others, share their experiences and emotions, and actively participate in the social processes falls in the field of social health. In a society where the conditions are becoming healthier, an individual with social well-being is expected to adaptively see the conditions improving, accepting his society with all its positive and negative aspects and attempting to help the society’s improvement. In addition to its importance in terms of the individual and occupational health and interaction with the coworkers and other society members, social health is important in terms of the public health. If a baker does not have a proper social well-being, not caring about his society, the bread health of a majority of the population may negatively change, leading to low quality bread. Thus, the current study aimed to investigate the social health of the bakers and the related variables in Isfahan, Iran. Methodology: This study was cross sectional-analytical and was conducted in 2017. The statistical population consisted of 469 bakers working in 171 traditional bakeries in Isfahan, who were selected out of 633 qualified bakeries by stratified sampling method in proportion to the size according to Cochran formula with the confidence level of 95% and error level of 0.07. The data were collected by the Adult Social Health Questionnaire (validated by Rafiey et al.) and Demographic Information Questionnaire. Each individual’s score were derived from 29 questions in the social health questionnaire with the components of social interaction, social responsibility, conscientiousness, attitude to society, empathy, family relationship, and social participation. In addition to the overall score, each component was scored. The social health was classified into five groups: very weak, weak, medium, good, very good, with their relationships with the demographic variables and each individual’s perceived social-economic status being assessed. The data were analyzed by Spearman correlation test and non-parametric covariance in SPSS 20. Findings: Three individuals worked in most of the studied bakeries. The mean age was 39.9 (±11.83). Those who worked in the bakeries had the work experience of 1 to 65 years with the average of 18.3 years (±12.31). Half of them had lower than 16.5 years of experience. However, 17% of the bakers had higher than 30 years of experience. Their social health scores were 18 to 40 (The minimum and maximum scores possible in the social health questionnaire were 10 and 145, respectively). Among the bakers, 3%, 36%, 27%, 26%, and 7% fall in very weak, weak, medium, good, and very good classes, respectively. 95.7% of the bakers viewed their socio-economic status to be in the 5th of 10 grades or lower in the society. Most of them (79.7%) evaluated their income to be low. These bakers’ social health had positive and direct relationship with their work experience (P-value≤0.05), such that an increase in each of the two variables by one unit increased the other by 0.304 and 0.316, respectively. The married individuals’ mean social health score were approximately higher than that of the unmarried ones by 9.7. Moreover, the social health of those with medium income was higher than that of the individuals with income by 6.22 (P-value=0.34). Discussion and Conclusion: The social health status was weak to medium among the traditional bakers in Isfahan. This seems to be resulted from the limited number of the bakers, alternating working time (early morning and late night), and reduced productive social interactions of them. The bakers probably do not have proper responsibility for their role in the society and are weak at understanding the others. These individuals might not have appropriate relationships with their families and relatives, not participating in the society improving programs. They also might not find themselves having a share in the society, being separated from it. These individuals have a relatively low subjective assessment of their socio-economic status. The mentioned bakers must be improved in the components of social interaction, empathy, conscientiousness, and attitude to society. Interventions are required, such as redesigning the workplace to increase the interactions between the bakers and people while observing the food hygiene. Moreover, programs have to be implemented to enhance the bakers’ social activities. The improvement of their business environment through socio-political pursuance to increase their income and reduce punishments of the governmental organizations probably enhances the bakers’ social health.