Impact of COVID-19 on health status of self-employed workers

Objectives: This study assessed the impact of the COVID-19 pandemic on the health status of self-employed workers by comparing their status before and during the pandemic, using nationwide data from the Korean Working Conditions Survey. Methods: The final study included 16 620 and 14 342 self-employed participants in the fifth (2017) and sixth (2020-2021) surveys, respectively. Musculoskeletal symptoms, systemic fatigue, headache, and eye strain, as well as mental health status, such as anxiety, depression, and insomnia, were assessed using a structured questionnaire. Gender, age, education level, and income were adjusted for the multivariable logistic regression analysis to assess pre- and peri-pandemic changes in the health status based on working conditions. Results: Compared with the pre-pandemic period, all aspects of the health status of self-employed individuals surveyed during the peri-pandemic period showed deterioration. Back pain increased 3.4 times (adjusted odds ratio [OR] 3.44; 95% CI: 3.15-3.75) compared with the pre-pandemic period, followed by anxiety, which increased 2.1 times (adjusted OR 2.13; 95% CI: 1.79-2.54). For single-person businesses, the overall health status showed statistically significant deterioration, highlighting the heightened vulnerability of these groups during this period. Conclusions: This study confirmed that the physical and mental health status of self-employed individuals significantly deteriorated during the COVID-19 pandemic period compared with the pre-pandemic period. These findings suggest the need for government health protection policies for vulnerable groups, such as self-employed individuals, during future pandemics when social control measures are implemented.