Background Working and employment conditions are weighty health determinants. Low-income countries are frequently exposed to occupational risks, employment agreements are poorly regulated and a high proportion of the working population are in the informal sector. Studies in Latin American and the Caribbean (LAC) have been hampered by the lack of reliable data available.

Objective To describe and compare the health inequality gap among workers of 20 countries of LAC.

Methods Data have been taken from the last available Working Conditions Survey, National Health Surveys and from official records and national statistical institutes of each country. Three indicators were calculated to estimate health status of the working population (poor-self-perceived health, fatal and non-fatal injuries at work and general mortality within the working-age population), stratified by sex, age, level of study and occupation. Disparity was measured using Keppel index of disparity (ID) and Kuznets relative. Absolute and relative differences were calculated using the best health status country as reference category.

Results Mortality among the working-age population was higher in men and varied from 87.4 deaths per 1000 inhabitants in Chile to over 182.2 in Bolivia. Keppel ID between countries was 0.5, indicating medium-high disparity. The prevalence of poor self-perceived health was higher in women and revealed a gradient by age, education level and occupation, in which young people in qualified non-manual occupations and high levels of study had lower prevalence. The ID was 0.7 between countries demonstrating high disparity and the range varied from 12.2 in Uruguay to 50.9 in Nicaragua.

Conclusions This study reveals the existence of wide gaps in health among workers in LAC, both within and between countries. The limitations of cross-country comparative data should considered. However, this analysis increases our understanding of the causes of inequalities and provides evidence to establish better public policies.