"No somos máquinas" (We are not machines): Worker perspectives of safety culture in meatpacking plants in the Midwest

Rural-Urban Health Care Cost Differences Among Latinx Adults With and Without Dementia in the United States

OBJECTIVES

To compare rural-urban health care costs among Latinx adults ages 51+ and examine variations by dementia status.

METHODS

Data are from the Health and Retirement Study (2006-2018 waves; n = 15,567). We inflation-adjusted all health care costs using the 2021 consumer price index. Geographic context and dementia status were the main exposure variables. We applied multivariate two-part generalized linear models and adjusted for sociodemographic and health characteristics.

RESULTS

Rural residents had higher total health care costs, regardless of dementia status. Total health care costs were $850 higher in rural ($2,640) compared to urban ($1,789) areas (p < .001). Out-of-pocket costs were $870 higher in rural ($2,677) compared to urban ($1,806) areas (p < .001). Dementia status was not an effect modifier.

DISCUSSION

Health care costs are disproportionately higher among Latinx rural, relative to urban, residents. Addressing health care costs among Latinx rural residents is a public health priority.

Workplace health culture and trust in the occupational health office: A descriptive study of meatpacking workers

INTRODUCTION

Worker trust in employer-provided occupational health services has not been explored in essential industries, such as meatpacking. The purpose of this study was to describe workplace health culture and trust in the occupational health office and highlight meatpacking workers' experiences with the occupational health office.

METHODS

Meatpacking workers were surveyed between February 2021 and October 2022. Descriptive statistics and nonparametric tests were used to explore trust across demographic variables, including workplace health culture. Thematic analysis was used to examine the short-answer qualitative data.

RESULTS

Among workers who completed surveys (n = 731), health culture was rated low (M = 1.3 (0.73); possible range 0-3). Trust in the occupational health office was also rated low (M = 8.2 (5.06); possible range 0-20). Workers' descriptions of interactions with the occupational health office were mostly unfavorable (287 negative opinion units; 97 positive opinion units) and primarily focused on quality of care, communication, the supervisor as gatekeeper to health services, and the prioritization of company interests.

CONCLUSION

Meatpacking worker health may be improved by building worker trust in the occupational health office. Suggested strategies include enhanced communication, protection of confidentiality, prioritization of worker well-being, and promotion of a stronger health culture in plants and throughout the industry. Supporting workers without a regular healthcare provider to establish a relationship with a primary care provider of their choice is also recommended.

Moral disengagement in the media discourses on meat and dairy production systems

Meat and dairy production and consumption are the subject of ongoing public debates that touch on various sustainability issues such as biodiversity loss, climate change, animal welfare, and social and health aspects. Despite extensive discussions specifically relating to the environmental impacts of livestock farming in conjunction with animal welfare aspects, there have been no substantial changes in production or consumption patterns. Moreover, the focus of extant research is usually on consumers' responses to public concerns around livestock production. In this study, we shed light on the discrepancy between the normative discourse and action of relevant value chain actors with the help of Bandura's theory of moral disengagement, which allows us to identify mechanisms that contribute to the perpetuation of unsustainable production and consumption patterns. In particular, we focus on the shifting of responsibility between actors in the normatively charged field of sustainable livestock production. We collected 109 media interviews on meat and dairy production and consumption from the years 2020-2022, including interviews with actors from agriculture, processing industries, and food retail. Using qualitative content analysis, we investigated the role of moral disengagement in the media discourse on meat and dairy production and explored differences between actors in terms of moral disengagement. We found that shifting of responsibility shows a quasi-circular dynamic of being shifted from all actors to all, in our case most frequently to consumers, politics, and (diffuse) economic forces. In addition, our analysis showed the use of social justifications, beneficial comparisons, and euphemistic labelling to be common mechanisms of moral disengagement, constituting a collective problem within agri-food systems.

Treating Workers as Essential Too: An Ethical Framework for Public Health Interventions to Prevent and Control COVID-19 Infections among Meat-processing Facility Workers and Their Communities in the United States

Meat is a multi-billion-dollar industry that relies on people performing risky physical work inside meat-processing facilities over long shifts in close proximity. These workers are socially disempowered, and many are members of groups beset by historic and ongoing structural discrimination. The combination of working conditions and worker characteristics facilitate the spread of SARS-CoV-2, the virus that causes COVID-19. Workers have been expected to put their health and lives at risk during the pandemic because of government and industry pressures to keep this "essential industry" producing. Numerous interventions can significantly reduce the risks to workers and their communities; however, the industry's implementation has been sporadic and inconsistent. With a focus on the U.S. context, this paper offers an ethical framework for infection prevention and control recommendations grounded in public health values of health and safety, interdependence and solidarity, and health equity and justice, with particular attention to considerations of reciprocity, equitable burden sharing, harm reduction, and health promotion. Meat-processing workers are owed an approach that protects their health relative to the risks of harms to them, their families, and their communities. Sacrifices from businesses benefitting financially from essential industry status are ethically warranted and should acknowledge the risks assumed by workers in the context of existing structural inequities.

Systemic racism and undocumented Latino migrant laborers during COVID-19: A narrative review and implications for improving occupational health

Background

Systemic racism is built upon the racial exploitation of minorities and has been further exposed inequalities amidst the COVID-19 global pandemic. The historic reliance of undocumented migrant Latino laborers continues to influence the modern-day work conditions Latinos face such as low wages, limited benefits, and an emphasis on productivity over safety, which also increases their risk for adverse health outcomes.

Objective

This narrative review aims to describe and highlight key risk factors on the impact of systemic racism and how it shapes the work and occupational health experiences of Latino laborers in the US, as well as strategies to overcome barriers.

Method

In this review, we explore empirical studies, news reports, and policy briefs that highlight the social factors impacting occupational health outcomes for undocumented Latino migrant laborers and synthesize the information to report major challenges experienced during the pandemic and propose recommendations for improving conditions and occupational health of these groups.

Results

Existing literature demonstrated that (1) documentation status was a barrier to federal relief programs during COVID-19; (2) though categorized as essential workers, workplace conditions were harmful towards preventing infection and transmission of COVID-19; and (3) there was an increased burden particularly for undocumented Latino women both in the workplace and at home during the pandemic. Recommendations include prioritization of undocumented immigrants in government relief, and addressing both individual and environmental level stressors in the workplace to promote inclusivity and reduce unnecessary suffering of Latino migrant workers.

Conclusion

Latino laborers should be treated with dignity and respect with workplace protections as they are designated as essential workers during the COVID-19 pandemic.

Structural Discrimination in Pandemic Policy: Essential Protections for Essential Workers

An inordinate number of low wage workers in essential industries are Black, Hispanic, or Latino, immigrants or refugees - groups beset by centuries of discrimination and burdened with disproportionate but preventable harms during the COVID-19 pandemic.

Health and Well-Being of Hispanic/Latino Meatpacking Workers in Nebraska: An Application of the Health Belief Model

BACKGROUND

Meatpacking is dirty, dangerous, and demanding work. In the United States, the industry predominately employs people from racial/ethnic minority backgrounds and immigrants, with 45% of the workforce identifying as Hispanic/Latino. Little is known about how the work environment affects worker engagement in health-promoting activities; however, occupational health professionals are uniquely positioned to advance worker health, safety, and general well-being.

METHODS

Hispanic/Latino meatpacking workers with work-related musculoskeletal pain and active health concerns were recruited to participate in a study to explore health, health behaviors, and the work environment. Five focus groups (N = 28) were conducted in Nebraska between March 2019 and February 2020. Thematic analysis using the Health Belief Model constructs was used to explain workers' health behaviors including utilization of occupational health services at their workplace.

FINDINGS

Workers believed that there was little they could do to prevent and treat health problems. They understood the perceived threat of health problems and the benefits of self-care, but the perceived barriers often outweighed the benefits. The workplace had few prompts to motivate or incentivize self-care both in and outside of work. In addition, workers did not trust the occupational health office and saw few benefits to accessing services. Together, these conditions resulted in low self-efficacy and limited engagement in health-promoting behaviors.

CONCLUSION/APPLICATION TO PRACTICE

Occupational health professionals should promote Total Worker Health and foster trust by providing culturally, linguistically, and literacy appropriate services and by identifying opportunities and reducing barriers for workers to engage in activities to promote their health, safety, and well-being.

Musculoskeletal Pain and Cardiovascular Risk in Hispanic/Latino Meatpacking Workers

BACKGROUND

Most meatpacking workers have pain affecting their back, arms, and/or wrists from work-related repetitive motions, forceful exertion, and awkward positioning. Chronic musculoskeletal pain is associated with obesity, hypertension, type II diabetes, heart attack, and stroke. Hispanic/Latino workers in the meatpacking industry are a vulnerable population; limited English, lack of health insurance, and fear of deportation often deter them from seeking care where preventable cardiovascular risks might be detected. The purpose of this study was to examine perceived health and actual cardiovascular risk among Hispanic/Latino meatpacking workers with musculoskeletal pain in Nebraska.

METHODS

Structured interviews were used to examine perceived health, awareness of cardiometabolic risk, and capacity for health self-management. Body mass index (BMI), lipids, blood pressure, Hemoglobin A1c (HbA1c), and cardiorespiratory fitness (step test) were used to examine cardiovascular risk.

FINDINGS

Of those interviewed (n = 39), musculoskeletal pain affected usual life activities in 64% (n = 25) of participants. Of those tested (n = 30), 93% (n = 28) had a BMI > 30 kg/m², 86% (n = 26) had at least one lipid abnormality, 50% (n = 15) had blood pressure > 120/80 mm Hg, and 43% (n = 13) had an HbA1c > 5.7%. Males had greater fitness than females (p = .03), but also greater lifetime risk of heart attack or stroke compared with females (p = .02).

CONCLUSION/APPLICATION TO PRACTICE

In this sample, cardiovascular risk exceeded that found in the general Hispanic population in the United States. Occupational health nurses can assist workers to be aware of their risk by measuring and providing culturally and linguistically appropriate education on blood pressure, BMI, cholesterol, and HbA1c.