Psychosocial stressors associated with Mexican migrant farmworkers in the midwest United States

Psychosocial Determinants of Mental Healthcare Use Among Mexican-origin Women from Farmworker Families in Southern California

Little is known about the contribution of psychosocial factors related to mental healthcare use among Mexican-origin women from farmworker families. Therefore, this study assessed relationships between acculturative stress, depressive symptoms, mental healthcare service use, and preferences for seeking care. Linear and logistic regression models and chi-square tests were performed to analyze survey data from 78 Mexican-origin women from farmworker families. Women were recruited in collaboration with promotoras and completed measures of acculturative stress, depressive symptoms, and mental healthcare use and preferences. Overall, 29.5% of the sample reported clinically significant depressive symptomatology. Acculturative stress was positively associated with depressive symptoms (b = 0.43, 95%CI = 0.27,0.59) after controlling for years in the U.S., primary language, and demographic characteristics. In addition, acculturative stress was associated with lower odds of mental healthcare use (OR = 0.96) after controlling for years in the U.S. and depressive symptoms. However, this association was no longer statistically significant when controlling for health insurance status and access to transportation. Mexican-origin women with high levels of acculturative stress were significantly more likely to seek care from a psychiatrist/psychologist than their peers (54.3% vs. 45.7%); however, this preference was not indicative of their use of mental healthcare services. Results suggest that acculturative stress is a risk factor for depressive symptoms and might contribute to a delay in seeking mental healthcare services in Mexican-origin women from farmworker families. Thus, interventions for this group should address aspects of acculturative stress as a strategy to increase mental health services use.

Cross-Cultural Validation of the Barcelona Immigration Stress Scale

The concept of acculturative stress has been the subject of debate, resulting in contradictory arguments regarding its measurement. Many of the existing acculturative stress instruments have been developed for use with specific migrant groups. The objective of the current study is to revisit the psychometric properties of the Barcelona Immigration Stress Scale, an instrument aimed at measuring stress levels associated with the migration trajectory in any migrant group. Using a sample of 915 migrants who consulted in primary care, we carried out principal component and confirmatory factor analyses as well as item response theory analyses applied both to the entire sample and to different migratory groups separately. The new reduced version of the scale has very good psychometric properties both in general and applied to the Latino migratory group, the largest in the area where the study was carried out. Results were acceptable among sub-Saharan, North African, and Asian groups but not among Eastern Europeans. These results are discussed through the specificities of each migratory group and the limitations of psychometrics to capture the complexity of immigration-related and acculturative stress.

Incorporating Structural Racism, Employment Discrimination, and Economic Inequities in the Social Determinants of Health Framework to Understand Agricultural Worker Health Inequities

In 2010, the federal government and several state governments began using the social determinants of health (SDOH) framework to highlight contributing factors of health inequities and, in 2022, recognized that structural racism was associated with health inequities. Yet, efforts to eliminate health inequities have disproportionately focused on individualized solutions instead of addressing structural racism. Many racial/ethnic-minority workers have been segregated to low-wage occupations that lack access to paid sick leave, such as agricultural work, which has been associated with health inequities. Research shows these inequities are attributable to structural racism enforced through laws that structure the employment system to disadvantage agricultural workers, who are disproportionately racial/ethnic-minority individuals, which will not be addressed with individualized solutions. In this article, we explain why the current SDOH framework and efforts to eliminate health inequities are inadequate, discuss Yearby's revised SDOH framework that includes structural racism as one of the root causes of health inequities, and illustrate how Yearby's revised SDOH framework better captures the impact of structural racism, which is associated with health inequities for agricultural workers. (Am J Public Health. 2023;113(S1):S65-S71. https://doi.org/10.2105/AJPH.2022.307166).

Racism and health care: Experiences of Latinx immigrant women in NYC during COVID-19

The COVID-19 pandemic has disproportionately affected minoritized racial groups, especially Latinx immigrants, evidenced by the high rates of COVID-19 infections, hospitalizations, and deaths among this population. With increasing xenophobia and anti-immigrant sentiment in parallel to the pandemic, it is critical to understand the perspectives of Latinx populations. This study explores Latinx immigrant women's perceptions of racism and xenophobia in their health care experiences in New York City (NYC) during the COVID-19 pandemic and, further, seeks to understand the role of perceived discrimination in health care settings and on health care access. Data were analyzed using a constant comparative method of analysis from twenty-one in-depth interviews conducted with foreign-born women in the five boroughs of New York City from diverse countries across Latin America. Four central themes emerged including: structural inequalities, discriminatory health care experiences, victimization in public institutions, and overcoming discrimination in health care settings. Latinx immigrant women described the ways in which perceptions and experiences of discrimination shaped their capacity to address health-related needs during the COVID-19 pandemic. This study provides evidence to a growing body of literature suggesting that structural racism and xenophobia and perceptions of anti-immigrant discrimination, including resulting structural inequalities, may have a negative effect on individuals' ability to access and engage the health care system, resulting in avoidance of health care services - a critical need during a global pandemic. Scholars, policymakers, and practitioners alike should be mindful of how racism and xenophobia shape Latinx immigrant communities' engagement with the health care system.

Acculturation, Work-Related Stressors, and Respective Coping Strategies among Male Indonesian Migrant Workers in the Manufacturing Industry in Taiwan: A Post-COVID Investigation

Globalization has prompted cross-cultural migration in search of employment opportunities, and poor adaptation during acculturation is widely known to cause additional psychosocial stress. Hence, the objective of this study was to investigate migrant workers' perceptions of acculturation, identify work-related stressors, and understand the respective coping strategies among male Indonesians in the manufacturing industry, particularly during the COVID-19 pandemic. Fifteen workers were recruited and interviewed on their acculturation experiences. We found that the workers were susceptible to forced adaptation to stressful conditions relating to work organization, economic distress, interaction with the manpower agencies, language barriers, and so on. During the pandemic, workers experienced overload, economic hardship, suspended home visits, isolation, discrimination, and fear of cluster infection in the crowded dormitory. We also found that workers were able to adopt coping strategies by capitalizing on resources at the individual, institutional, and governmental policy levels to actively solve problems, increase emotional support, and fortify self-appraisals. The identified coping strategies could inform policy development to assist with positive adaptation and promote the well-being of the migrant worker population.

Examination of Ecological Systems Contexts Within a Latino-Based Community Sport Youth Development Initiative

Youth Development Programs (YDPs) can serve as effective mechanisms to alleviate social and psychological adversities while enhancing and developing resilience among youth. Recently, more YDPs have incorporated sport within Sport for Development (SFD) models to achieve these goals. Due to the growing Latino population in the US and the wide achievement gap between Latinos and other demographic populations, there is a need to explore programs that may support individual development as well as long-term change with regard to social inequality. There is also a need to better understand the ecological contexts within SFD programs and how these contexts may support underserved youth. Specifically, using an ecological systems perspective, this study seeks to explore the implementation of a sport program by a YDP in order to examine the ecological processes that may support or inhibit the efficacy of sport programs working with underserved youth. Juntos is a YDP that primarily serves Latinx youth and families by assisting youth with graduating high school and pursuing higher education opportunities. Juntos incorporates two annual soccer tournaments (i.e., Kicking it with Juntos and Copa Unidos). A qualitative case study approach was implemented in two counties in North Carolina. Interviews were conducted with tournament participants, county coordinators and planning committee members. Findings found three key themes related to three ecological levels 1. At the Microsystem level, sport was implemented to engage youth and connect to non-sport program outcomes, but divergent perceptions of goals among stakeholders potentially inhibited intentional implementation. At the Mesosystem level, sport provided a mechanism to engage in collaborative relationships and encouraged parental participation. At the Macrosystem level, sport celebrated Latino culture and attempted to address social barriers facing Latinx youth, but some aspects of culture may have created barriers to access for girls. Findings suggested that while the programs emphasized mesosystem engagement, more integration across exosystem and macrosystem levels may be needed for sustainable outcomes.

Familias Divididas [divided families]: Transnational family separation and undocumented Latinx immigrant health

Undocumented Latinx immigrants (ULIs) comprise a large segment of the U.S. population, yet they remain at high risk for diminished health outcomes due to increased exposure to adverse experiences and context. Transnational family separation and the distress that accompanies it is an example of a common adverse experience that is chronic and that impacts the lives of many ULIs. However, despite how chronic and central transnationalism is to the lives of ULIs, little is known about its relation to the health outcomes of ULIs. To that end, this study examined the relation between distress due to transnational family separation and the physical and mental health of ULIs. To do so, the study utilized respondent-driven sampling and path analysis methodologies to cross-sectionally examine how distress from transnational separation was related to the physical and mental health of ULIs (n = 229). Results revealed that as distress from transnational family separation increased so too did participant's depressive (β = .25, p < .001), anxiety (β = .18, p = .006), and physical symptoms (β = .24, p < .0001). Distress from transnational family separation was also more strongly related to physical and depressive symptoms than to anxiety symptoms. Considering these results, important systemic changes to our approach to healthcare delivery and access among ULIs communities are needed to promote the well-being of this at-risk population. Recommendations for doing so are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Rural Latino health and the built environment: a systematic review

Objective: This study systematically reviewed literature examining the influence of the rural built environment on Latinos' health outcomes and behaviour in the United States. A secondary aim of the study was to identify strategies developed to address challenges in the rural built environment affecting Latinos' health.Design: This study followed the reporting guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles included in the final analysis clearly linked Latino health outcomes to characteristics of the rural built environment.Results: Of the nearly 2,500 articles identified in the initial search, the final review included approximately 146 full-text sources. The majority of the articles focused on aspects of Latinos' physical (n = 68), behavioural (n = 43), and mental health (n = 23).Conclusions: Rural Latino neighbourhoods in the United States possess limited access to health care, internet, transportation, and recreation infrastructure, which negatively impacts health outcomes and behaviours. Strategies developed to mitigate these issues include but are not limited to: the use of telecommunications to distribute health information; the use of community health workers and mobile clinics to increase awareness and availability of select health services; the use of worksite trainings and adaptations to the workplace; and the promotion of safety net programmes, such as the Supplemental Nutrition Programme for Women, Infants and Children (WIC). This review supports the need for a more robust research agenda documenting the health experiences of rural Latinos of various nationalities, age groups, and genders.

Work, Stressors, and Psychosocial Adjustment of Undocumented Guatemalan Adolescents in United States Agriculture: A Mixed-Methods Approach

This research focused on undocumented male Guatemalan migrant adolescents' experiences and stressors in United States agriculture. Study 1 applied a phenomenological method to explore work-life experiences of Guatemalan minors (n = 10) aged 15-17 (M_age  = 16.4). Findings highlighted three themes (1) "Just keep pushing forward," (2) "It feels ugly but that's life," and (3) "I have to do everything on my own." Using a separate sample, Study 2 examined the association between stressors and depressive symptoms among Guatemalan migrant adolescents (n = 28), aged 15-20 (M_age  = 17.71). Results showed loneliness, social isolation, and work conditions as correlates for depressive symptoms. Findings highlighted a distinct developmental path among migrant farmworker adolescents and offered insight into their resilience and developmental threats.

Culture, Structure, and Health: Narratives of Low-income Bangladeshi Migrant Workers from the United Arab Emirates

Increasingly, health scholars are paying attention to the health experiences of immigrant communities, particularly in the backdrop of the global flows of goods, services, and people across borders. In spite of the increasing public health emphasis on health outcomes of immigrants within the Middle Eastern (ME) countries, immigrant communities are often constructed as monoliths and the voices of immigrant communities are traditionally absent from mainstream health policy and program discourses. The health experiences of immigrants, their access to resources, and the health trajectories through the life-course followed by them and their descendants influence the deep-seated patterns of ethnic health disparities documented in the ME. Based on the culture-centered approach, we engaged in in-depth face-to-face interviews, and focus groups discussions with a total of 44 research participants, to understand how low-income Bangladeshi migrant workers in the United Arab Emirates (UAE), who live at the borders of mainstream Arab society, define, construct, and negotiate health issues. Participants articulate in their narratives their nuanced cultural understanding of good health as a complex, holistic practice, the achievement of which is obstructed by barriers such as immigration and insurance structures. Further, they enact their agency in resource impoverished circumstances to protect their mental health and physical well-being through daily strategies and acts of resistance.

Perceived Discrimination and Mental Well-being in Arab Americans from Southeast Michigan: a Cross-Sectional Study

There is growing evidence for the adverse health effects of structural and individual forms of discrimination in multiple religious, ethnic, and racial groups. Since the September 11, 2001 terrorist attacks, Arab Americans have experienced increasingly more frequent and visible forms of discrimination. However, the impact of these experiences on their mental well-being requires further investigation. This study examines the association between perceived discrimination and several markers of mental health and well-being, using cross-sectional data from a convenience sample of 279 Arab American adults from southeast Michigan. After adjustment for a series of relevant confounders, perceived discrimination was significantly associated with depressive symptoms (estimate 0.93, 95% CI 0.53, 1.34, p < 0.01), anxiety symptoms (estimate 0.48, 95% CI 0.19, 0.77, p < 0.01), and poor self-rated health (OR 1.31, 95% CI 1.08, 1.58, p < 0.01). The study highlights the need to address and mitigate health disparities among individuals of Arab descent and improves awareness of the potential health effects of ongoing structural and interpersonal discrimination toward this population.

Stress Among Latinos: Does it Vary by Occupation and Agricultural Season?

OBJECTIVE

Stress is pervasive among Latino immigrants. We identified seasonal and occupational patterns in stress among rural Latino immigrants.

METHODS

During three agricultural periods, farmworker and non-farmworker participants responded to a 24-item stress questionnaire (Snipes et al, 2007). We measured the associations of stress with occupation, with season, and occupation within season, adjusting for demographic variables.

RESULTS

The highest levels of stress were observed in the pre-thinning season when pruning takes place among farmworkers. Stress is significantly higher in farmworkers compared with non-farmworkers only in the non-spray season when crops are dormant. Higher income was associated with decreased stress in the pre-thinning and thinning seasons when buds and small fruit are removed from orchards.

CONCLUSIONS

Identification of strategies to reduce stress in Latino migrants is warranted. Although some sources of stress may be intractable, others may be amenable to intervention.

Global output of research on the health of international migrant workers from 2000 to 2017

BACKGROUND

Approximately 150 million international migrant workers work under conditions that increase their risk of illness and injuries. The current study aimed to assess and analyze the global output of research on the health of international migrant workers to promote national and international policies that could help improve the health of international migrant workers.

METHODS

A bibliometric methodology was implemented using Scopus database after retrieving documents relevant to the health of migrant workers during the study period from 2000 to 2017.

RESULTS

In total, 955 documents were retrieved. The mean number of authors per document was 4.5 while the mean number of citation per document was 10.2. The retrieved documents were mainly in health policy and systems (n = 452; 47.3%), infectious diseases (n = 252; 26.4%), and mental and psychosocial health (n = 239; 25.0%). The health of Latino migrant farmworkers represented the largest cluster of keywords. The USA led (n = 389; 40.7%) with regard to the number of publications followed by China (n = 86; 9.0%) and the UK (n = 66; 6.9%). Researchers from the USA and Spain dominated the field. There were limited international research collaboration and a limited number and size of research networks. The American Journal of Industrial Medicine was most active (7.1%; n = 68) in publishing documents on health of migrant workers while the Wake Forest University was the most active (10.9%; n = 104) institution in this topic.

CONCLUSION

The volume of global research output on the health of migrant workers was low. There was inadequate research on non-communicable diseases and maternal health of migrant workers. International research collaboration and the number of research networks were limited. Role of several world regions, particularly Arab region with 11% of international migrant workforce was also limited. There is an urgent need to prioritize research on migrant workers, especially female migrant workers in regions with low research contribution.

Health care service utilization of documented and undocumented hired farmworkers in the U.S

This article analyzes issues related to U.S. hired farmworkers' utilization of health care services and their specific choices among health care provider and health bill payment method options. Using data from the National Agricultural Workers Surveys for the years 2000-2012, this article employs propensity score matching and probit estimation techniques to examine the health care utilization of hired farmworkers. This study's results indicate that undocumented hired farmworkers are 10.7 and 3% less likely to use U.S. and foreign health care, respectively, compared to documented farmworkers. Health insurance is found to significantly increase hired farmworkers' use of U.S. health care by 22.3%. Notably, compared to their documented working peers, undocumented workers are much less likely to patronize private clinics. They are even less likely to rely on migrant health centers even when these providers are their most viable sources of health care service.

Sexual Health Help-Seeking Behavior among Migrants from Sub-Saharan Africa and South East Asia living in High Income Countries: A Systematic Review

The number of migrants has increased globally. This phenomenon has contributed to increasing health problems amongst migrants in high-income countries, including vulnerability for HIV acquisition and other sexual health issues. Adaptation processes in destination countries can present difficulties for migrants to seek help from and gain access to health services. This study examined migrants’ from sub-Saharan Africa (SSA) and South East Asia (SEA) sexual health help-seeking behavior in high-income countries with universal health coverage. The systematic review followed PRISMA guidelines and was registered with PROSPERO. Several databases were searched from 2000 to 2017. Of 2824 studies, 15 met the inclusion criteria. These consisted of 12 qualitative and three quantitative studies conducted in Australia, Spain, the United Kingdom, Belgium, Scotland, Ireland, and Sweden. Migrants experienced a range of difficulties accessing health services, specifically those related to sexual health, in high-income countries. Few studies described sources of sexual health help-seeking or facilitators to help-seeking. Barriers to access were numerous, including: stigma, direct and indirect costs, difficulty navigating health systems in destination countries and lack of cultural competency within health services. More culturally secure health services, increased health service literacy and policy support to mitigate costs, will improve health service access for migrants from SSA and SEA. Addressing the structural drivers for stigma and discrimination remains an ongoing and critical challenge.

Migrant workers’ (non)belonging in rural British Columbia, Canada: storied experiences of Marginal Living

Purpose

The purpose of this paper is to examine the experiences of belonging and wellbeing among temporary migrant agricultural workers (TMAWs) in a rural setting in the interior of British Columbia, Canada.

Design/methodology/approach

A qualitative narrative approach informed by participatory action research principles was employed. In total, 12 migrant workers participated in two to four one-on-one interviews and/or focus group conversations.

Findings

The analysis revealed an over-arching theme of Marginal Living encompassing stories of always on the outside, mechanisms of isolation and exclusion; struggling for the basics, realities of worrying about daily bare necessities; and “nothing but a worker’s,” experiences of being reduced only to one’s labor. These storied experiences each impacted workers’ wellbeing and typically limited their ability to feel a sense of belonging. Yet, workers exerted agency and resilience through storied experiences of “one family and for those who come next.” Their efforts contributed to building a sense of community through mutual support and advocacy.

Originality/value

Very few studies have focused on the day-to-day experiences of this population and its influence on their sense of belonging and wellbeing. This study is also the first to examine this topic within this particular region (the rural BC interior). These findings can provide a starting point for improved program planning to address challenges faced by TMAWs in rural Western Canada. Further, they expand the understanding of concepts such as partial citizenship and structural exclusion as they apply in the day-to-day realities of migrant workers in rural BC.

The Impact of Work Demand and Gender on Occupational and Psychosocial Stress in Hispanic Farmworkers

Hispanic farmworkers experience hazardous work conditions, language barriers, poverty, and limited healthcare access that increase their risk for health problems. We sought to characterize occupational and lifestyle stressors in farmworker couples and to examine the impact of seasonal work demand and gender on health outcomes. We administered surveys to 31 couples (N = 62) in May (low work demand) and September (high work demand) of 2012. Measures included acculturation, perceived stress, depressive symptoms, quality of life, decision latitude, support (supervisor, co-worker), and work-family conflict. This population did not report significant differences in stress in low and high work demand times. Women reported more work-family conflict (F = 19.06, p 0.0001; F = 11.28, p = 0.0015) and less supervisor support (F = 6.56, p = 0.0135). Women experienced more conflict between work and family and less support at work. This group reported low depressive symptomology and moderate levels of stress; a subset reported elevated levels.

Mental Health Among Latina Farmworkers and Other Employed Latinas in North Carolina

The mental health of Latinas with manual occupations, particularly those employed in agriculture, is a public health concern. The goals of this analysis were to describe the mental health of Latina farmworkers, and to compare their mental health with that of other Latina manual workers. Participants included 35 employed Latina farmworkers, 35 employed non-farmworkers, and 25 unemployed non-farmworkers who completed interviews in 2012. Measures included stress, anxiety, depressive symptoms, elevated depressive symptoms, and risk for alcohol dependence. Farmworkers had greater stress and anxiety than did employed and unemployed non-farmworkers. Employed Latinas, whether farmworkers or in other occupations, had greater stress and anxiety than unemployed Latinas. Depressive symptoms, although high, did not differ significantly by occupation and employment. Few were at risk for alcohol dependence. Concrete steps are needed to address the mental health of Latina farmworkers, and to continue documentation of mental health concerns and their causes in this population.

Elevated Depressive Symptoms Among Hired Crop Workers in the United States: Variation by Sociodemographic and Employment Characteristics

We present prevalence rates, along with demographic and economic characteristics associated with elevated depressive symptoms (EDS), in a nationally representative sample of hired crop workers in the United States. We analyzed in-person interviews with 3,691 crop workers collected in 2009-2010 as part of a mental health and psychosocial supplement to the National Agricultural Workers Survey. The prevalence of EDS was 8.3% in men and 17.1% in women. For men, multivariate analysis showed that EDS was associated with years of education, family composition, having a great deal of difficulty being separated from family, having fair or poor general health, ability to read English, fear of being fired from their current farm job, and method of payment (piece, salary, or a combination). Interactions were found between region of the country and family composition. Multivariate analyses for women showed that fear of being fired, fair or poor general health, having children ≤15 years of age, being unaccompanied by their nuclear family, expectation for length of time continuing to do farm work in the United States, and authorization status were associated with EDS. Interactions were found with Hispanic ethnicity and region of the country, as well as presence of the nuclear family and region. The present study identifies important risk factors in this first population-based assessment of EDS in a nationally representative sample of U.S. crop workers. The importance of social support from family, job insecurity, and high prevalence of EDS in female crop workers support the need for screening and outreach in this primarily rural group of men and women crop workers.

Coping Strategies That Mitigate Against Symptoms of Depression Among Latino Farmworkers

Latino farmworkers have a higher rate of depression when compared with other Latinos and the general adult population in the United States. Researchers have suggested oppressive labor policies, acculturation stressor, anti-immigrant polices and attitudes, and the dangers associated to farm work as culprits to high rates of depression among farmworkers. We examined the traits farmworkers reported that helped them mitigate symptoms of depression. Our sample consisted of 64 adult male and female farmworkers who lived in western Texas and worked in Eastern New Mexico. We used the Center for Epidemiologic Studies Depression Scale Revised (CESD-R) and self-reports of symptoms of depression to assess for depression. We found that, among this sample, the rates of depression were similar to other studies and that farmworkers used cognitive restructuring strategies to mitigate symptoms of depression.

Work, Health, Safety and Well-Being: Current State of the Art

This introductory chapter will present a review of the current state of the art in relation to employee health, safety and well-being (HSW). The work environment and the nature of work itself are both important influences on HSW. A substantial part of the general morbidity of the population is related to work. It is estimated that workers suffer 270 million occupational accidents and 160 million occupational diseases each year. The chapter will first define HSW. It will then review the current state of the art by outlining key HSW issues in the contemporary world of work, identifying key needs. It will then discuss the evolution of key theoretical perspectives in this area by linking theory to practice and highlighting the need for aligning perspectives and integrating approaches to managing HSW in the workplace.

Social context matters: Ethnicity, discrimination and stress reactivity

Exposure to chronic discrimination is associated with increased morbidity and mortality. The study of biobehavioral pathways linking discrimination with health outcomes has mostly focused on the cardiovascular system, with fewer studies addressing the hypothalamus-pituitary-adrenal (HPA) axis. In this study we tested associations between Latino ethnicity, experiences of discrimination, and cortisol responses to an acute laboratory stressor. One hundred fifty eight individuals (92 female, 66 male) between the ages of 18 and 29 years participated in the study. Salivary cortisol was measured once before and eight times after administration of a laboratory stressor (the Trier Social Stress Test). Past experiences of discrimination were measured with the Experiences of Discrimination Scale. Findings from conditional process modeling suggest that Latino ethnicity predicted a) heightened cortisol reactivity and b) more pronounced cortisol recovery through discrimination experiences (mediator), and that this effect was further moderated by sex with a significant indirect effect only among males. The direct path from Latino ethnicity to cortisol reactivity or cortisol recovery was, however, not significant. In sum, findings suggest that Latino ethnicity and discrimination interact to predict cortisol dysregulation, which implies that an appropriate model for understanding minority health discrepancies must incorporate interactive processes and cannot simply rely on the effects of ethnicity or discrimination alone.

A Guide to the Design of Occupational Safety and Health Training for Immigrant, Latino/a Dairy Workers

Industrialized dairy production in the U.S. relies on an immigrant, primarily Latino/a, workforce to meet greater production demands. Given the high rates of injuries and illnesses on U.S. dairies, there is pressing need to develop culturally appropriate training to promote safe practices among immigrant, Latino/a dairy workers. To date, there have been few published research articles or guidelines specific to developing effective occupational safety and health (OSH) training for immigrant, Latino/a workers in the dairy industry. Literature relevant to safety training for immigrant workers in agriculture and other high-risk industries (e.g., construction) was examined to identify promising approaches. The aim of this paper is to provide a practical guide for researchers and practitioners involved in the design and implementation of effective OSH training programs for immigrant, Latino/a workers in the dairy industry. The search was restricted to peer-reviewed academic journals and guidelines published between 1980 and 2015 by universities or extension programs, written in English, and related to health and safety training among immigrant, Latino/a workers within agriculture and other high-risk industries. Relevant recommendations regarding effective training transfer were also included from literature in the field of industrial-organizational psychology. A total of 97 articles were identified, of which 65 met the inclusion criteria and made a unique and significant contribution. The review revealed a number of promising strategies for how to effectively tailor health and safety training for immigrant, Latino/a workers in the dairy industry grouped under five main themes: (1) understanding and involving workers; (2) training content and materials; (3) training methods; (4) maximizing worker engagement; and (5) program evaluation. The identification of best practices in the design and implementation of training programs for immigrant, Latino/a workers within agriculture and other high-risk industries can inform the development of more effective and sustainable health and safety training for immigrant, Latino/a dairy workers in the U.S. and other countries.

Cardiovascular disease risk factors among Latino migrant and seasonal farmworkers

Migrant and seasonal (MS) farmworkers are an important component of the US economy. Their unique occupational health concerns have garnered research, but chronic disease research in this population is lacking. It is unclear whether health differences exist between migrant (those who migrate to and travel a distance from the home environment and thus live in temporary housing for the purpose of employment) and seasonal workers (those who work in the agricultural industry on a seasonal basis, whose long-term home environments are often near work locations and thus may be considered more "settled"), since most research presents MS farmworkers as a homogenous group. This study explored potential differences in cardiovascular disease risk factors, (i.e., diabetes, current smoking, obesity, hypertension, and hypercholesterolemia) by sex and MS status among a sample of 282 English- and Spanish- speaking Latino MS farmworkers in the Midwest using cross-sectional survey and clinical laboratory data. Results showed that in multivariate logistic regression analyses, migrant workers (odds ratio [OR] = 2.15) had a higher likelihood of being obese compared with seasonal workers (P < .05). MS farmworkers did not differ in likelihood of smoking, diabetes, hypertension, or hypercholesterolemia. In adjusted analyses, females were more likely to be obese (OR = 3.29) and have diabetes (OR = 4.74) compared with males (P < .05); and males were more likely to be current smokers (OR = 7.50) as compared with females (P < .05). This study provides insight into chronic health concerns among this predominantly Latino farmworker population and suggests that future prevention and intervention research may need to focus on sex differences rather than MS farmworker status.

Living Sin Papeles

In the United States, the construction of “illegality” of undocumented Latino workers is predicated upon multiple interacting social, economic, political, and sociological factors and consignment to an inferior social status, harsh living conditions, and exploitation. These “cumulative vulnerabilities” contribute to increased stressors and poor psychological health outcomes. However, little is known about these marginalized workers’ experience of negotiating life in “illegality.” This qualitative study adopts a social constructivist perspective to examine the strategies these undocumented workers use to manage “illegality” and psychosocial stress. We conducted four focus groups with 27 participants and in-depth interviews with eight of these participants. Thematic analysis combined with constant comparison yielded the overarching theme of living sin papeles (without legal papers). Findings reveal that, phenomenologically, sin papeles extends far beyond legal status, being a condition of ever-present instability, insecurity, and hypervigilance that affects the social, work, health, and living conditions of undocumented Latino immigrants.

Depression among Mexican men on the migration frontier: the role of family separation and other structural and situational stressors

This study documents the mental health of Mexican migrant men in a new non-traditional settlement in the Rocky Mountain West and examines the role of family separation and other structural and situational stressors in relation to depressive symptoms. Using a community-based participatory research approach, we conducted interviewer-assisted surveys with 134 Mexican migrant men. Findings revealed that, overall, 46 % of participants reported depressive symptoms in the range for clinical concern and that single and married men who were separated from their families were particularly vulnerable to poor mental health. Best predictors of depression included both structural stressors (family separation, sending remittances to Mexico) and situational stressors (fearfulness, worry about police confrontation, treatment by non-Latinos, and lack of support). These findings highlight the need for complex and contextually-sensitive mental health interventions designed to protect this vulnerable population on the migration frontier and to promote their mental health.

Evaluating Short-Form Versions of the CES-D for Measuring Depressive Symptoms Among Immigrants From Mexico

This article examines the feasibility of using a short-form version of the Center for Epidemiologic Studies–Depression Scale (CES-D) in community mental health research with Mexican immigrants. Several features of three published short versions of the CES-D were examined using data combined from seven diverse Mexican immigrant samples from across the United States ( N= 685). Results indicate that published short-form versions of the CES-D are reliable, they account for most of the variance in scores from the full CES-D, and there is little evidence that the use of short forms attenuates associations with other concepts relevant to understanding the mental health of Mexican immigrants. Although additional validation research is necessary, the results of this study suggest that short-form versions of the CES-D can be used to study mental health among Mexican immigrants.

Work and health among Latina mothers in farmworker families

BACKGROUND

Work organization is important for the health of vulnerable workers, particularly women. This analysis describes work organization for Latinas in farmworker families and delineates the associations of work organization with health indicators.

METHODS

Up to 220 Latina women in farmworker families completed interviews from October 2012 to July 2013. Interviews addressed job structure, job demand, job control, and job support. Health measures included stress, depressive symptoms, physical activity, family conflict, and family economic security.

RESULTS

Three fifths of the women were employed. Several work organization dimensions, including shift, psychological demand, work safety climate, and benefits, were associated with participant health as expected, on the basis of the work organization and job demands-control-support models.

CONCLUSIONS

Research should address women's health and specific work responsibilities. Occupational safety policy must consider the importance of work organization in the health of vulnerable workers.

Going Beyond the Injury: Regulatory Conditions Contributing to Latina/o Immigrants' Occupational Psychosocial Stressors

BACKGROUND

Utilizing a psychosocial stress approach, we report psychosocial stressors that Latina/o immigrant day laborers in Baltimore report as workplace hazards and the contextual factors that shape these stressors.

METHODS

Through a community-academic partnership, we conducted focus groups (n = 18) and key informant interviews (n = 9) using instruments developed between academics and the community partner to inquire Latina/o immigrants' jobs, hazard awareness, occupational illnesses and injuries, and reporting behaviors. We conducted a transcript-based thematic analysis.

RESULTS

The psychosocial stressors that Latina/o day laborers report as dangers at work are anxiety beating the deadline and fear from wage theft, sudden termination and immigration enforcement.

DISCUSSION

More attention needs to be given to Latina/o immigrant day laborers' occupational psychosocial risks. Policies should be made to lower barriers for Latina/o immigrants to report grievances to state agencies.

Housing and Neighborhood Characteristics and Latino Farmworker Family Well-Being

Housing quality and neighborhood characteristics affect individual health and family well-being. This analysis describes characteristics of farmworker housing and neighborhoods and delineates the associations of housing and local neighborhood with indicators of family well-being. Mothers in North Carolina farmworker families (n = 248) completed interviews in 2011-2012. Family well-being measures included stress, family conflict, and outward orientation. Housing measures included ownership and facilities, and neighborhood measures included heavy traffic and driving time to grocery stores. Families experienced elevated stress and conflict, and limited outward orientation. Few owned their homes, which were generally crowded. Few had enclosed play spaces for their children. For many, traffic made it difficult to walk on the street. Housing and neighborhood characteristics were related to increased stress and limited outward orientation. Housing and neighborhood characteristics are important for research on the health of families in vulnerable populations, such as farmworker families.

Interpersonal and social correlates of depressive symptoms among Latinas in farmworker families living in North Carolina

Little research is available about the mental health of Latina women in farmworker families living in the southern United States, where Latino immigrants are relatively recent arrivals. This study examined interpersonal correlates (family conflict, family's outward orientation, and perceived discrimination) and social correlates (residential mobility and economic insecurity) of depressive symptoms and of meeting a threshold of depressive symptoms that could be clinically significant (a cut-point of 10 or higher in a short Center for Epidemiologic Studies-Depression Scale) among Latinas in farmworker families living in North Carolina. Data were collected from April 19, 2011 to April 20, 2012 as part of Niños Sanos, a prospective study of Latino women and children (N = 248). Regression models showed that exposure to family conflict, perceived discrimination, and economic insecurity were associated with more depressive symptoms. Likewise, perceived discrimination and economic insecurity were associated with a threshold of depressive symptoms that could be clinically significant, above and beyond family conflict. The findings suggested that policies that lessen the discrimination of farmworkers and their families and reduce economic insecurity, as well as interventions that support positive family functioning, might be beneficial for the mental health of Latinas in farmworker families living in new immigrant destinations.

Understanding the Role of Social Factors in Farmworker Housing and Health

Differences in social advantage significantly influence health conditions and life expectancy within any population. Such factors reproduce historic class, race, and ethnic disparities in community success. Few populations in the United States face more social and economic disadvantage than farmworkers, and farmworker housing has significant potential to ameliorate or amplify the health impact of those disadvantages. Drawing on the limited direct research on farmworkers, and on additional research about poor, isolated, and immigrant societies, we propose four mechanisms through which housing can be expected to affect farmworker health: quality of social capital within farmworker communities, stress effects of poor housing situations, effects of housing on social support for healthy behaviors, and interactions among these factors, especially effects on children that can last for generations. Policy and planning definitions of "adequate" farmworker housing should take a more holistic view of housing needs to support specific social and community benefits in design decisions.

Promoting adoption of fall prevention measures among Latino workers and residential contractors: formative research findings

BACKGROUND

Falls from heights remain a concern in construction, particularly for foreign-born Latino construction workers employed by small residential contractors. The social ecological model provides a framework to assess the individual and contextual factors influencing the risk for falls.

METHODS

Five focus groups and thirteen in-depth interviews with workers, small residential contractors, and key informants were conducted in 2012 in San Francisco and Philadelphia. Data were analyzed with qualitative methods.

RESULTS

Economic conditions in residential construction, coupled with a lack of enforcement and vulnerabilities of the foreign-born workforce, are principal contributors to risk for falls. Small contractors perceive strong economic disincentives for implementation of fall protection and foreign-born Latino workers experience a variety of social, cultural and occupational pressures impeding its use.

CONCLUSIONS

Increased adoption of fall protection cannot be accomplished solely by targeting Latino construction workers. Research is needed on incentives to influence contractor behavior and facilitate adoption of fall protection measures.

Emotional Testimonies: An Ethnographic Study of Emotional Suffering Related to Migration from Mexico to Arizona

It is increasingly argued that social and economic inequities poorly affect overall health. One of the means through which these inequities are translated to the body is via negative emotions, which carry known psychological and physiological responses. This paper examines migration-related psychosocial stressors impacting first-generation Mexican immigrants in southern Arizona, and reports on the primary emotional experiences immigrants associate with these stressors. Data were drawn from a qualitative, ethnographic study conducted over the course of 14 months during 2013-2014 with first-generation Mexican immigrants (N = 40) residing in Tucson Arizona and service providers working directly in the immigrant community (N = 32). Results indicate that the primary structural vulnerabilities that cause emotional hardship among immigrants are pre-migration stressors and adversity, dangerous border crossings, detention and deportation, undocumented citizenship status, family separation, and extreme poverty. Many of these factors have intensified over the past decade due to increased border security and state level anti-immigrant legislation in Arizona. Immigrants connected these hardships to the emotions of trauma (50%), fear (65%), depression (75%), loneliness (75%), sadness (80%), and stress (85%), and most respondents reported suffering from three or more of these emotions. Given the heavy emotional toll of migration and the direct impact that regional legislation and border security had on well-being, this paper argues that emotion be considered an important mechanism for health declines in the immigrant community. In order to stem the frequency and intensity of emotional stress in the Mexican immigrant community in Tucson, it is imperative to support organizations and policies that promote community building and support networks and also expand access to and availability of mental health services for immigrants regardless of documentation status.

Job characteristics and work safety climate among North Carolina farmworkers with H-2A visas

ABSTRACT Migrant farmworkers are a vulnerable population. Migrant farmworkers with H-2A visas are the only agricultural workers with temporary work permits. Little research has directly focused on the job characteristics and work safety of workers with H-2A visas. This analysis (1) describes their personal and job characteristics, job hazards, and stressors; (2) describes their perceived work safety climate; and (3) examines associations of perceived work safety climate with job characteristics, job hazards, and stressors. Data are from a cross-sectional component of a larger study of farmworker pesticide exposure; in 2012 interviews were conducted with 163 migrant farmworkers with H-2A visas in North Carolina. The sample was limited to men aged 30 to 70 years. Migrant farmworkers with H-2A visas experience the same hazards as do other farmworkers. Their mean score on the Perceived Work Safety Climate Scale 25.5 (SD = 3.7) is similar to that of other farmworkers and other immigrant workers. Perceived work safety climate is associated with hours worked per week (P = .02), precarious employment (P < .001), planting and cultivating (P = .002), topping tobacco (P = .0012), and stress (P = .02). Perceived work safety climate is particularly important for migrant farmworkers with H-2A visas because their labor contracts limit their options to change employers. Additional research on the status of work safety climate among agricultural workers is needed, as well as on the factors that affect work safety climate and on the safety characteristics that are affected by work safety climate. Policy changes that lead to improved work safety climate should be considered.

Everyday violence, structural racism and mistreatment at the US-Mexico border

Immigration laws that militarize communities may exacerbate ethno-racial health disparities. We aimed to document the prevalence of and ways in which immigration enforcement policy and militarization of the US-Mexico border is experienced as everyday violence. Militarization is defined as the saturation of and pervasive encounters with immigration officials including local police enacting immigration and border enforcement policy with military style tactics and weapons. Data were drawn from a random household sample of US citizen and permanent residents of Mexican descent in the Arizona border region (2006-2008). Qualitative and quantitative data documented the frequency and nature of immigration related profiling, mistreatment and resistance to institutionalized victimization. Participants described living and working in a highly militarized environment, wherein immigration-related profiling and mistreatment were common immigration law enforcement practices. Approximately 25% of respondents described an immigration-related mistreatment episode, of which 62% were personally victimized. Nearly 75% of episodes occurred in a community location rather than at a US port of entry. Participant mistreatment narratives suggest the normalization of immigration-related mistreatment among the population. Given border security remains at the core of immigration reform debates, it is imperative that scholars advance the understanding of the public health impact of such enforcement policies on the daily lives of Mexican-origin US permanent residents, and their non-immigrant US citizen co-ethnics. Immigration policy that sanctions institutional practices of discrimination, such as ethno-racial profiling and mistreatment, are forms of structural racism and everyday violence. Metrics and systems for monitoring immigration and border enforcement policies and institutional practices deleterious to the health of US citizens and residents should be established.

Acculturation and HIV-related sexual behaviours among international migrants: a systematic review and meta-analysis

This review examines the global literature regarding the relationship between acculturation and HIV-related sexual behaviours among international migrants. Seventy-nine articles published in English-language journals prior to July 2012 met the criteria for inclusion. We conducted a systematic review and subset meta-analysis of correlations between acculturation and five types of sexual behaviours including condom use, multiple partnerships, early sexual initiation, sexually transmitted diseases (STDs) and other unsafe sexual practices. Immigrants high in mainstream acculturation were more likely to have multiple partnerships, early sexual initiation, STDs and unsafe sex (rs ranged from 0.10 to 0.16), but acculturation was not associated with condom use (r = 0.02). Gender moderated the relationships between acculturation and multiple partnerships, STDs and unsafe sex. The relationship between acculturation and unsafe sex also varied across ethnicity. These findings suggest that acculturation may serve as a risk factor towards immigrants' HIV-related sexual health. We offered a theoretical framework and suggested applying cross-cultural and longitudinal designs in future research on acculturation and health behaviours.

Impact of social discrimination, job concerns, and social support on Filipino immigrant worker mental health and substance use

BACKGROUND

The personal and social impact of mental health problems and substance use on workforce participation is costly. Social determinants of health contribute significantly to health disparities beyond effects associated with work. Guided by a theory-driven model, we identified pathways by which social determinants shape immigrant worker health.

METHOD

Associations between known social determinants of mental health problems and substance use (social discrimination, job and employment concerns, and social support) were examined using structural equation modeling in a sample of 1,397 immigrants from the Filipino American Community Epidemiological Study.

RESULTS

Social discrimination and low social support were associated with mental health problems and substance use (P < 0.05). Job and employment concerns were associated with mental health problems, but not substance use.

CONCLUSIONS

The integration of social factors into occupational health research is needed, along with prevention efforts designed for foreign-born ethnic minority workers.

Occupational health outcomes for workers in the agriculture, forestry and fishing sector: implications for immigrant workers in the southeastern US

BACKGROUND

Workers in the Agriculture, Forestry, and Fisheries (AgFF) sector experience exposures directly related to the work itself, as well as the physical environment in which the work occurs. Health outcomes vary from immediate to delayed, and from acute to chronic.

METHODS

We reviewed existing literature on the health outcomes of work in the AgFF sector and identified areas where further research is needed to understand the impact of these exposures on immigrant Latino workers in the southeastern US.

RESULTS

Outcomes related to specific body systems (e.g., musculoskeletal, respiratory) as well as particular exposure sources (e.g., pesticides, noise) were reviewed. The most extensive evidence exists for agriculture, with a particular focus on chemical exposures. Little research in the southeastern US has examined health outcomes of exposures of immigrant workers in forestry or fisheries.

CONCLUSION

As the AgFF labor force includes a growing number of Latino immigrants, more research is needed to characterize a broad range of exposures and health outcomes experienced by this population, particularly in forestry and fisheries.

Stress, depression and coping among Latino migrant and seasonal farmworkers

Research shows that one in four migrant farmworkers experienced an episode of one or more mental health disorders such as stress, depression, or anxiety in their lifetime. The purpose of this mixed methods study was to explore experiences and perceptions related to stress and depression among Latino migrant and seasonal farmworkers (MSFWs), and to identify their coping behaviors for dealing with these mental health conditions. Using a mixed methods research approach, three focus group interviews of a sample of Latino MSFWs (N = 29) were conducted and a quantitative survey was implemented (N = 57) at community sites in eastern North Carolina. Four major themes emerged from the focus group data: (1) physical stress related to working conditions; (2) mental stress related to family situations, work environment, documentation status, and lack of resources; (3) depression related to separation from family and the lack of resources; and (4) use of positive and negative mechanisms for coping with stress and depression. A discussion of these themes, results from the survey findings, implications for intervention and outreach programs, along with recommendations for further research, are provided.

The border community and immigration stress scale: a preliminary examination of a community responsive measure in two Southwest samples

Understanding contemporary socio-cultural stressors may assist educational, clinical and policy-level health promotion efforts. This study presents descriptive findings on a new measure, the border community and immigration stress scale. The data were from two community surveys as part of community based participatory projects conducted in the Southwestern US border region. This scale includes stressful experiences reflected in extant measures, with new items reflecting heightened local migration pressures and health care barriers. Stressors representing each main domain, including novel ones, were reported with frequency and at high intensity in the predominantly Mexican-descent samples. Total stress was also significantly associated with mental and physical health indicators. The study suggests particularly high health burdens tied to the experience of stressors in the US border region. Further, many of the stressors are also likely relevant for other communities within developed nations also experiencing high levels of migration.

Battling discrimination and social isolation: psychological distress among Latino day laborers

Day labor is comprised of predominately male and recent Latino immigrants, mainly from Mexico and Central America who work in an unregulated and informal market. Three-quarters of the day labor force is undocumented and live under the federal poverty threshold as work is seasonal and highly contingent on the weather and the local economy. However, in spite of their exposure to significant health risks, little is known about the impact of Latino day laborers' (LDLs) work and life conditions on their mental health. This mixed methods study extends the literature by using the minority stress theoretical model to examine the relationship between discrimination and social isolation as well as participant identified protective factors such as religiosity and sending remittances with psychological distress. A quantitative survey with 150 LDLs was conducted and was followed by a qualitative member checking focus group to extend upon the quantitative results as well as the minority stress model with the lived experiences of these immigrant workers. Results reveal implications for prevention efforts with this hard-to-reach and marginalized population.

Examining the Effects of Mexican Serial Migration and Family Separations on Acculturative Stress, Depression, and Family Functioning

This study examined the role of parent-child separations during serial migration to the United States in predicting individual- and family-level outcomes in Mexican immigrant families. We assessed parents’ subjective appraisals of their family’s separation and reunion experiences to explore associations with self-reported acculturative stress, depression and family functioning. Data were collected from an urban, low-income community sample of Mexican immigrant parents ( N = 53). Seventy percent ( N = 37) of the parents experienced a separation from at least one child during immigration. Separated status parents reported significantly higher levels of acculturative stress, but no significant differences were found between separated and nonseparated status parents on depression or family functioning. Findings also revealed that negative appraisals of the family’s reunion experience were associated with higher levels of acculturative stress, depression, and unhealthy family functioning. We discuss the implications for future research to address the mental health of Mexican immigrant families in the United States.