Herbal Remedies Used by Selected Migrant Farmworkers in El Paso, Texas

On-Farm Health Screening Needs of Immigrant Dairy Workers in the Texas Panhandle and South Plains

The objective of this pilot study was to determine the health needs of dairy farm workers and the feasibility of on-farm health risk screenings in the Texas Panhandle and South Plains. A cross-sectional study design was used to collect survey responses concerning health needs, occupational, and economic characteristics among 300 dairy workers between April 2020 and July 2021. Participants were predominantly immigrant Hispanic (88.8%) males (83.0%) of approximately 34.4 (SD 9.9) years of age, worked 6.0 (SD 0.4; Range 3-7) days a week and 9.9 (SD 1.5; Range 6-13) hours a day, earning a mean hourly rate of $13.40 (SD $2.80). Participants reported interest in attending on-farm health risk screenings (93.8%) as well as receiving a COVID-19 vaccine if it became available (86.4%). Health service categories were ranked from: (1st "most important") preventative care (Mean Rank 2.3), (2nd) laboratory and diagnostic care (Mean Rank 2.6), (3rd) nutritional and physical fitness support (Mean Rank 2.8), (4th) mental health care (Mean Rank 3.4), and (5th) workplace interventions (Mean Rank 3.6). Participants reported obtaining health information predominantly from internet searches (32.0%) and social media (17.7%). Findings suggest there is need and interest for on-farm health risk screenings and education among immigrant dairy workers in the Texas Panhandle-South Plains region. Addressing known barriers to health should be paramount to the organization of on-farm health risk screenings.

Health-seeking behaviour and practices among immigrant retail traders in an urban setting in North-Western Ghana

Purpose

This study aims to investigate the health-care-seeking behaviour and practices of West African migrants who reside and operate in Wa, Ghana, as itinerant retailers.

Design/methodology/approach

The study was cross-sectional and used the quantitative research approach. The analysis was done on a target population comprising 122 itinerant immigrant retail traders in Wa, Ghana. Fisher’s exact test and logistic regression were used to analyse the data.

Findings

Malaria was the commonest disease among them. Five in ten of the migrants preferred to report malaria episodes to a private health facility than to a government facility. Significant associations were identified between four dimensions (health facility, self-medication, home remedy and consult others) of health-seeking behaviour, and some background characteristics. The main reason why migrants prefer government health facilities was because of their better health personnel. They self-medicated because of easy accessibility of over-the-counter medicine shops. Also, when ill, the migrants usually consulted family members who would be in a position to take them home when their ailment worsens.

Research limitations/implications

Snowball sampling was used to select the respondents which could potentially lead to a sample that is not fully representative of the population in general.

Originality/value

Studies concerning migration and health in Ghana have been focused on internal migrants. Yet, minority immigrant traders equally encounter adverse health conditions but limited studies have been conducted to espouse their health-seeking behaviour. This study imperatively contributes to the subject matter that has limited literature in the country.

Herbal/Plant Remedies and Supplements Used by Hispanics/Latinxs for Diabetes: Source of Functional Foods?

PURPOSE

The purpose of this study was to explore the use of herbal/plant remedies and supplements for type 2 diabetes (T2DM) among Hispanics/Latinxs in North Carolina and identify demographic and diabetes-related factors associated with use of these therapies.

METHODS

Baseline data from a family-based diabetes intervention tailored for Hispanics/Latinxs were analyzed using descriptive statistics, bivariate analyses, and logistic regression. A convenience sample of 186 adults with T2DM and adult family members with and without T2DM was recruited from community-based settings and data obtained from face-to-face interviews conducted in Spanish.

RESULTS

Most participants were female (73%) with an average age of 45 years old. Among this predominantly immigrant sample (96%), 78% of participants reported being from Mexico. Sixty percent had T2DM, and average A1C was 8.7% for persons with T2DM. Nearly a third reported using 51 different remedies for diabetes management. Most ingested them concurrently with prescribed medications; however, 11.3% reported altering the dose of medications when using herbal/plant remedies or supplements. Most common items were prickly pear cactus, pineapple, celery, aloe vera, parsley, and spinach. Using herbs/plants was positively correlated with age, A1C, and years with T2DM. The odds of using herbs/plants increased 28% for every 1% increase in A1C (adjusted odds ratio = 1.28, P = .003).

CONCLUSIONS

Asking about herbal/plant remedy and supplement use is important. Although there is limited efficacy and safety studies for some items, multiple reported remedies are functional foods with biologically active ingredients to promote health. Patient education is needed on safe and unsafe items and use with prescribed medications.

Factors Related to Disclosure and Nondisclosure of Dietary Supplements in Primary Care, Integrative Medicine, and Naturopathic Medicine

Background:

Patients infrequently disclose use of dietary supplements to providers. Little is known about factors that motivate patients to disclose supplement use. The study aimed to identify reported factors motivating patients’ disclosure and nondisclosure of dietary supplement use and explore differences based on type of supplement and provider practice.

Methods:

Mixed methods study combining qualitative content analysis of semi-structured interviews with statistical analyses to assess differences in identified factors by provider practice type and supplement type. Seventy-eight English-speaking patients who reported taking 466 dietary supplements in the previous 30 days were recruited from primary care and Complementary and Alternative Medicine (CAM), and Integrative Medicine (IM) offices in Southern California.

Results:

We identified nine themes related to disclosure and nine related to nondisclosure of dietary supplement use. Major themes were features of the office visit, circumstances in patient health and medical care, and provider/patient characteristics. The most commonly raised theme promoting disclosure of supplement use was provider inquiry. Patients associate disclosure with having concerns about a supplement but also with annual physical exams and some routine topics of discussion, including self-care, lab results, and new medication prescriptions. Themes related to nondisclosure included lack of provider inquiry, features of the office visit, such as supplements being unrelated to the visit purpose, and patients’ convictions that supplements are safe or not important to discuss. Themes did not vary by supplement type. Primary care patients were more likely than CAM/IM patients to attribute nondisclosure to convictions that supplements were beneficial, not worth mentioning, or equivalent to food (p ≤ 0.001).

Conclusions:

When providers fail to ask directly about dietary supplement use, disclosure is often an impromptu decision that is driven by the content of provider-patient interactions. Ensuring disclosure of dietary supplement use to prevent potential drug-supplement interactions or adverse health outcomes likely requires consistent, proactive provider queries about supplement use.

Tes, Licuados, and Capsulas: herbal self-care remedies of Latino/Hispanic immigrants for type 2 diabetes

PURPOSE

The purpose of this cross-sectional, descriptive study was to explore the characteristics of herbal remedy use for diabetes among Latinos/Hispanics with type 2 diabetes.

METHODS

A convenience sample of 75 Latino/Hispanic adults with type 2 diabetes was recruited from community-based settings in North Carolina. Data were collected through face-to-face bilingual interviews. Measures included a demographic questionnaire; the Traditional, Complementary, and Alternative Practices Questionnaire; and biophysical indicators of A1C and body mass index.

RESULTS

Sixty-nine percent of the sample reported using herbal remedies for diabetes self-care. Forty-nine herbal products were identified. The most commonly reported products were prickly pear cactus, aloe vera, celery, and chayote. The perceived effectiveness of products varied; some said they helped "a lot" while others noted the development of side effects. Over three quarters (77%) of persons using herbal remedies reported concurrent use with prescribed medications. Also, some participants reported skipping or altering the dose of diabetes medications when using herbal remedies. Most (77%) reported not disclosing herbal remedy use to health care providers.

CONCLUSIONS

Diabetes educators and other health care providers need to ask Latino/Hispanic clients about their use of herbal remedies and become knowledgeable about herbal products to provide advice about safety.

A comparison of traditional food and health strategies among Taiwanese and Chinese immigrants in Atlanta, Georgia, USA

BACKGROUND

Ethnobotanical studies on the use of plants amongst migrant populations are of great relevance to public health. Traditional health strategies, which incorporate plants as medicines, foods, or both - can play an important role in individual well-being. However, at the same time, migrant populations' traditional knowledge of such practices may be under a state of greater threat of decline due to factors such as limited access to the plant materials and physical isolation from the homeland, which serves as the primary living reservoir for this knowledge.

METHODS

In this study, we conducted a medical ethnobotanical survey focusing on a comparison of local medicinal food and health strategies with members of two Asian immigrant populations in metro-Atlanta: Chinese and Taiwanese. Snowball sampling techniques were employed to recruit 83 study participants, 57 of which were included in the final analysis. Semi-structured interview techniques were used to question participants about their beliefs and usage of the yin yang system, usage of Chinese herbs and medicinal foods, preference and usage of Eastern and Western medicines, and gardening for medicinal foods.

RESULTS AND CONCLUSION

Comparison of the two groups demonstrated a remarkable difference in health strategies concerning medicinal plant use, including statistically significant differences in beliefs concerning yin and yang, uses of Eastern versus Western medicine, and gardening for medicinal foods. Domestic health strategies in the form of medicinal foods play an important role in local health practices, especially among the Taiwanese participants. The collective desire for the use of both Eastern and Western medicine by both groups highlights the important role that cultural competency training will play in preparing allopathic health practitioners to serve increasingly diverse patient populations in the US.

Intercultural health and ethnobotany: how to improve healthcare for underserved and minority communities?

ETHNOPHARMACOLOGICAL RELEVANCE

The present conceptual review explores intercultural healthcare--defined as the integration of traditional medicine and biomedicine as complementary healthcare systems--in minority and underserved communities. This integration can take place at different levels: individuals (patients, healers, biomedical healthcare providers), institutions (health centers, hospitals) or society (government policy).

BACKGROUND

Contemporary ethnobotany research of traditional medicine has primarily dealt with the botanical identification of plants commonly used by local communities, and the identification of health conditions treated with these plants, whereas ethnopharmacology has focused on the bioactivity of traditional remedies. On the other hand, medical anthropology seems to be the scholarship more involved with research into patients' healthcare-seeking itineraries and their interaction with traditional versus biomedical healthcare systems. The direct impact of these studies on public health of local communities can be contested.

AIM OF THE REVIEW

To compare and discuss the body of scholarly work that deals with different aspects of traditional medicine in underserved and minority communities, and to reflect on how gaps identified in research can be bridged to help improve healthcare in these communities.

KEY FINDINGS

The literature covers a broad range of information of relevance to intercultural healthcare. This information is fragmented across different scientific and clinical disciplines. A conceptual review of these studies identifies a clear need to devote more attention to ways in which research on traditional medicine can be more effectively applied to improve local public health in biomedical resource-poor settings, or in geographic areas that have disparities in access to healthcare.

CONCLUSIONS

Scholars studying traditional medicine should prioritize a more interdisciplinary and applied perspective to their work in order to forge a more direct social impact on public health in local communities most in need of healthcare.

Exploratory study of the occupational health and health-seeking of migrant and seasonal farmworkers on the U.S.-Mexico border

The U.S. migrant and seasonal farmworker (MSFW) workforce is aging. Aging causes functional changes that can affect work performance and increase injury/accident risk. It also has been linked with deferred health-seeking. The exploratory study was conducted to investigate occupational injuries and health-seeking in Hispanic MSFW on the U.S.-Mexico border. Data were collected using an abbreviated Spanish-version of the California Agricultural Worker Health Survey. Nearly 60% of the 141 participants were middle-aged or older. Musculoskeletal injuries and those consistent with agrochemical and environmental exposures were common. Farmworkers aged >40 years were 2.5-5 times more likely than younger MSFW to report persistent single and multiple injuries involving the knees, shoulder, feet, and hands. Except for neck and back injuries, few received any medical treatment. Although many self-treated with traditional home remedies, few used CAM practitioners. The study findings highlight the multiple workplace health and health-seeking challenges faced by aging immigrant MSFW.

Neuropsychiatric symptoms and the use of complementary and alternative medicine

OBJECTIVES

To assess the prevalence of complementary and alternative medicine (CAM) use by U.S. adults reporting neuropsychiatric symptoms and whether this prevalence changes based on the number of symptoms reported. Additional objectives include identifying patterns of CAM use, reasons for use, and disclosure of use with conventional providers in U.S. adults with neuropsychiatric symptoms.

DESIGN

Secondary database analysis of a prospective survey.

PARTICIPANTS

A total of 23,393 U.S. adults from the 2007 National Health Interview Survey.

METHODS

We compared CAM use between adults with and without neuropsychiatric symptoms. Symptoms included self-reported anxiety, depression, insomnia, headaches, memory deficits, attention deficits, and excessive sleepiness. CAM use was defined as use of mind-body therapies (eg, meditation), biological therapies (eg, herbs), or manipulation therapies (eg, massage) or alternative medical systems (eg, Ayurveda). Statistical analysis included bivariable comparisons and multivariable logistical regression analyses.

MAIN OUTCOME MEASURES

The prevalence of CAM use among adults with neuropsychiatric symptoms within the previous 12 months and the comparison of CAM use between those with and without neuropsychiatric symptoms.

RESULTS

Adults with neuropsychiatric symptoms had a greater prevalence of CAM use compared with adults who did not have neuropsychiatric symptoms (43.8% versus 29.7%, P < .001); this prevalence increased with an increasing number of symptoms (trend, P < .001). Differences in the likelihood of CAM use as determined by the number of symptoms persisted after we adjusted for covariates. Twenty percent of patients used CAM because standard treatments were either too expensive or ineffective, and 25% used CAM because it was recommended by a conventional provider. Adults with at least one neuropsychiatric symptom were more likely to disclose the use of CAM to a conventional provider (47.9% versus 39.0%, P < .001).

CONCLUSION

More than 40% of adults with neuropsychiatric symptoms commonly observed in many diagnoses use CAM; an increasing number of symptoms was associated with an increased likelihood of CAM use.

Medicinal plants used in the Huasteca Potosina, México

ETHNOPHARMACOLOGICAL IMPORTANCE

Medicinal plants have been a source of medicinal compounds since ancient times. This study documented the use of plant species in traditional medicine in the municipality of Aquismón, San Luis Potosí, México.

MATERIALS AND METHODS

Direct interviews were performed with inhabitants from Aquismón. The interviews were analyzed with two quantitative tools: (a) the informant consensus factor (ICF) that estimates the level of agreement about which medicinal plants may be used for each category and (b) the relative importance (RI) that determines the extent of potential utilization of each species.

RESULTS

A total of 73 plant species with medicinal purposes, belonging to 37 families and used to treat 52 illnesses and 2 cultural filiations were reported by interviewees. Nineteen mixtures with medicinal plants were reported by the interviewers. Matricaria recutita was the most used plant for combinations (five mixtures). The results of the ICF showed that diseases of the digestive and respiratory systems had the greatest agreement. The most versatile species according to their RI are Ruta graveolens, Tagetes erecta, Ocimum basilicum and Erigeron karwinskianus.

CONCLUSION

This study demonstrates that plant species play an important role in healing practices and magical-religious rituals among inhabitants from Huasteca Potosina. Further studies with medicinal flora, including mixtures, from Aquismón are required for the experimental validation of their traditional uses.

Self care and health-seeking behavior of migrant farmworkers

There are an estimated three million migrant and seasonal farmworkers (MSFW) in the United States. In addition to the inherent dangers of farm work, numerous factors place MSFW at even greater risk for work-related injuries. Little is known about how MSFW care for work-related injuries, and how the decision to seek professional care is made. A prospective survey using face-to-face structured interviews was used to explore the type and frequency of occupational injuries as well as self-care and health-care seeking practices of MSFW. Musculoskeletal injuries were the most commonly reported injuries, followed by injuries of the skin and chemical exposure. Self care with over-the-counter remedies was the predominant method of dealing with injuries, and, with the exception of chemical exposure, was found to be for the most part, appropriate. The reported use of alternative medicine or herbal remedies was low. Future research efforts should focus on ergonomic modifications and farmworker education to reduce or prevent musculoskeletal injuries. The number of reported chemical exposures and inappropriate treatment draw attention to the need for continued efforts for both primary prevention of exposure and optimal treatment once exposure occurs.

Overcoming language and literacy barriers in safety and health training of agricultural workers

The workforce in all areas of United States agriculture and forestry is becoming increasingly diverse in language, culture, and education. Many agricultural workers are immigrants who have limited English language skills and limited educational attainment. Providing safety and health training to this large, diverse, dispersed, and often transient population of workers is challenging. This review, prepared for the 2010 Agricultural Safety and Health Council of America/National Institute for Occupational Safety and Health conference, "Be Safe, Be Profitable: Protecting Workers in Agriculture," is divided into five sections. First, we describe the occupational and demographic characteristics of agricultural workers in the United States to highlight their safety and health training needs. Second, we summarize current research on the social and cultural attributes of agricultural workers and agricultural employers that affect the provision of safety and health training. Worker and employer attributes include language, literacy, financial limitations, work beliefs, and health beliefs. Third, we review current initiatives addressing safety and health training for agricultural workers that consider worker language and literacy. These initiatives are limited to a few specific topics (e.g., pesticides, heat stress); they do not provide general programs of safety training that would help establish a culture of workplace safety. However, several innovative approaches to health and safety training are being implemented, including the use of community-based participatory approaches and lay health promoter programs. Fourth, the limited industry response for safety training with this linguistically diverse and educationally limited workforce is summarized. Finally, gaps in knowledge and practice are summarized and recommendations to develop educationally, culturally, and linguistically appropriate safety and health training are presented.

Exploring the prevalence of Ayurveda use among Asian Indians

OBJECTIVE

Despite a growing body of literature on complementary and alternative medicine, there is still limited information on the use of Ayurveda in the United States. Because Ayurveda is one of the world's major traditional medical systems, knowledge of its use is important. In particular, information on utilization by Asian Indians living in the United States is needed due to increased immigration from India and related regions. Recent reports of heavy metal contamination of some imported Ayurveda products underscore this need. For this reason, an exploratory survey was conducted.

DESIGN

A semistructured 21-item questionnaire was administered using face-to-face interviews.

PARTICIPANTS AND SETTING

The study comprised a convenience sample of 64 Asian Indians living in Northern California.

OUTCOME MEASURES

Main outcome measures included sociodemographic variables, questions on awareness, knowledge and use of Ayurvedic products or services, use of other nutritional/herbal products, and reasons for use.

RESULTS

In the sample, 95% of the participants were aware of Ayurveda, 78% had knowledge of Ayurvedic products or treatments, and about 59% had used or were currently using Ayurveda. Only 18% of those using Ayurveda had informed their Western medical doctors.

CONCLUSIONS

Given its common use in the United States by Asian Indians, its cultural relevance, potential therapeutic value, and possible safety concerns, physician and consumer education along with more empirical research is warranted.

Patient Disclosure about Herb and Supplement Use among Adults in the US

Analyses of 2002 National Health Interview supplement on complementary and alternative medicine (NHI%AM) indicate that approximately 38 million adults in the US (18.9% of the population) used natural herbs or supplements in the preceding 12 months, but only one-third told their physician about this use. The objectives of this study are: (i) to determine subpopulation rates of patient-physician communication about herbal product and natural supplement use and (ii) to identify the relative influence of patient factors and interaction factors associated with patient-physician communication about herb and supplement use. Logistic secondary analysis was done by using the complementary and alternative medicine supplement of the 2002 National Health Interview Survey. Subjects were a random stratified sample of US adults who used herbs in the past 12 months (n = 5 196) and self-reported rates of disclosure to physicians about herb and supplement use. Results show that disclosure rates were significantly lower for males, younger adults, racial and ethnic minorities and less intensive users of medical care. Across subpopulations, disclosure was the exception rather than the norm. Given the potential risks of delayed or inappropriate treatment and adverse drug reactions and interactions, physicians should be aware of herb and supplement use and counsel patients on the potential risks and benefits of these treatments.

Delivery of health services to migrant and seasonal farmworkers

Farmworkers are low-paid, uninsured employees in an extremely hazardous industry, and they provide an essential service for U.S. society. This review evaluates the delivery of health services to farmworkers. It describes the farmworker population in the United States, noting characteristics (e.g., migratory and immigration status) that limit their access to and utilization of health services. It describes the health services needs of this population, including occupational health, mental health, oral health, and chronic disease treatment. Cultural, structural, legal, financial, and geographic barriers to health services utilization are described. Existing research on health services utilization among farmworkers is discussed. Programs that have been developed to address the barriers to health services utilization among farmworkers are reviewed. Finally, research needed to improve knowledge of farmworker health services utilization is suggested. These research needs include formal evaluations of existing programs and basic research to characterize the health services utilization patterns of farmworkers.

Treating skin disease: self-management behaviors of Latino farmworkers

Latino migrant and seasonal farmworkers experience high rates of skin disease that result from their working and living conditions. Knowledge of the ways farmworkers treat skin disease symptoms will provide a foundation for developing culturally appropriate health education, improving the delivery of health services, and improving occupational health policy for agricultural workers. The purpose of this paper is to describe skin disease self-management practices among Latino migrant and seasonal farmworkers in North Carolina. This analysis uses a qualitative design based on in-depth interviews with 30 Latino farmworkers (six females, 24 males). Computer assisted, systematic procedures are used to analyze the verbatim transcripts of these interviews. Participants shared a consistent set of health self-management actions in treating skin disease. These actions were within the domains of self-care and medical care. A model of skin disease self-management among Latino farmworkers includes the self-care actions of hygiene, use of home remedies and use of over-the-counter remedies, with farmworkers often combining different domains of self-care. While farmworkers acknowledge the benefits of medical care, they are also mindful of barriers to its use, including cost, transportation and language. The large percentage of farmworkers who experience skin problems indicates that health outreach workers who serve this population need to provide education on preventing and treating skin problems, and they need to recommend to farmworkers appropriate over-the-counter medicines for the treatment of these skin problems. Appropriate medical care for treating skin problems that are dangerous and reduce farmworkers' quality-of-life needs to be made available to this population.