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Smith RWA, Nelson RG, Magpiong AR, South SK, Dervarics A, Plattner P, Coe Schweiger B, Reynolds AW. The plantation system and the roots of the southern rural mortality penalty in the northern Blackland Prairies of Texas. Health Place 2024; 88:103234. [PMID: 38833850 DOI: 10.1016/j.healthplace.2024.103234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/28/2024] [Accepted: 03/18/2024] [Indexed: 06/06/2024]
Abstract
In recent decades, public health researchers have observed that the health of rural people has declined relative to the health of urban people in the United States. This disparity in health and life expectancy across the rural/urban divide has been described as the Rural Mortality Penalty. However, public health researchers have also noted that health and life expectancies are not uniform across the rural United States, but vary according to race, sex, gender, and other factors. Rural health disparities also vary geospatially and are especially pronounced in the American South, leading to recent calls for greater attention to the structural factors that shape the health of rural Southerners. In this study, we take an anthropological and historically explicit approach to study the impacts of systemic violence on rural health. Specifically, we focus on farm labor within the plantation system as a context where geospatial, racial, and sexual differences in mortality, often studied in isolation, find a common historical source. Here we analyze vital records data from the post-emancipation period in the Blackland Prairies ecoregion of Texas, a period when emerging forms of plantation labor such as tenant farming, convict leasing, and migrant labor were being developed to maintain the plantation economy after the abolishment of chattel slavery. We find that the plantation system remains a strong predictor of differential mortalities in rural Texas, accounting for nearly all the variation that exists across the rural/urban divide and elucidating the complex interactions of race, sex, labor, and health in the rural South.
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Affiliation(s)
- Rick W A Smith
- Department of Sociology and Anthropology, George Mason University, Fairfax, VA, USA; Women and Gender Studies, George Mason University, Fairfax, VA, USA; Indigenous Science, Technology, and Society Lab, Faculty of Native Studies, University of Alberta, Edmonton, Alberta, Canada.
| | - Robin G Nelson
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA.
| | - Amanda R Magpiong
- Department of Sociology and Anthropology, George Mason University, Fairfax, VA, USA
| | - Stacey K South
- Department of Sociology and Anthropology, George Mason University, Fairfax, VA, USA
| | - Audrey Dervarics
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Paige Plattner
- Department of Anthropology, Baylor University, Waco, TX, USA
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Phelan S, Tseng M, Kelleher A, Kim E, Macedo C, Charbonneau V, Gilbert I, Parro D, Rawlings L. Increasing Access to Medical Care for Hispanic Women Without Insurance: A Mobile Clinic Approach. J Immigr Minor Health 2024; 26:482-491. [PMID: 38170427 DOI: 10.1007/s10903-023-01575-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 01/05/2024]
Abstract
The purpose of this study was to describe the health status and barriers of people who sought care on a free mobile health clinic for women without insurance in California. Participants were 221 women who attended the Salud para Mujeres (Women's Health) mobile medical clinic between 2019 and 2021. Medical chart abstractions provided data on sociodemographic factors, medical history, barriers to care, depressive symptoms, and dietary factors. Anthropometric measure, blood pressure, and biomarkers of cardiometabolic disease risk were also abstracted. Participants were young adult (29.1 [SD 9.3] years), Hispanic (97.6%), farm-working (62.2%) women from Mexico (87.0%). Prevalent barriers to accessing (non-mobile) medical care included high cost (74.5%), language (47.6%), hours of operation (36.2%), and transportation (31.4%). The majority (89.5%) of patients had overweight (34.0%) or obesity (55.5%), and 27% had hypertension. Among those (n = 127) receiving a lipid panel, 60.3% had higher than recommended levels of low-density lipoprotein and 89% had lower than recommended levels of high-density lipoprotein. Point-of-care HbA1c tests (n = 133) indicated that 9.0% had diabetes and 24.8% had prediabetes. Over half (53.1%) of patients reported prevalent occupational exposure to pesticides and 19% had moderate to severe depressive symptoms. Weekly or more frequent consumption of sugar sweetened beverages (70.9%) and fast food (43.5%) were also prevalent. Mobile health units have potential for reaching women who face several barriers to care and experience major risk factors for cardometabolic disease. Findings suggest a compelling need to assure that Hispanic and Indigenous women and farmworkers have access to healthcare.
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Affiliation(s)
- Suzanne Phelan
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA.
| | - Marilyn Tseng
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Anita Kelleher
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Erin Kim
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Cristina Macedo
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Vicki Charbonneau
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA
| | | | - David Parro
- SLO NOOR Foundation, San Luis Obispo, CA, USA
| | - Luke Rawlings
- Marian Regional Medical Center, Santa Maria, CA, USA
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Maxwell AE, Young S, Gomez N, Tran K, Chang LC, Nails E, Gere D, Bastani R. Aprendiendo de La Vida (Learning from Life): Development of a Radionovela to Promote Preventive Health Care Utilization among Indigenous Farmworkers from Mexico Living in California. THE JOURNAL OF MEDICAL HUMANITIES 2022; 43:365-376. [PMID: 34251581 PMCID: PMC10699854 DOI: 10.1007/s10912-021-09704-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 06/13/2023]
Abstract
Mixtecs and Zapotecs, originating from the Oaxaca area in Mexico, are among the largest indigenous groups of workers in California. Many adults in this community only access the health care system when sick and as a last resort. This article describes the development of a radionovela to inform the community about the importance of preventive health care. It was developed following the Sabido Method. The methodology to develop a radionovela may be of interest to other public health practitioners who want to develop educational materials in an engaging format, especially for communities that rely on oral, not written information.
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Affiliation(s)
- Annette E Maxwell
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Sandra Young
- Mixteco/Indigena Community Organizing Project, Oxnard, CA, USA
| | - Norma Gomez
- Mixteco/Indigena Community Organizing Project, Oxnard, CA, USA
| | - Khoa Tran
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - L Cindy Chang
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Elisabeth Nails
- Art and Global Health Center, University of California, Los Angeles, CA, USA
| | - David Gere
- Art and Global Health Center, University of California, Los Angeles, CA, USA
| | - Roshan Bastani
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
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4
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Pacheco C, Ponce-Gonzales I, Diaz MS, Maxwell AE. Exploring Barriers to Access Prenatal Care Among Indigenous Mexican and Guatemalan Women in Washington State. WOMEN'S REPRODUCTIVE HEALTH (PHILADELPHIA, PA.) 2022; 10:110-124. [PMID: 37288310 PMCID: PMC10243752 DOI: 10.1080/23293691.2022.2061319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 06/09/2023]
Abstract
Migrant and Seasonal Agricultural Workers including indigenous women that are not of Hispanic descent face many barriers to access prenatal care. We conducted a survey in Spanish and three indigenous languages to explore knowledge, attitudes and behaviors regarding prenatal care among 82 female agricultural workers, Mixteco, Triqui and Awakateko, residing in the State of Washington. Our findings highlight the importance of collecting disaggregated data from different indigenous communities and of providing indigenous language support. Our study provides new information for developing messages to promote prenatal care that take into account the knowledge and beliefs that are prevalent in these communities.
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Affiliation(s)
- Colleen Pacheco
- Sea Mar Community Health Centers, 125 N. 18 Street, Suite A, Mount Vernon, WA 98273, USA
| | - Ileana Ponce-Gonzales
- Coalition for Migrants & Refugees, Department of Health Services, University of Washington, Washington, USA
| | - Marcela Suarez Diaz
- Sea Mar Community Health Centers, 125 N. 18 Street, Suite A, Mount Vernon, WA 98273, USA
| | - Annette E. Maxwell
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, USA
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Bloss JE, LePrevost CE, Zahra AG, Firnhaber GC, Cofie LE, Zepeda R, Lee JGL. Advancing the Health of Migrant and Seasonal Farmworkers in the United States: Identifying Gaps in the Existing Literature, 2021. Health Promot Pract 2021; 23:432-444. [PMID: 34549654 PMCID: PMC9096586 DOI: 10.1177/15248399211033308] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There are profound health inequities for agricultural workers. We sought to assess the literature on migrant and seasonal farmworker health with an eye toward health promotion interventions, special populations, use of community health workers (CHWs), and technology. We conducted a systematic mapping review by searching five databases in March 2021. Using quantitative content analysis after establishing interrater reliability, we coded titles and abstracts to assess 13 topics and six characteristics of the research such as its focus on health promotion, use of technology, and inclusion of CHWs. We identified 1,083 records. Just 8.2% of records described or evaluated a health promotion effort to intervene in farmworker well-being and even fewer (4.2%) examined unique populations of farmworkers such as indigenous farmworkers (n = 11) or sexual minority farmworkers (n = 1). A small body of literature focused on the role of CHWs or promotores most frequently described their role in implementing health interventions. The literature on farmworker health has gaps regarding health promotion interventions, special populations, and integration of CHWs into research projects. We offer suggestions to fill in identified gaps in the literature.
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Affiliation(s)
| | - Catherine E LePrevost
- North Carolina State University, Raleigh, NC, USA.,North Carolina Agromedicine Institute, Greenville, NC, USA
| | | | | | | | - Ramón Zepeda
- Student Action with Farmworkers, Durham, NC, USA
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Méndez M, Flores-Haro G, Zucker L. The (in)visible victims of disaster: Understanding the vulnerability of undocumented Latino/a and indigenous immigrants. GEOFORUM; JOURNAL OF PHYSICAL, HUMAN, AND REGIONAL GEOSCIENCES 2020; 116:50-62. [PMID: 32834081 PMCID: PMC7413658 DOI: 10.1016/j.geoforum.2020.07.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 05/05/2023]
Abstract
As climate change advances, communities across the United States are adapting to the increased threat of wildfires, drought, heatwaves, and infectious diseases. Such disasters are expected to become more frequent and severe. Now more than ever, it is crucial to understand how these events amplify existing inequalities, and how to lessen the resulting harms. Differences in human vulnerability to disaster stem from a range of social, economic, historical, and political factors. We argue that given their social status, undocumented Latino/a and Indigenous immigrants are particularly vulnerable to disasters and require special consideration in disaster planning. They are disproportionately affected by racial discrimination, exploitation, economic hardships, less English and Spanish proficiency, and fear of deportation in their everyday lives- their pre-disaster marginalized status. In the case of the Thomas Fire in California's Ventura and Santa Barbara counties, we show that emergency response and recovery efforts ignored their needs. Resources were directed toward privileged individuals, leaving local immigrant rights and environmental justice groups to provide essential services such as language access to emergency information in Spanish and Indigenous tongues; labor protections for farmworkers endangered in the fields; and a private disaster relief fund for undocumented immigrants ineligible for federal aid. The article concludes with preliminary participant observations from the COVID-19 pandemic response in the region, indicating how lessons from the fire have informed official actions. As governments grapple with the increasing severity of disasters, understanding the differential impacts on undocumented immigrants can help improve disaster planning to protect the most vulnerable and stigmatized populations.
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Affiliation(s)
- Michael Méndez
- School of Social Ecology, Department of Urban Planning and Public Policy, University of California, Irvine, 300 Social Ecology I, Irvine, CA 92697-7075, United States
| | - Genevieve Flores-Haro
- Mixteco/Indígena Community Organizing Project, 520 W. 5th St., Suite G Oxnard, CA 93030, United States
| | - Lucas Zucker
- Central Coast Alliance United for a Sustainable Economy (CAUSE), 2021 Sperry Ave. #9, Ventura, CA 93003, United States
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Rodríguez-Campo VA, Valenzuela-Suazo SV. Migrantes y sus condiciones de trabajo y salud: revisión integrativa desde la mirada de enfermería. ESCOLA ANNA NERY 2020. [DOI: 10.1590/2177-9465-ean-2019-0299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
RESUMEN Objetivo Analizar la producción científica, indexada, asociada a las condiciones laborales y de salud en migrantes. Metodo Revisión integrativa de artículos publicados en el periodo 2009 a 2019, utilizando bases de indización Medline/PUBMED; ScIELO; SCOPUS utilizando los descriptores MeSH y DeCS: Condiciones de Trabajo, Estado de Salud, Inmigrantes. Resultados Se obtuvo un total de 21 estudios., distribuidos en 17 en Medline/PUBMED; 3 en ScIELO y 1 en SCOPUS. La mayoría de artículos cuantitativo fueron realizados en Brasil y España. La discriminación, explotación, mala calidad de vida, nivel de educación, mala autopercepción de salud, fueron principales resultados. Conclusiones Existe una falta de estudios que evidencien la realidad ocurrida en América Latina, para enfermería como disciplina y profesión se abre un gran desafío para estudiar a la población trabajadora migrante, pues permitirá entregar evidencias de este grupo humano, se lograrán generar intervenciones que favorezcan la salud de esta población y se podrán promover conductas saludables a nivel laboral e individual
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8
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Bonmatí-Tomas A, Malagón-Aguilera MC, Gelabert-Vilella S, Bosch-Farré C, Vaandrager L, García-Gil MM, Juvinyà-Canal D. Salutogenic health promotion program for migrant women at risk of social exclusion. Int J Equity Health 2019; 18:139. [PMID: 31481094 PMCID: PMC6724247 DOI: 10.1186/s12939-019-1032-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 08/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migrant women at risk of social exclusion often experience health inequities based on gender, country of origin or socioeconomic status. Traditional health promotion programs designed for this population have focused on covering their basic needs or modifying lifestyle behaviors. The salutogenic model of health could offer a new perspective enabling health promotion programs to reduce the impact of health inequities. This study evaluated the effectiveness of a salutogenic health promotion program focused on the empowerment of migrant women at risk of social exclusion. METHODS A four-session salutogenic health promotion program was conducted over a period of 6 months. In a quasi-experimental pre-test post-test design, an ad hoc questionnaire was administered to 26 women to collect sociodemographic data, together with 5 validated instruments: Antonovsky's Sense of Coherence (SOC-13), Duke-UNC-11 (perceived social support), Quality of Life Short Form-36 (SF-36), Rosenberg's Self-Esteem Scale, and the Cohen et al. Perceived Stress Scale (PSS-10). Descriptive analysis and multiple linear regression models were performed. Statistical tests were considered significant with a two-tailed p value < 0.05. RESULTS Participants had a low initial SOC-13 score (60.36; SD 8.16), which did not show significant change after the health promotion program. Perceived social support (37.07; SD 6.28) and mental quality of life also remained unchanged, while physical quality of life increased from 50.84 (SD 4.60) to 53.08 (SD 5.31) (p = 0.049). Self-esteem showed an increasing trend from 30.14 (SD 4.21) to 31.92 (SD 4.38) (p = 0.120). Perceived stress decreased from 20.57 (SD 2.91) to 18.38 (SD 3.78) (p = 0.016). A greater effect was observed at the end of the program in women with lower initial scores for SOC-13 and quality of life and higher initial scores of perceived stress. CONCLUSIONS The health promotion program reduced perceived stress, increased physical quality of life and showed a trend toward increased self-esteem, especially among migrant women with multiple vulnerability factors. The salutogenic model of health should be considered as a good practice to apply in health promotion programs and to be included in national policies to reduce health inequity in migrant populations.
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Affiliation(s)
- A Bonmatí-Tomas
- Faculty of Nursing, University of Girona, Emili Grahit, 77, 17071, Girona, Spain. .,Health and Health Care Research Group, University of Girona, Emili Grahit, 77, 17071, Girona, Spain. .,European Training Consortium-Public Health and Health Promotion, Emili Grahit, 77, 17071, Girona, Spain.
| | - M C Malagón-Aguilera
- Faculty of Nursing, University of Girona, Emili Grahit, 77, 17071, Girona, Spain.,Health and Health Care Research Group, University of Girona, Emili Grahit, 77, 17071, Girona, Spain
| | - S Gelabert-Vilella
- Faculty of Nursing, University of Girona, Emili Grahit, 77, 17071, Girona, Spain
| | - C Bosch-Farré
- Faculty of Nursing, University of Girona, Emili Grahit, 77, 17071, Girona, Spain.,Health and Health Care Research Group, University of Girona, Emili Grahit, 77, 17071, Girona, Spain
| | - L Vaandrager
- European Training Consortium-Public Health and Health Promotion, Emili Grahit, 77, 17071, Girona, Spain.,Department of Social Sciences, Heath and Society, Wageningen University & Research, Hollandseweg 1, Wageningen, KN, 6706, The Netherlands
| | - M M García-Gil
- Vascular Health Research Group, Unitat de Suport a la Recerca Girona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Girona, Spain.,Information System for Research in Primary Care (SIDIAP), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
| | - D Juvinyà-Canal
- Health and Health Care Research Group, University of Girona, Emili Grahit, 77, 17071, Girona, Spain.,Chair of Health Promotion, University of Girona, Emili Grahit, 77, 17071, Girona, Spain
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Calderón M, Alvarado-Villacorta R, Barrios M, Quiroz-Robladillo D, Guzmán Naupay DR, Obregon A, Calderón Chávez S, Glaser L, Carnero AM, Cortez-Vergara C, Iglesias Quilca D, Colque Gonzales J, Moore D. Health need assessment in an indigenous high-altitude population living on an island in Lake Titicaca, Perú. Int J Equity Health 2019; 18:94. [PMID: 31215456 PMCID: PMC6582488 DOI: 10.1186/s12939-019-0993-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 06/03/2019] [Indexed: 11/29/2022] Open
Abstract
Background Health needs and access to health care is a huge challenge in developing countries, especially in some isolated indigenous communities. Amantani is an island located at 3854 m above sea level in Lake Titicaca, Peru. There is no official date on key local health needs and determinants, which precludes the prioritization and efficient implementation of health interventions. The objective of this study is to validate a health need assessment tool and ascertain the main health needs of the indigenous high-altitude population living on Amantani. Methods We conducted a cross-sectional study to describe the health needs of the indigenous population of Amantani using a questionnaire based on the “Peruvian Demographic and Health Survey”. The questionnaire underwent expert and field-work validation. We selected a random sample of the island residents using two-stage cluster sampling. We estimated the prevalence of key health needs and determinants, and evaluated their distribution by age, sex and education through prevalence ratio. All analyses accounted for the complex sampling design. Results We surveyed 337 individuals (223 adults and 144 children) in 151 houses. The most frequent health needs were: (i) lack of access to medical screening for a)non-communicable diseases (> 63.0%) and b)eye problems (76.5%); and (ii) poor knowledge about communicable diseases (> 54.3%), cancer (71.4%) and contraception (> 32.9%). Smoking and alcohol use was more frequent in males (PR = 4.70 IC95%:1.41–15.63 and PR = 1.69 95% CI:1.27–2.25, respectively). People with higher education had more knowledge about TB/HIV and cancer prevention (p < 0.05). Regarding children’s health, > 38% have never undergone eye or dental examination. Corporal punishment and physical bullying at school in the last month were relatively common (23 and 33%, respectively). Conclusion The main health needs in Amantani are related to poor healthcare access and lack of awareness of disease prevention. Our findings can be used to develop and implement efficient health interventions to improve the health and quality of life of indigenous populations living in the islands in Southern Peru/Northern Bolivia. Electronic supplementary material The online version of this article (10.1186/s12939-019-0993-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- María Calderón
- London School of Hygiene and Tropical Medicine, London, UK.
| | | | | | | | | | - Ana Obregon
- Hospital Nacional Cayetano Heredia, Lima, Peru
| | | | | | | | | | | | | | - David Moore
- London School of Hygiene and Tropical Medicine, London, UK
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10
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Abstract
Immigration laws and policies, as well as related media and public discourse, have a direct and significant effect on the health and well-being of children and families. The purpose of this article is to identify the impact of family immigration status and immigration laws on children's health, to understand the legal system that immigrant children face, and to describe opportunities for health care professionals to engage in advocacy at the systems level, from the local community to Capitol Hill.
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Affiliation(s)
- Julie M Linton
- University of South Carolina School of Medicine Greenville, Prisma Health Upstate Children's Hospital, 20 Medical Ridge Drive, Greenville, SC 29605, USA; Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Jennifer Nagda
- Young Center for Immigrant Children's Rights, 6020 South University Avenue, Chicago, IL 60637, USA
| | - Olanrewaju O Falusi
- George Washington University School of Medicine and Health Sciences, Children's National Health System, 2233 Wisconsin Avenue Northwest, Suite 317, Washington, DC 20007, USA
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11
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León-Pérez G. Internal migration and the health of Indigenous Mexicans: A longitudinal study. SSM Popul Health 2019; 8:100407. [PMID: 31193502 PMCID: PMC6529827 DOI: 10.1016/j.ssmph.2019.100407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/04/2019] [Accepted: 05/07/2019] [Indexed: 12/25/2022] Open
Abstract
Rationale Indigenous peoples have historically comprised a substantial part of migration streams around the world, yet our understanding of the effects of migration on indigenous health is limited. Objective To explore the migration-indigenous health relationship by assessing the impact of internal migration on the self-rated health trajectories of indigenous Mexicans. Data and method Using three waves of data (2002-2012) from the Mexican Family Life Survey, I estimated linear growth curves to examine differences in initial self-rated health and changes in self-rated health between indigenous and non-indigenous respondents (N = 12,533). Then, I investigated whether migrating domestically during the study period shaped indigenous health trajectories. Results At the baseline interview (before migration), indigenous migrants reported significantly better self-rated health than indigenous non-migrants and than all non-indigenous respondents. In spite of their better initial health, indigenous migrants' health deteriorated substantially after migration, such that by the time of the last interview they reported the worst health. The self-rated health of all other groups improved during the same period. Conclusion Findings provide evidence of pre-migration health selection and post-migration health deterioration among Mexican indigenous migrants. These results suggest that internal migration is a risk factor that has an independent effect on indigenous health even after adjusting for personal, family, socioeconomic, and health care factors.
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Affiliation(s)
- Gabriela León-Pérez
- Department of Sociology, Virginia Commonwealth University, 827 West Franklin Street, Richmond, VA, 23284-2040, USA
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12
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Maxwell AE, Young S, Moe E, Bastani R, Wentzell E. Understanding Factors that Influence Health Care Utilization Among Mixtec and Zapotec Women in a Farmworker Community in California. J Community Health 2019; 43:356-365. [PMID: 28975501 DOI: 10.1007/s10900-017-0430-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This paper examines health care utilization among indigenous immigrants from Oaxaca, Mexico, who have settled in a farmworker community in southern California. In 2016, two trained Spanish-Mixteco and Spanish-Zapoteco bi-lingual interviewers conducted in-depth interviews with 44 indigenous women residing in Oxnard, California on issues that affect health care utilization. Interviews were conducted in Mixteco, Zapoteco and Spanish and were coded to identify structural, cultural, and provider-related barriers to health care utilization. Five bi-lingual Spanish-Mixteco indigenous interpreters employed at local clinics were also interviewed. Many women reported lack of health insurance, inability to pay, language barriers, long waiting times, rushed encounters with providers, and seeking western medical care only after home remedies did not work. However, several women were able to access routine health care services, often with support from indigenous interpreters employed at clinics. Interviews with five interpreters found that they provided assistance with interpretation during medical encounters and appointment making. They also educated patients about upcoming exams, identified low-cost services and insurance programs available to patients, assisted with paperwork and occasionally educated physicians on behalf of their patients. In addition to addressing barriers to health care access our findings suggest the importance of identifying and leveraging community assets, such as indigenous navigators, when developing programs for such underserved communities. Our findings can inform best practice in settings that provide health care to indigenous populations and may also apply to settings that provide health care to other immigrant communities that have very limited familiarity and contact with western health care.
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Affiliation(s)
- Annette E Maxwell
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Sandra Young
- Mixteco/Indigena Community Organizing Project, PO Box 20543, Oxnard, CA, 93034, USA
| | - Emily Moe
- Department of Anthropology, University of Iowa, Iowa City, IA, USA
| | - Roshan Bastani
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Emily Wentzell
- Department of Anthropology, University of Iowa, Iowa City, IA, USA
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Young S, Gomez N, Maxwell AE. Providing Health Education to Mixtec Farmworkers in California via Workshops and Radio: A Feasibility Study. Health Promot Pract 2018; 20:520-528. [PMID: 29745264 DOI: 10.1177/1524839918772282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Originating from one of the poorest areas in Mexico, Mixtecs are one of the largest indigenous groups of workers in California. Providing health education to this group is challenging because many do not speak English or Spanish, and indigenous languages are mainly oral, not written. We explored the feasibility of conveying health information through the radio and in promotora-led workshops. The study included an evaluation of the workshops through surveys before the workshop and 4 to 6 months later in a subsample of 96 indigenous women. The number of radio listeners averaged more than 2,000 per month, and 500 community members attended a workshop. Among women who completed pre- and postworkshop assessments (N = 75), there was a statistically significant increase in knowledge of how to get a wellness visit, where to get a free mammogram, and mammography screening guidelines. Women who ever had a mammogram or wellness visit at baseline were significantly more likely to report receipt of this service during the follow-up period than women who never had this service. Educational workshops and radio are promising and culturally appropriate strategies to provide health information in this community. However, many women need additional assistance to navigate access to health care.
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Affiliation(s)
- Sandra Young
- 1 Mixteco/Indigena Community Organizing Project, Oxnard, CA, USA
| | - Norma Gomez
- 1 Mixteco/Indigena Community Organizing Project, Oxnard, CA, USA
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Alecrim TFDA, Mitano F, Reis AAD, Roos CM, Palha PF, Protti-Zanatta ST. Experience of health professionals in care of the homeless population with tuberculosis. Rev Esc Enferm USP 2016; 50:808-815. [DOI: 10.1590/s0080-623420160000600014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 09/29/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract OBJECTIVE Analyzing statements of health professionals from a Street Clinic regarding care of a homeless population with tuberculosis. METHOD This is a qualitative research, conducted in the central region of São Paulo at three basic health units in the period of November to December 2014. A semi-structured interview guideline was implemented for data collection and all interviews were recorded using a digital recorder. RESULTS Six health professionals were interviewed. According to the Discourse Analysis perspective, three discursive segments emerged: experiences on care in the streets; weaknesses inherent to the treatment process; and incentives as a means of maintaining sick people in treatment. CONCLUSION Caring for a the homeless population with tuberculosis constitutes a new and challenging experience. It involves difficulties in dealing with the reality of a miserable social context, a lack and inadequacy of services, as well as care limitations for treatment and treatment dropout, which reinforces multiresistance. However, the investigated Street Clinic teams seek to expand access to health and social care services to this population.
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Affiliation(s)
| | - Fernando Mitano
- Universidade de São Paulo, Brazil; Universidade Lúrio, Moçambique
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The Challenge and Benefit of the Inclusion of Race in Medical School Education. J Racial Ethn Health Disparities 2015; 3:183-6. [DOI: 10.1007/s40615-015-0147-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 06/22/2015] [Accepted: 06/24/2015] [Indexed: 11/26/2022]
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