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Kasten-Arias C, Hodes T, Marino M, Kaufmann J, Lucas JA, Estela Vasquez Guzman C, Giebultowicz S, Chan B, Heintzman J. Healthcare utilization for asthma exacerbation among children of migrant and seasonal farmworkers. Prev Med Rep 2024; 38:102598. [PMID: 38283959 PMCID: PMC10821615 DOI: 10.1016/j.pmedr.2024.102598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/14/2023] [Accepted: 01/05/2024] [Indexed: 01/30/2024] Open
Abstract
Latino children of Migrant and Seasonal Farmworkers (MSFWs) with asthma are at risk for poor health outcomes due to medical access barriers. We compared differences in acute care utilization for asthma exacerbations among migrant and non-migrant Latino and non-Hispanic white (NHW) children at U.S. community health centers. A retrospective observational study utilizing electronic health record data from the ADVANCE Clinical Research Network of United States community health centers included 13,423 children ages 3-17 with a primary care visit between 2005 and 2017 from eight states. Emergency department (ED) and hospitalization data came from Oregon Medicaid claims. Outcomes included acute clinic visits, ED visits, and hospitalizations for asthma exacerbation. Regression analyses adjusted for patient-level covariates. Latino children had higher odds of acute clinic visits for asthma exacerbation compared to NHW children (MSFW odds ratio [OR] = 1.17, 95 % CI = 1.03-1.33; without migrant status OR = 1.13, 95 % CI = 1.03-1.23). MSFW children using Oregon Medicaid had fewer ED visits (rate ratio [RR] = 0.72, 95 % CI = 0.52-0.99) and hospitalizations (RR = 0.47, 95 % CI = 0.26-0.86) compared to NHW children. Increased community health center visits may help mitigate disparities in acute asthma care for MSFW children.
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Affiliation(s)
| | - Tahlia Hodes
- Oregon Health & Science University, Department of Family Medicine, Portland OR, USA
| | - Miguel Marino
- Oregon Health & Science University, Department of Family Medicine, Portland OR, USA
| | - Jorge Kaufmann
- Oregon Health & Science University, Department of Family Medicine, Portland OR, USA
| | - Jennifer A. Lucas
- Oregon Health & Science University, Department of Family Medicine, Portland OR, USA
| | | | | | - Brian Chan
- OCHIN, Inc. Portland, OR, USA
- Oregon Health & Science University, Department of Medicine, Division of General Internal Medicine & Geriatrics, Portland OR, USA
| | - John Heintzman
- Oregon Health & Science University, Department of Family Medicine, Portland OR, USA
- OCHIN, Inc. Portland, OR, USA
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Kim JY, Yang Y. Factors affecting unmet medical needs of patients with diabetes: A population-based study. Nurs Open 2023; 10:6845-6855. [PMID: 37461150 PMCID: PMC10495713 DOI: 10.1002/nop2.1933] [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] [Received: 09/22/2022] [Revised: 06/06/2023] [Accepted: 06/27/2023] [Indexed: 09/13/2023] Open
Abstract
AIMS The purpose of this study was to identify unmet medical needs and related factors in patients with diabetes. DESIGN A cross-sectional study. METHODS Participants included 2269 diabetes patients aged >19 years by using data from the National Health and Nutrition Examination Surveys. A complex sample design multiple logistic regression analysis was performed. RESULTS The study found that 8.7% of diabetes patients experienced unmet medical needs, and it was found to be higher for those who thought their self-assessed health status was unhealthy and often felt stressed in their daily life. Gender and education level had a moderating effect on income level on unmet medical needs experience. CONCLUSION These findings have important implications for nursing practice in the management of diabetes. Nurses can develop targeted interventions that address the specific needs of patients who are at risk for unmet medical needs, particularly those from low-income backgrounds. By considering the factors that contribute to unmet medical needs and the moderating effect of income level, nurses can improve patient outcomes and reduce the burden of diabetes.
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Affiliation(s)
- Ji Young Kim
- Department of NursingWonkwang Health Science UniversityIksanSouth Korea
| | - Youngran Yang
- College of Nursing, Research Institute of Nursing ScienceJeonbuk National UniversityJeonjuSouth Korea
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Carlos Chavez FL, Moore BA, Bohanek JG. Latino Migrant Farmworker Youths' Perceptions of Access to Care in the Southeast: A Qualitative Approach. J Agromedicine 2023; 28:821-839. [PMID: 37198942 DOI: 10.1080/1059924x.2023.2215753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
This study explored Latino Migrant Farmworker (LMFW) youths' perceptions regarding access to health care in the United States (U.S.). Twenty semi-structured audio-voice recorded interviews were conducted with LMFW youths (aged 15-20 years old) in Georgia and Florida. Thematic analysis was used to explore whether, and how, LMFW youths would seek health care in the U.S. as well as their personal views toward health care. Five distinct perceptions regarding accessing health care were delineated: (1) cultural-related views and attitudes toward health care, (2) transportation dependency, (3) English language as a barrier for communication, (4) lack of knowledge of available resources, and (5) embracing the obligation, and the necessity, of work. Some of LMFW youths' perceptions of seeking access to health care in the U.S. point to barriers related to social determinants of health. These barriers suggest the need for significant reform within the U.S. health care system to include farmworker youths' health needs and to promote cultural responsiveness among clinicians and rural health providers to better serve this vulnerable population.
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Affiliation(s)
- Fiorella L Carlos Chavez
- Edson College of Nursing and Health Innovation, The Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ, USA
| | - Bethany A Moore
- Harry S Truman School of Public Affairs, College of Arts and Sciences, University of Missouri, Columbia, MO, USA
| | - Jennifer G Bohanek
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
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Schut RA, Boen C. State Immigration Policy Contexts and Racialized Legal Status Disparities in Health Care Utilization Among U.S. Agricultural Workers. Demography 2022; 59:2079-2107. [PMID: 36383020 PMCID: PMC10296624 DOI: 10.1215/00703370-10342687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Research links restrictive immigration policies to immigrant health and health care outcomes. Yet most studies in this area focus on the impact of single policies in particular years, with few assessing how broader state-level immigration policy contexts affect groups by nativity, race/ethnicity, and legal status. Linking data from the National Agricultural Workers Survey (2005-2012) with information on state immigration policies, we use an intersectional approach to examine the links between policy contexts and health care utilization by nativity, race/ethnicity, and legal status. We also assess the associations between two specific types of state immigration policies-those governing immigrant access to Medicaid and driver's licenses-and health care utilization disparities. We find that state-level immigration policy contexts are associated with health care utilization among U.S.-born and naturalized U.S. citizen non-White Latinx agricultural workers, who report lower levels of health care utilization and greater barriers to care-seeking in more restrictive policy contexts. By contrast, we find little evidence that state policies shaped health care utilization among undocumented workers. These findings advance understanding of the impact of "policies of exclusion" on the lives of marginalized groups and underscore the importance of racialized legal status in considering the links between sociopolitical contexts and health and health care disparities.
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Affiliation(s)
- Rebecca Anna Schut
- The Center for Health and the Social Sciences, the University of Chicago, Chicago, IL, USA
| | - Courtney Boen
- Department of Sociology, Population Studies Center, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
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Donley N, Bullard RD, Economos J, Figueroa I, Lee J, Liebman AK, Martinez DN, Shafiei F. Pesticides and environmental injustice in the USA: root causes, current regulatory reinforcement and a path forward. BMC Public Health 2022; 22:708. [PMID: 35436924 PMCID: PMC9017009 DOI: 10.1186/s12889-022-13057-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/22/2022] [Indexed: 12/20/2022] Open
Abstract
Many environmental pollutants are known to have disproportionate effects on Black, Indigenous and People of Color (BIPOC) as well as communities of low-income and wealth. The reasons for these disproportionate effects are complex and involve hundreds of years of systematic oppression kept in place through structural racism and classism in the USA. Here we analyze the available literature and existing datasets to determine the extent to which disparities in exposure and harm exist for one of the most widespread pollutants in the world – pesticides. Our objective was to identify and discuss not only the historical injustices that have led to these disparities, but also the current laws, policies and regulatory practices that perpetuate them to this day with the ultimate goal of proposing achievable solutions. Disparities in exposures and harms from pesticides are widespread, impacting BIPOC and low-income communities in both rural and urban settings and occurring throughout the entire lifecycle of the pesticide from production to end-use. These disparities are being perpetuated by current laws and regulations through 1) a pesticide safety double standard, 2) inadequate worker protections, and 3) export of dangerous pesticides to developing countries. Racial, ethnic and income disparities are also maintained through policies and regulatory practices that 4) fail to implement environmental justice Executive Orders, 5) fail to account for unintended pesticide use or provide adequate training and support, 6) fail to effectively monitor and follow-up with vulnerable communities post-approval, and 7) fail to implement essential protections for children. Here we’ve identified federal laws, regulations, policies, and practices that allow for disparities in pesticide exposure and harm to remain entrenched in everyday life for environmental justice communities. This is not simply a pesticides issue, but a broader public health and civil rights issue. The true fix is to shift the USA to a more just system based on the Precautionary Principle to prevent harmful pollution exposure to everyone, regardless of skin tone or income. However, there are actions that can be taken within our existing framework in the short term to make our unjust regulatory system work better for everyone.
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Stone GA, Fernandez M, DeSantiago A. Rural Latino health and the built environment: a systematic review. ETHNICITY & HEALTH 2022; 27:1-26. [PMID: 30999761 DOI: 10.1080/13557858.2019.1606899] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 04/08/2019] [Indexed: 05/21/2023]
Abstract
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.
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Affiliation(s)
- Garrett A Stone
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, USA
| | - Mariela Fernandez
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, USA
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Weng SF, Malik A, Wongsin U, Lohmeyer FM, Lin LF, Atique S, Jian WS, Gusman Y, Iqbal U. Health Service Access among Indonesian Migrant Domestic Workers in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073759. [PMID: 33916514 PMCID: PMC8038466 DOI: 10.3390/ijerph18073759] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 11/16/2022]
Abstract
The number of migrant workers in Taiwan increases annually. The majority is from Indonesia and most of them are female caregivers. This study aims to determine the access to health services and the associated factors among Indonesian female domestic workers in Taiwan. In this cross-sectional study, data were collected from February to May 2019, using a structured questionnaire. Subsequently, multiple logistic regression was used to examine the association between socio-demographic factors and health service access. Two hundred and eighty-four domestic migrant workers were interviewed. Eighty-five percent of the respondents declared sickness at work, but only 48.8% seek health care services. Factors associated with health service access were marital status, income, and the availability of an attendant to accompany the migrant workers to the healthcare facilities. Language barrier and time flexibility were the main obstacles. Further research and an effective health service policy are needed for the domestic migrant workers to better access health care services.
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Affiliation(s)
- Shuen-Fu Weng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei City 110, Taiwan;
- Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 110, Taiwan
| | - Azis Malik
- Master Program in Global Health & Development Department, College of Public Health, Taipei Medical University, Taipei City 110, Taiwan;
| | - Utoomporn Wongsin
- PhD Program in Global Health & Health Security Department, College of Public Health, Taipei Medical University, Taipei City 110, Taiwan;
| | | | - Li-Fong Lin
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei City 110, Taiwan; (L.-F.L.); (W.-S.J.)
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei City 110, Taiwan
- Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei City 110, Taiwan
| | - Suleman Atique
- Department of Health Informatics, College of Public Health and Health Informatics, University of Ha’il, Ha’il City 55211, Saudi Arabia;
| | - Wen-Shan Jian
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei City 110, Taiwan; (L.-F.L.); (W.-S.J.)
- Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei City 110, Taiwan
- School of Health Care Administration, Taipei Medical University, Taipei City 110, Taiwan
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei City 110, Taiwan
| | - Yuherina Gusman
- International Doctoral Program for Asia Pacific Studies, National Chengchi University, Taipei City 11605, Taiwan;
| | - Usman Iqbal
- Master Program in Global Health & Development Department, College of Public Health, Taipei Medical University, Taipei City 110, Taiwan;
- PhD Program in Global Health & Health Security Department, College of Public Health, Taipei Medical University, Taipei City 110, Taiwan;
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei City 110, Taiwan
- Correspondence: ; Tel.: +886-2-6638-2736 (ext. 1321)
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Respiratory Health and Suspected Asthma among Hired Latinx Child Farmworkers in Rural North Carolina. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217939. [PMID: 33138070 PMCID: PMC7662586 DOI: 10.3390/ijerph17217939] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/14/2020] [Accepted: 10/27/2020] [Indexed: 01/24/2023]
Abstract
The aim of this study was to evaluate respiratory health problems, including suspected asthma, and healthcare provider utilization among a sample of Latinx hired child farmworkers in rural North Carolina (n = 140). In 2018, a respiratory health questionnaire and breathing tests were collected from Latinx child (11–19 years) farmworkers (35.0% girls and 65.0% boys). Overall, 21.4% of children reported having been told by a medical provider that they had asthma, yet based on a combination of responses to respiratory survey questions, 36.4% or 15% more were identified as having suspected asthma. While 56.4% reported having a regular medical doctor, 38% had not had a medical exam in the past year. Respiratory dysfunction, including suspected, or uncontrolled asthma was prevalent among this group. Latinx children working in agriculture are vulnerable to occupational hazards and exposures and require assurances that they will receive access to high quality healthcare services that include routine respiratory health screenings.
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Yoon YS, Jung B, Kim D, Ha IH. Factors Underlying Unmet Medical Needs: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2391. [PMID: 31284469 PMCID: PMC6651044 DOI: 10.3390/ijerph16132391] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/01/2019] [Accepted: 07/01/2019] [Indexed: 11/30/2022]
Abstract
Unmet medical needs refer to the state where a patient's medical care or service is insufficient, inadequate, or lacking. Numerous factors influence unmet medical needs. We used a multi-pronged approach to explore the factors influencing unmet medical needs in the Korean health care system according to Anderson's Behavioral Model of Health Services Use. To this end, we used data from 11,378 adults over 19 years old in the 2016 Korea Health Panel Survey and performed multiple logistic regression analyses. The odds of experiencing unmet medical needs were significantly greater among older participants (odds ratio (OR) = 2.51, 95% confidence interval (CI) = 1.78-3.56); low-income participants (OR = 1.41, 95% CI = 1.14-1.75); non-workers (OR = 1.24, 95% CI = 1.06-1.46); those who had received non-covered treatment (OR = 1.24, 95% CI = 1.08-1.42); those who did not regularly exercise (OR = 1.23, 95% CI = 1.02-1.48); and those experiencing pain (OR = 2.29, 95% CI = 1.97-2.66), worse self-rated health status (OR = 2.29, 95% CI = 1.89-2.79), and severe depression (OR = 2.46, 95% CI = 1.39-4.35). About one in ten Korean citizens (11.60%) have unmet medical service needs. Policies that strengthen coverage for physically and economically vulnerable groups are needed.
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Affiliation(s)
- Young Suk Yoon
- Department of Korean Medicine Rehabilitation, Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul 06110, Korea
| | - Boyoung Jung
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul 06110, Korea.
| | - Dongsu Kim
- KM Policy Research Center, Korea Institute of Oriental Medicine, 1672, Yuseong-daero, Yuseong-gu, Daejeon 34054, Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul 06110, Korea.
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Mendez IM, Pories ML, Cordova L, Malki A, Wiggins MF, Lee JGL. A pilot project to increase health literacy among youth from seasonal farmworker families in rural eastern North Carolina: a qualitative exploration of implementation and impact. J Med Libr Assoc 2019; 107:179-186. [PMID: 31019386 PMCID: PMC6466499 DOI: 10.5195/jmla.2019.560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/01/2018] [Indexed: 11/20/2022] Open
Abstract
Objective There are substantial health inequalities for seasonal agricultural workers and their families in the United States. One identified inequality is in health literacy. The authors explored the implementation and impact of connecting youth from seasonal farmworker families who participated in a leadership and college pipeline program with Internet access by providing a tablet with a paid cellular data plan and university library–based health literacy training. Methods With the support of a National Network of Libraries of Medicine Health Information Outreach Award, we conducted a qualitative, utilization-focused evaluation by conducting semi-structured interviews from December 2017 through February 2018 with middle and high school age participants in the program (n=10). After parental consent and youth assent, we recorded interviews with participants at program activity locations or in their homes. We then utilized inductive thematic analysis with 2 primary coders. Results We identified four themes: (1) having access to the Internet can be transformative, (2) access resulted in increased knowledge of and interest in one’s own and others’ health, (3) “Google” is the norm, and (4) participant training increased self-efficacy to determine credible sources and resources. Conclusion Providing Internet access and iPads was possible to implement and resulted in increased utilization of health information. The combination of Internet access with training on information literacy was a key factor in achieving these positive outcomes. The findings suggest the importance of ensuring equitable access to the Internet in efforts to improve educational and health outcomes for seasonal farmworkers and their families.
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Affiliation(s)
- Israel M Mendez
- Research Assistant, Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC,
| | - Mary Lisa Pories
- College of Health and Human Performance, East Carolina University, Greenville, NC,
| | - Leah Cordova
- STEM Librarian, Research and Instructional Services, Joyner Library, East Carolina University, Greenville, NC,
| | - Andreina Malki
- Youth Director, Student Action with Farmworkers, Durham, NC,
| | | | - Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, and Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC,
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Graefe DR, De Jong GF, Howe Hasanali S, Galvan C. Immigrants, Place, and Health: Destination Area Health Contexts and Routine Physician and Dental Care for Children of Mexican Immigrants. INTERNATIONAL MIGRATION REVIEW 2018. [DOI: 10.1177/0197918318789128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Notable healthcare disparities are shown among the children of Mexican immigrants across different Hispanic immigrant destinations. A hostile local immigrant-receptivity climate and alternative institutional community context indicators are integrated with individual-level data on physician and dental care from the 1996 and 2001 Survey of Income and Program Participation to explain this variation. Mexican immigrants’ children in new Hispanic immigrant destinations are 20 percent less likely to see a doctor, and a negative receptivity climate explains about half of this effect. Community health clinic availability and greater state leniency toward immigrant child public health insurance eligibility facilitate healthcare access.
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Abstract
The purpose of this study was to explore the health beliefs of migrant farmworkers parents by approaching and interviewing the sample population in a health clinic where they seek care for their children. It is impossible to plan, implement care, or create health care delivery models without knowledge of health beliefs. An understanding of parental health beliefs in the vulnerable population of migrant farmworkers will assure a more informed approach to health matters of their children, while also improving health care delivery and providing culturally specific health care models. Collecting data in locations historically proven to generate trust and respect supported the objectives of this research study and promoted direct engagement with a group that is often misunderstood and marginalized. Twenty migrant farmworkers parents were interviewed during growing season in the largely agricultural setting of Weld County, Colorado. Associated variables/phenomena determining health beliefs include parental decision-making regarding children's health maintenance, injury prevention, and health care. The overarching theme that emerged from the data was pride in having healthy children with major themes of respect, convenience and inhibition/suppression.
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Ip EH, Marshall SA, Arcury TA, Suerken CK, Trejo G, Skelton JA, Quandt SA. Child Feeding Style and Dietary Outcomes in a Cohort of Latino Farmworker Families. J Acad Nutr Diet 2017; 118:1208-1219. [PMID: 28966049 DOI: 10.1016/j.jand.2017.07.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 07/27/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND The high level of obesity in Latino children, especially in farmworker families, may be partly attributed to feeding styles of parents. Feeding styles used in Latino farmworker families have not been well characterized. OBJECTIVE This study sought to identify and describe feeding styles used by mothers in farmworker families with 2.5- to 3.5-year-old children, describe how styles change over time, and characterize the relationship of feeding styles to dietary outcomes and measures of overweight and obesity. DESIGN This was a longitudinal cohort study, with families participating for a 2-year period; surveys were administered to mothers with varying frequency depending on the instrument, and dietary measurements were collected at baseline and 12 and 24 months. PARTICIPANTS/SETTING Eligible participants were self-identified Latino women with a co-resident child aged 2.5 to 3.5 years old and at least one household member engaged in farm work during the previous year. The sample included 248 farmworker families enrolled between 2011 and 2012 in the Niños Sanos study, a longitudinal investigation of Latino mothers and their young children in rural North Carolina. Eleven families provided incomplete dietary data, so the analysis included 237 families. Fifteen families were lost to follow-up and 12 withdrew during the course of the study. MAIN OUTCOME MEASURES Feeding style was assessed using items from the Caregiver's Feeding Style Questionnaire, selected dietary components were assessed using the Revised Children's Diet Quality Index, and weight outcomes were determined using body mass index-for-age percentile. Performance on the Caregiver's Feeding Style Questionnaire items was used to assign mothers to one of four feeding style states. STATISTICAL ANALYSES PERFORMED Exploratory factor analysis was conducted on baseline data to verify the replicability of the factor structure of the instrument Caregiver's Feeding Style Questionnaire. Hidden Markov Model analysis was used to delineate different subtypes of feeding style. Multivariable mixed-effects regression models were used to assess the impact of feeding style on selected dietary components, energy intake, and body mass index-for-age percentile. RESULTS Four distinct states emerged from the Hidden Markov Model: low parent-centered (PC)/moderate child-centered (CC) feeding style (28% at baseline), high PC/CC without physical control (24%), high PC/CC (26%), and moderate PC/CC (22%). The low PC/moderate CC state increased in prevalence over time. Compared to high PC/CC, the low PC/moderate CC state was associated with greater intake of added sugars (P<0.01), lower intake of whole grains and vegetables (P<0.01), and lower overall diet quality (P<0.05). Children in low PC/moderate CC also had higher mean body mass index percentiles (76.2 percentile vs 66.7 percentile in high PC/CC; P<0.001). CONCLUSIONS High PC feeding along with high CC feeding is associated with improved diet quality and weight outcomes for children in the study.
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Khongthanachayopit S, Laohasiriwong W. Accessibility to health services among migrant workers in the Northeast of Thailand. F1000Res 2017; 6:972. [PMID: 29034076 PMCID: PMC5615766 DOI: 10.12688/f1000research.11651.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2017] [Indexed: 11/20/2022] Open
Abstract
Background. There is an increasing trend of trans-border migration from neighboring countries to Thailand. According to human rights laws, everyone must have access to health services, even if they are from other nationalities. However, a small minority of health personnel in Thailand discriminate against immigrant workers, as they are from a lower financial bracket. Methods. This cross-sectional study aims to determine the prevalence of accessibility to health services and factors associated with access to health services among migrant workers who work along the Northeast border of Thailand. A total of 621 legal migrant workers were randomly selected to respond to a structured questionnaire about the satisfaction of health services, using the 5As of health services: availability; accessibility; accommodation; affordability; acceptability. Associations between independent variables and access to health services were analysed using multiple logistic regression analysis. Results. The results indicated that the majority of these registered migrant workers were female (63.9%) with an average age of 29± 8.61 years old, and were married (54.3%). Most of the workers worked at restaurants (80%), whereas only 20% were in agricultural sectors. Only 14% (95% CI: 11-17%) of migrant workers had access to health services. The factors that were significantly associated with accessibility to health service experienced ill health during the past one year (OR = 2.48; 95%CI; 1.54-3.97; p-value<0.001) ; have been married (OR = 2.32; 95% CI: 1.40 - 3.90; p-value <0.001). Conclusions. Most of the migrant workers could not access health services. The ones who did access health services were married or ill.
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Affiliation(s)
| | - Wongsa Laohasiriwong
- Research and Training Center for Enhancing Quality of Life of Working-Age People, Faculty of Public Health, Khon Kaen University, Khon Kaen, 40002, Thailand
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Arcury TA, Skelton JA, Ip EH, Suerken CK, Trejo G, Quandt SA. Anticipatory Guidance about Child Diet and Physical Activity for Latino Farmworker Mothers. J Health Care Poor Underserved 2016; 27:1064-79. [PMID: 27524752 DOI: 10.1353/hpu.2016.0136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND This analysis describes farmworker child health care utilization, anticipatory guidance for child weight, and the association of anticipatory guidance with personal characteristics, practice characteristics, and child's health care utilization. METHODS Data are from interviews conducted with 221 North Carolina Latino farmworker mothers with a child aged 4-5 years. RESULTS Half of the children were healthy weight, 19.0% were overweight, and 28.5% were obese. Most (56.4%) had been with the usual practice for two years or longer; most had well-child visits less frequently than once per year (71.5%). Fewer children with well-child visits than without were obese (14.8% vs. 35.5%; p=.01). More children with obesity than with healthy weight or overweight received guidance messages; more children without a well-child care visit in the past 12 months received guidance messages. CONCLUSIONS Health care providers are addressing anticipatory guidance when the opportunity arises. Creative approaches to address disparate primary care for farmworker families are important.
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Physical Activity States of Preschool-Aged Latino Children in Farmworker Families: Predictive Factors and Relationship With BMI Percentile. J Phys Act Health 2016; 13:726-32. [PMID: 26800568 DOI: 10.1123/jpah.2015-0534] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Obesity disproportionately affects children of Latino farmworkers. Further research is needed to identify patterns of physical activity (PA) in this group and understand how PA affects Body Mass Index (BMI) percentile. METHODS Two hundred and forty-four participants ages 2.5 to 3.5 in the Niños Sanos longitudinal study wore accelerometers that measured daily PA. Several PA-related parameters formed a profile for conducting hidden Markov modeling (HMM), which identified different states of PA. RESULTS Latino farmworker children were generally sedentary. Two different states were selected using HMM-less active and more active. In the more active state; members spent more minutes in moderate-vigorous physical activity (MVPA). Most children were in the less active state at any given time; however, switching between states occurred commonly. One variable-mother's concern regarding lack of PA-was a marginally significant predictor of membership in the more active state. State did not predict BMI or weight percentile after adjusting for caloric intake. CONCLUSION Most children demonstrated high amounts of sedentary behavior, and rates of MVPA fell far below recommended levels for both states. The lack of statistically significant results for risk factors and PA state on weight-related outcomes is likely due to the homogeneous behaviors of the children.
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Lee K, Pond D. The Impact of Head Start Enrollment Duration on Migrant Children's Health Outcomes. SOCIAL WORK IN HEALTH CARE 2015; 54:869-891. [PMID: 26671242 DOI: 10.1080/00981389.2015.1061087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of this study is to examine whether family characteristics and the length of children's enrollment in Migrant Head Start affects children's health treatment. Children in the Michigan Migrant Head Start were classified depending on years of enrollments: One year (n = 638), two years (n = 293), and three or more years (n = 426). Logistic regression analyses were conducted to examine whether the probability of children receiving health treatment differed depending on years of enrollment. There is a higher health treatment rate among children who attended Head Start for multiple years than for those who attended for one year. Children's special needs status, of siblings, ethnicity, parental educational level, and marital status were related to preventative dental and physical health treatment outcomes. Although the primary goal of Head Start is school readiness rather than health improvement, migrant and seasonal farmworker children are likely to receive more health treatment if they attend more years of comprehensive intervention, such as Head Start, for positive physical and dental health.
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Affiliation(s)
- Kyunghee Lee
- a School of Social Work , Michigan State University , East Lansing , Michigan , USA
| | - Debora Pond
- a School of Social Work , Michigan State University , East Lansing , Michigan , USA
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18
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Abstract
Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes.
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Nichols M, Stein AD, Wold JL. Health status of children of migrant farm workers: Farm Worker Family Health Program, Moultrie, Georgia. Am J Public Health 2013; 104:365-70. [PMID: 24328649 DOI: 10.2105/ajph.2013.301511] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated the health status of migrant farmworkers' children served by the Farm Worker Family Health Program (FWFHP) in Moultrie, Georgia. METHODS We analyzed data from children aged 0 to 16 years examined through the FWFHP from 2003 to 2011 (n across years = 179-415). We compared their prevalence of overweight, obesity, elevated blood pressure, anemia, and stunting with that of children in the United States and Mexico. RESULTS Across study years, prevalence of overweight, obesity, elevated blood pressure, anemia, and stunting ranged from 13.5% to 21.8%, 24.0% to 37.4%, 4.1% to 20.2%, 10.1% to 23.9%, and 1% to 6.4%, respectively. Children in the FWFHP had a higher prevalence of obesity than children in all comparison groups, and FWFHP children aged 6 to 12 years had a higher prevalence of elevated blood pressure than all comparison groups. Older FWFHP children had a higher prevalence of anemia than US children and Mexican children. Children in FWFHP had a higher prevalence of stunting than US and Mexican American children. CONCLUSIONS We observed an elevated prevalence of obesity, anemia among older age groups, and stunting in this sample of children of migrant workers.
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Affiliation(s)
- Memorie Nichols
- Memorie Nichols is with the Division of Biological and Biomedical Sciences, Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA. Aryeh D. Stein is with the Department of Global Health, Rollins School of Public Health, Emory University. Judith Lupo Wold is with the Lillian Carter Center for Global Health and Social Responsibility, Nell Hodgson Woodruff School of Nursing, Emory University
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20
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Syed ST, Gerber BS, Sharp LK. Traveling towards disease: transportation barriers to health care access. J Community Health 2013. [PMID: 23543372 DOI: 10.1007/s10900‐013‐9681‐1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes.
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Affiliation(s)
- Samina T Syed
- Section of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, 1819 W. Polk Street, M/C 640, Chicago, IL 60612, USA.
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21
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McLaurin JA, Liebman AK. Unique Agricultural Safety and Health Issues of Migrant and Immigrant Children. J Agromedicine 2012; 17:186-96. [DOI: 10.1080/1059924x.2012.658010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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22
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Bauer S, Kantayya VS. Improving access to primary care and health outcomes in migrant farm worker populations: challenges and opportunities. Dis Mon 2011; 56:706-18. [PMID: 21168577 DOI: 10.1016/j.disamonth.2010.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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23
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Pérez-Escamilla R, Garcia J, Song D. HEALTH CARE ACCESS AMONG HISPANIC IMMIGRANTS: ¿ALGUIEN ESTÁ ESCUCHANDO? [IS ANYBODY LISTENING?]. ACTA ACUST UNITED AC 2010; 34:47-67. [PMID: 21116464 DOI: 10.1111/j.1556-4797.2010.01051.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This systematic review identified 77 studies to examine patterns and determinants of health care access among Hispanic immigrants (HI) living in the U.S. In spite of major mental and physical care needs, HI and their families are at very high risk of not having access to health care compared with non-immigrant Hispanics and non-Hispanic whites. Noncitizenship status is a major barrier for accessing health care due to program ineligibility and fear of stigma and deportation. Low English proficiency is also an important barrier to health care. Culturally appropriate community outreach programs relying heavily on community health workers, also known as promotoras, have improved health care access and quality. Mexico shares the health care cost for HIs living in bordering states, calling for a binational dialogue. Mixed-methods research is needed to better understand: a) the net influence of acculturation on migrant health; b) the role of informal (e.g., family) vs. formal (e.g. promotoras) social support at facilitating health care access; c) issues related to 'single' male migrant farm workers; d) the "Hispanic mortality paradox"; e) traditional healing and medicine among HI. Comprehensive health and immigration reforms are needed to respect the human right that HIs have to gain access to health care.
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Connor A, Layne L, Thomisee K. Providing Care for Migrant Farm Worker Families in Their Unique Sociocultural Context and Environment. J Transcult Nurs 2010; 21:159-66. [DOI: 10.1177/1043659609357631] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This article highlights the Farm Worker Family Health Program’s (FWFHP) strategies for providing care to migrant farm workers residing within a unique social and cultural context. The care provided by health professions students from a variety of disciplines extends and augments the work of the local migrant farm worker clinic that is pushed beyond capacity during peak growing and harvest times. Nursing’s social responsibility to care for underserved populations is a guiding principle of the FWFHP and shapes how the work is translated into action. The FWFHP is a community—academic partnership that began in the rural southeastern United States in 1993. Challenges facing migrant farm worker families include access to health care, language, health literacy, housing and sanitation, family and community integrity, and workplace safety. The nursing practice strategies used to address these health challenges may be adapted to strengthen health programs serving other populations who live in poverty or reside in low-resource settings.
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Affiliation(s)
| | - Laura Layne
- Fulton County Health Department, Atlanta, GA, USA
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25
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Steege AL, Baron S, Davis S, Torres-Kilgore J, Sweeney MH. Pandemic influenza and farmworkers: the effects of employment, social, and economic factors. Am J Public Health 2009; 99 Suppl 2:S308-15. [PMID: 19797742 PMCID: PMC4504372 DOI: 10.2105/ajph.2009.161091] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2009] [Indexed: 11/04/2022]
Abstract
Employment, social, and economic factors have the potential to affect the magnitude of an influenza pandemic among farmworkers. Prevention efforts targeted toward livestock farmworkers, including increased access to seasonal influenza vaccine, risk reduction training, various forms of personal protection, and workplace sanitation, are needed. Crop and livestock farmworkers are at increased risk of exposure to influenza A viruses because of limited resources, substandard housing, immigration status, communication and cultural barriers, and discrimination. Recommendations were gathered from migrant clinicians, farmworker advocates, state and federal government agencies, industry stakeholders, and researchers to overcome these barriers, including surveillance of livestock farmworkers, inclusion of farmworker service organizations in planning efforts, and separation of immigration enforcement from emergency assistance.
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Affiliation(s)
- Andrea L Steege
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH 45226, USA.
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26
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Yoo JP, Slack KS, Holl JL. Material hardship and the physical health of school-aged children in low-income households. Am J Public Health 2009; 99:829-36. [PMID: 18703452 PMCID: PMC2667853 DOI: 10.2105/ajph.2007.119776] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2008] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the relationship between material hardship reported by low-income caregivers and caregivers' assessments of their children's overall health. METHODS We used logistic regression techniques to analyze data from 1073 children aged 5 through 11 years whose caregivers participated in multiple waves of the Illinois Families Study. RESULTS Caregivers' reports of food hardship were strongly associated with their assessments of their children's health. Other sources of self-reported material hardship were also associated with caregivers' assessments of their children's health, but the effects disappeared when we controlled for caregiver physical health status and mental health status. Proximal measures of material hardship better explained low-income children's health than traditional socioeconomic measures. There were no statistically significant cumulative effects of material hardships above and beyond individual hardship effects. CONCLUSIONS Our findings highlight the importance of developing and supporting programs and policies that ensure access to better-quality food, higher quantities of food, and better living conditions for low-income children, as well as health promotion and prevention efforts targeted toward their primary caregivers as ways to reduce health disparities for this population.
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Affiliation(s)
- Joan P Yoo
- School of Social Work, University of North Carolina, 325 Pittsboro St, CB#3550, Chapel Hill, NC 27599-3550, USA.
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27
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Enhancing the Measurement of Health Disparities for Vulnerable Populations. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2008; 14 Suppl:S45-52. [DOI: 10.1097/01.phh.0000338386.59565.dc] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Weathers AC, Minkovitz CS, Diener-West M, O'Campo P. The effect of parental immigration authorization on health insurance coverage for migrant Latino children. J Immigr Minor Health 2008; 10:247-54. [PMID: 18188701 DOI: 10.1007/s10903-007-9072-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine if immigration authorization among parents is associated with health insurance coverage for migrant Latino children. DATA SOURCE A cross-sectional household survey of 300 migrant families for which one child, aged <13 years, was randomly selected. RESULTS Most children lacked insurance (73%) and had unauthorized parents (77%). Having an authorized parent or parental stay of more than 5 years in the US were each positively associated with children's health insurance coverage [OR: 4.9; 95% CI: (2.7-8.7) and [OR = 6.7; 95% CI: (3.8-12.0), respectively]. The effect of parental authorization did not persist in multivariable logistic regression analysis; however, more than 5 years of parental stay in the US remained associated with children's insurance coverage [OR = 4.8; 95% CI (1.8-12.2)], regardless of parental authorization. CONCLUSION Increased parental familiarity with US health and/or social services agencies, rather than parental authorization status, is important to obtaining health insurance for migrant children. Efforts to insure eligible migrant children should focus on recently arrived families.
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Affiliation(s)
- Andrea C Weathers
- Department of Maternal and Child Health, The University of North Carolina, Chapel Hill, NC 27599-7445, USA.
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Borjan M, Constantino P, Robson MG. New Jersey migrant and seasonal farm workers: enumeration and access to healthcare study. New Solut 2008; 18:77-86. [PMID: 18375372 DOI: 10.2190/ns.18.1.e] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Despite the demanding physical labor Migrant and Seasonal Farm Workers (MSFW) provide to meet consumer demands and keep the nation's agricultural industry gainful, MSFWs are the most economically disadvantaged population in the nation. MSFWs lack sufficient access to health care and suffer more illnesses than the general population. Besides the difficulties in providing adequate health care to this population, enumeration of MSFWs has been an even greater challenge due to their mobility and illegal status. Through the analysis of secondary data sources, this study looks to approximate the number of MSFWs in the state of New Jersey and to investigate MSFW access to health care. Farm workers are a vital part of not only New Jersey's agricultural economy but also the entire nation's economy. Understanding the health needs of this population, and knowing the number of individuals that comprise this population, would not only help eliminate many health problems but it also would better prepare health officials in meeting the needs of the MSFW population.
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Affiliation(s)
- Marija Borjan
- Rutgers University, 88 Lipman Dr. Suite 104 New Brunswick, NJ 08901, USA
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Gentry K, Quandt SA, Davis SW, Grzywacz JG, Hiott AE, Arcury TA. Child healthcare in two farmworker populations. J Community Health 2007; 32:419-31. [PMID: 17940873 DOI: 10.1007/s10900-007-9062-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Children in farmworker families are medically underserved. Little research has documented the healthcare of these children. This analysis uses data collected from two populations of Latino farmworker families, one located in western North Carolina and western Virginia, and the other located in eastern North Carolina, to describe and compare child healthcare utilization and mothers' satisfaction with their children's healthcare. Child, mother, household and health services characteristics are examined as causes of variation in child healthcare utilization and mothers' satisfaction for each farmworker population. Results highlight strengths in the provision of healthcare to farmworker children, including most receiving care at a consistent healthcare facility, age appropriate time since last visit, and satisfaction with the care received. Shortcomings in farmworker child healthcare include few having a consistent healthcare provider, and many not receiving visits with recommended frequency. Differences observed in child health services between the two populations include dissatisfaction with care received, perceptions that healthcare staff members are disrespectful, and difficulties with transportation. Further research is needed to determine the best means of providing care to this underserved population.
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Affiliation(s)
- Kimberly Gentry
- Northwestern Carolina Oncology and Hematology, Mulberry Medical Park, 401 Mulberry Street SW, Suite 210, Lenoir, NC 28645, USA
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Connor A, Rainer LP, Simcox JB, Thomisee K. Increasing the Delivery of Health Care Services to Migrant Farm Worker Families Through a Community Partnership Model. Public Health Nurs 2007; 24:355-60. [PMID: 17553025 DOI: 10.1111/j.1525-1446.2007.00644.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Farm Worker Family Health Program (FWFHP) is a 13-year community partnership model designed to increase delivery of health care services for migrant farm worker families. During a yearly 2-week immersion experience, 90 students and faculty members provide health care services, including physical examinations, health screenings, health education, physical therapy, and dental care for 1,000 migrant farm workers and migrant children. Students and faculty members gain a deeper appreciation of the health and social issues that migrant farm worker families face by providing health care services in the places where migrant families live, work, and are educated. Although the model is not unique, it is significant because of its sustained history, interdisciplinary collaboration among community and academic partners, mutual trust and connections among the partners, and the way the program is tailored to meet the needs of the population served. The principles of social responsibility and leadership frame the FWFHP experience. This community partnership model can be replicated by others working with at-risk populations in low-resource settings.
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Affiliation(s)
- Ann Connor
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia 30322-4027, USA.
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Abstract
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.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
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Kilanowski JF, Ryan-Wenger NA. Health status in an invisible population: carnival and migrant worker children. West J Nurs Res 2007; 29:100-20. [PMID: 17228063 DOI: 10.1177/0193945906295484] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
One goal of Healthy People 2010 (2003) is to close the gap of disparities in access to care and health. The purpose of this descriptive exploratory study was to evaluate health status indicators in the children of itinerant carnival and migrant farmworkers aged birth to 12 years. Health status outcomes (immunization records, well-child examinations, dental health status, and growth parameters) were compared between the two groups and to national averages to identify health disparities. All forms were available in Spanish and English. A total of 97 children were recruited for this study: 45 carnival children and 52 migrant farmworker children.
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Howell EM, Hughes D. A tale of two counties: expanding health insurance coverage for children in California. Milbank Q 2006; 84:521-54. [PMID: 16953809 PMCID: PMC2690249 DOI: 10.1111/j.1468-0009.2006.00457.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
During difficult economic times, many California counties have expanded health insurance coverage for low-income children. These Children's Health Initiatives (CHIs) enroll children in public programs and provide new health insurance, Healthy Kids, for those ineligible for existing programs. This article describes the policy issues in implementing the Santa Clara and San Mateo County CHIs, as well as the children's enrollment levels and utilization of services. These CHIs are among the first of the thirty California counties planning or implementing such initiatives. Their success depends on leadership from county agencies that have not traditionally worked closely together, as well as the development of a diverse public and private funding base. This effort to provide universal coverage for all children is important to national policymakers desiring similar goals.
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Seid M, Stevens GD. Access to care and children's primary care experiences: results from a prospective cohort study. Health Serv Res 2005; 40:1758-80. [PMID: 16336547 PMCID: PMC1361228 DOI: 10.1111/j.1475-6773.2005.00435.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To examine whether and how different kinds of access to care (financial, potential, and realized) predict parent-report child primary care experiences in an urban community sample. DATA SOURCES/STUDY SETTING A prospective cohort study was performed. Baseline survey data were collected (67 percent response rate) from 3,406 parents of kindergarten through sixth grade students in a large urban school district in California during the 1999-2000 school year. A 1-year survey (80.4 percent response rate) resulted in a final sample of 2,738. STUDY DESIGN Data were analyzed using multiple regression models with robust estimation. The dependent variable was Time 2 parent reports of primary care experiences, assessed via the Parents' Perceptions of Primary Care (P3C) measure. The independent variables were financial access (insurance status), potential access (presence of a regular source of care), and realized access (foregone care), controlling for child and family characteristics (race/ethnicity, parent's language, mother's education level, and child chronic health condition status) and baseline P3C scores. DATA COLLECTION Data were collected by mail, telephone, and in person in English, Spanish, Vietnamese, and Tagalog. PRINCIPAL FINDINGS Controlling for baseline P3C scores and child and family characteristics, having no health insurance at both baseline and Time 2 was associated with a 6.2-point lower Time 2 P3C score, relative to having had health insurance at both time points. Having a regular provider at Time 2 (either always having had one or gaining one during the year) was associated with, on average, a 10-point higher Time 2 P3C score, compared to children without a regular provider (either never having had one or losing one during the year). Episodes of foregone care during the year were associated with 10.7 points lower Time 2 P3C scores, relative to children whose parents did not report foregone care. Similar relationships were found between all three measures of access to care and each of the sub-domain measures of primary care experience. CONCLUSIONS Financial, potential, and realized access to care are associated prospectively with the full range of primary care experiences--comprehensiveness, communication, coordination, and contextual knowledge--beyond continuity and accessibility. Access to a regular source of care and to needed care are each associated with larger effects on primary care experiences than is the presence of health insurance. Gaining insurance or a regular source of care results in primary care experiences similar to always having had these, while losing a regular source of care has a more immediate effect than losing insurance on primary care experiences.
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Markowitz DL, Cosminsky S. Overweight and stunting in migrant Hispanic children in the USA. ECONOMICS AND HUMAN BIOLOGY 2005; 3:215-40. [PMID: 15963772 DOI: 10.1016/j.ehb.2005.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2005] [Accepted: 05/09/2005] [Indexed: 05/03/2023]
Abstract
In order to evaluate the need for preventive interventions to improve nutrition, the BMI/sex/age percentile, height/sex/age percentile, prevalence of stunting, at-risk-for-overweight and overweight in a group of migrant Hispanic children, aged 2-18, in southern New Jersey, USA, was assessed using anthropometric measurements of height, weight and skinfold thickness with reference to the NHANES 1999-2000. Results showed that the frequency of overweight in this sample--20%--exceeds that of the general U.S. pediatric population and equals or exceeds (in 2-5-year olds) that of settled Mexican-Americans. Being born in the U.S. significantly diminished the prevalence of stunting, especially in boys. The children of migrant Hispanic agricultural workers belong to a marginalized, poor and insecure population who are not included in the National Health and Nutrition Examination studies, because of their transience. This is the first anthropometric study to evaluate growth in this population in over 20 years.
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Affiliation(s)
- Diane L Markowitz
- Department of Geography and Anthropology, Rowan University, 201 Mullica Hill Road, Glassboro, NJ 08028, USA.
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Current World Literature. Curr Opin Allergy Clin Immunol 2005. [DOI: 10.1097/01.all.0000162314.10050.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Shi L, Stevens GD. Vulnerability and unmet health care needs. The influence of multiple risk factors. J Gen Intern Med 2005; 20:148-54. [PMID: 15836548 PMCID: PMC1490048 DOI: 10.1111/j.1525-1497.2005.40136.x] [Citation(s) in RCA: 182] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2004] [Indexed: 11/30/2022]
Abstract
CONTEXT Previous studies have demonstrated a strong association between minority race, low socioeconomic status (SES), and lack of potential access to care (e.g., no insurance coverage and no regular source of care) and poor receipt of health care services. Most studies have examined the independent effects of these risk factors for poor access, but more practical models are needed to account for the clustering of multiple risks. OBJECTIVE To present a profile of risk factors for poor access based on income, insurance coverage, and having a regular source of care, and examine the association of the profiles with unmet health care needs due to cost. Relationships are examined by race/ethnicity. DESIGN Analysis of 32,374 adults from the 2000 National Health Interview Survey. MAIN OUTCOME MEASURES Reported unmet needs due to cost: missing/delaying needed medical care, and delaying obtaining prescriptions, mental health care, or dental care. RESULTS Controlling for personal demographic and community factors, individuals who were low income, uninsured, and had no regular source of care were more likely to miss or delay needed health care services due to cost. After controlling for these risk factors, whites were more likely than other racial/ethnic groups to report unmet needs. When presented as a risk profile, a clear gradient existed in the likelihood of having an unmet need according to the number of risk factors, regardless of racial/ethnic group. CONCLUSION Unmet health care needs due to cost increased with higher risk profiles for each racial and ethnic group. Without attention to these co-occurring risk factors for poor access, it is unlikely that substantial reductions in disparities will be made in assuring access to needed health care services among vulnerable populations.
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Affiliation(s)
- Leiyu Shi
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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