Housing Conditions and Health Implications for Migrant Agricultural Workers in Canada: A Scoping Review

Migrant agricultural workers face various health inequities that have led to preventable illness and death. This paper investigates how material housing conditions have shaped physical and mental health outcomes for temporary foreign workers in Canadian agriculture. We conducted a scoping review of literature on migrant agricultural worker housing in Canada published between 2000-2022, analysing insights on the physical quality of workers' housing in relation to international frameworks on housing quality. Our review revealed a range of housing-related health risks, including: (1) Sanitation, food security, and water; (2) Thermal safety, electricity, and utilities; (3) Habitability of structure, air quality, and exposure to hazards; (4) Spacing, privacy, and co-worker relations and; (5) Geographic proximity to necessary services and social opportunities. Although housing has been increasingly recognized as a social determinant of health, little research examines how migrant farmworkers' accommodations shape their health outcomes, particularly in Canada. This scoping review provides timely insights and recommendations to inform research, policy, and public health interventions.

Health, social and legal supports for migrant agricultural workers in France, Italy, Spain, Germany, Canada, Australia and New Zealand: a scoping review

Introduction

We carried out a scoping review to examine what previous literature can teach us about practices and possibilities for support services for migrant agricultural workers.

Methods

Following guidelines for scoping reviews as outlined by Arksey and O'Malley (2005) and further refined by Levac et. al (2010) we conducted searches of several databases and two additional searches to capture regions of focus and more current literature. We used a thematic analysis to generate our themes.

Results

Our analysis yielded four key themes: (1) political, economic and legal factors; (2) living and working conditions; (3) facilitators/barriers to navigating services and supports and; (4) potential and existing strategies for social support for migrant agricultural workers. The first two themes pointed more to structural and material conditions that both posed barriers for this population to access supports, but also illustrated vulnerabilities that pointed to the need for a variety of services and protections. Under the third, we highlighted the ways that the design of services and supports, or their degree of accessibility, could shape the level of help available to this population. Lastly, potential and existing strategies for social support discussed in the literature included an emphasis on mental health and wellbeing, occupational health and safety training and documentation, and policy reforms to secure the status and address the precarity of this workforce.

Discussion

While research on social support and service provision for migrant agricultural workers is still in its infancy, a strength of this body of work is its attention to macro-level issues that advocate for strategies that address root factors that shape this group's health. Further research is required to expand our understanding of social support roles and possibilities across other domains and sectors for this population.

Correction: Colindres et al. Migrant Agricultural Workers' Health, Safety and Access to Protections: A Descriptive Survey Identifying Structural Gaps and Vulnerabilities in the Interior of British Columbia, Canada. Int. J. Environ. Res. Public Health 2021, 18, 3696

In the original article [...].

Migrant Agricultural Workers' Health, Safety and Access to Protections: A Descriptive Survey Identifying Structural Gaps and Vulnerabilities in the Interior of British Columbia, Canada

In this paper, we provide descriptive data that characterize the health, safety, and social care environment of migrant agricultural workers in British Columbia, Canada. Through the administration of surveys (n = 179), we gathered information in three domains: (1) living and working conditions; (2) barriers to rights, health, safety and advocacy/reporting; (3) accessibility of services. Our study confirms what predominantly qualitative studies and Ontario-based survey data indicate in terms of health, legal, and social barriers to care and protection for this population. Our findings also highlight the prevalence of communication barriers and the limited degree of confidence in government authorities and contact with support organizations this population faces. Notably, survey respondents expressed a strong intention to report concerns/issues to authorities while simultaneously reporting that they lacked the knowledge to initiate such complaints. These findings call into question government responses that task the agricultural industry with addressing access and service gaps that may be more effectively addressed by government agencies and service providers. In order to improve supports and protections for migrant agricultural workers, policies and practices should be implemented that: (1) empower workers to independently access health, social, and legal protections and limit workers’ dependence on their employers when help-seeking; (2) provide avenues for increased proactive inspections, anonymous reporting, alternative housing/employment and meaningful 2-way communication with regulators so that the burden of reporting is lessened for this workforce; (3) systematically address breaches in privacy, translation, and adequate workplace injury assessments in the healthcare system. Ultimately, the COVID-19 context has put into sharper focus the complex gaps in health, social and legal services and protections for migrant agricultural workers. The close chronology of our data collection with this event can help us understand the factors that have resulted in so much tragedy among this workforce.

Emerging best practices for supporting temporary migrant farmworkers in Western Canada

The aim of this study was to examine the role of support people in determining migrant agricultural workers' access to, or ability to navigate, public spaces and services. While the role of support networks for this population is still in its infancy, much can be gained from understanding the emerging best practices for helping this group. Using a situational analysis research approach, we carried out 4 focus groups and 25 one-on-one interviews, recruiting a total of 30 informal and formal support people as study participants between 2018 and 2019. Data analysis occurred over a 2-year period largely simultaneously with data collection. Developing analytic maps as outlined by Clarke's approach to situational analysis, we reviewed texts and preliminary codes by organising them in terms of situations, social worlds, and discursive positions. Ultimately, we identified four best practices: (a) Anticipating and addressing barriers; (b) building trust and community; (c) acknowledging rights and system accountability and (d) bearing witness and looking to the future. Underlying these best practices was the need for support people to display 'support readiness', or specialised skills, motivation and a personal connection to migrant farmworkers. While these practices have the potential to improve migrant workers' ability to fully participate in public spaces and access public services, until systemic constraints are addressed, support people will be unable to fill the gaps in support for this population.

Connecting knowledge with action for health equity: a critical interpretive synthesis of promising practices

Connecting knowledge with action (KWA) for health equity involves interventions that can redistribute power and resources at local, national, and global levels. Although there is ample and compelling evidence on the nature, distribution, and impact of health inequities, advancing health equity is inhibited by policy arenas shaped by colonial legacies and neoliberal ideology. Effective progress toward health equity requires attention to evidence that can promote the kind of socio-political restructuring needed to address root causes of health inequities. In this critical interpretive synthesis, results of a recent scoping review were broadened to identify evidence-informed promising practices for KWA for health equity. Following screening procedures, 10 literature reviews and 22 research studies were included in the synthesis. Analysis involved repeated readings of these 32 articles to extract descriptive data, assess clarity and quality, and identify promising practices. Four distinct kinds of promising practices for connecting KWA for health equity were identified and included: ways of structuring systems, ways of working together, and ways of doing research and ways of doing knowledge translation. Our synthesis reveals that advancing health equity requires greater awareness, dialogue, and action that aligns with the what is known about the causes of health inequities. By critically reflecting on dominant discourses and assumptions, and mobilizing political will from a more informed and transparent democratic exercise, knowledge to action for health equity can be achieved.

"I Will Not Leave My Body Here": Migrant Farmworkers' Health and Safety Amidst a Climate of Coercion

Every year more temporary migrant workers come to Canada to fill labour shortages in the agricultural sector. While research has examined the ways that these workers are made vulnerable and exploitable due to their temporary statuses, less has focused on the subjective experiences of migrant agricultural workers in regards their workplace health and safety. We conducted interviews and focus groups with migrant workers in the interior of British Columbia, Canada and used a narrative line of inquiry to highlight two main themes that illustrate the implicit and complex mechanisms that can structure migrant agricultural workers’ workplace climate, and ultimately, endanger their health and safety. The two themes we elaborate are (1) authorities that silence; and (2) “I will not leave my body here.” We discuss the implications of each theme, ultimately arguing that a number of complex political and economic forces create a climate of coercion in which workers feel compelled to choose between their health and safety and tenuous economic security.

Priorities and challenges for a palliative approach to care for rural indigenous populations: A scoping review

We carried out a scoping review to identify key priorities and challenges relevant to rural Indigenous palliative care stated in existing literature. Our scoping review activities followed Arskey and O'Malley's principles for conducting a scoping review. We included peer-reviewed literature from MEDLINE, CINAHL and EMBASE that included a discussion of Indigenous populations, palliative care, and rural settings, and did not use date limits. The literature search was conducted in April 2016, and the retrieved literature was screened for relevance and appropriateness April 2016-March of 2017. In addition to the academic literature, a scan of the grey literature was conducted in March 2017. The retrieved grey literature was screened for relevance and reviewed by a team from a provincial health authority serving Indigenous peoples to ensure relevance in a rural BC setting. Once reviewed for relevance and appropriateness, we added four reports to supplement our analysis. Ultimately, 44 peer-reviewed articles and 4 pieces of grey literature met our inclusion criteria and were included in the review. Our analysis revealed several challenges and priorities relevant to rural Indigenous palliative care. Key challenges included: (i) environmental and contextual issues; (ii) institutional barriers; and (iii) interpersonal dynamics challenging client/clinician interactions. Priorities included: (i) family connections throughout the dying process; (ii) building local capacity for palliative care to provide more relevant and culturally appropriate care; and (iii) flexibility and multi-sectoral partnerships to address the complexity of day-to-day needs for patients/families. These findings point to several areas for change and action that can improve the relevance, access and comprehensiveness of palliative care programming for rural Indigenous communities in Canada and elsewhere. Taking into account of the diversity and unique strengths of each Indigenous community will be vital in developing sustainable and meaningful change.

Belonging and Mental Wellbeing Among a Rural Indian-Canadian Diaspora: Navigating Tensions in "Finding a Space of Our Own"

Belonging is linked to a variety of positive health outcomes. Yet this relationship is not well understood, particularly among rural immigrant diasporas. In this article, we explore the experiences of community belonging and wellbeing among a rural Indian-Canadian diaspora in the Interior of British Columbia, Canada, our central research questions being, "What are the experiences of belonging in this community? How does a sense of belonging (or lack of) shape mental health and wellbeing among local residents?" Using a situational analysis research approach, our findings indicate that local residents must navigate several tensions within an overarching reality of finding a space of our own. Such tensions reveal contradictory experiences of tight-knitedness, context-informed notions of cultural continuity, access/acceptability barriers, particularly in relation to rural agricultural living, and competing expectations of "small town" life. Such tensions can begin to be addressed through creative service provision, collaborative decision making, and diversity-informed program planning.

A Review of Mental Health Approaches for Rural Communities: Complexities and Opportunities in the Canadian Context

Three mental health approaches with potential relevance to rural Canada were reviewed: telepsychiatry, integrated mental health models, and community-based approaches. These approaches have been evaluated in relation to their cost-effectiveness, comprehensiveness, client-centredness, cultural appropriateness, acceptability, feasibility and fidelity; criteria that may vary amidst rural contexts. Collaborative approaches to care, technologies fully integrated into local health systems, multi-sectoral capacity-building, and further engagement with informal social support networks may be particularly promising strategies in rural communities. More research is required to determine rural mental health pathways among diverse social groups, and further, to establish the acceptability of novel approaches in mental health.

Indigenous Storytelling and Participatory Action Research: Allies Toward Decolonization? Reflections From the Peoples' International Health Tribunal

Storytelling, in its various forms, has often been described as a practice with great emancipatory potential. In turn, Indigenous knowledge shows great promise in guiding a participatory action research (PAR) methodology. Yet these two approaches are rarely discussed in relation to one another, nor, has much been written in terms of how these two approaches may work synergistically toward a decolonizing research approach. In this article, I report on a community-driven knowledge translation activity, the Peoples' International Health Tribunal, as an exemplar of how narrative and PAR approaches, guided by local Indigenous knowledge, have great potential to build methodologically and ethically robust research processes. Implications for building globally relevant research alliances and scholarship are further discussed, particularly in relation to working with Indigenous communities.

Strengths amidst vulnerabilities: the paradox of resistance in a mining-affected community in Guatemala

The influence of large-scale mining on the psychosocial wellbeing and mental health of diverse Indigenous communities has attracted increased attention. In previous reports, we have discussed the influence of a gold mining operation on the health of a community in the Western highlands of Guatemala. Here, we discuss the community strengths, and acts of resistance of this community, that is, community processes that promoted mental health amidst this context. Using an anti-colonial narrative methodology that incorporated participatory action research principles, we developed a research design in collaboration with community leaders and participants. Data collection involved focus groups, individual interviews and photo-sharing with 54 men and women between the ages of 18 and 67. Data analysis was guided by iterative and ongoing conversations with participants and McCormack's narrative lenses. Study findings revealed key mechanisms and sources of resistance, including a shared cultural identity, a spiritual knowing and being, 'defending our rights, defending our territory,' and, speaking truth to power. These overlapping strengths were identified by participants as key protective factors in facing challenges and adversity. Yet ultimately, these same strengths were often the most eroded or endangered due the influence of large-scale mining operations in the region. These community strengths and acts of resistance reveal important priorities for promoting mental health and wellbeing for populations impacted by large-scale mining operations. Mental health practitioners must attend to both the strengths and parallel vulnerabilities that may be occasioned by large-scale projects of this nature.

Tensions in anti-colonial research: lessons learned by collaborating with a mining-affected indigenous community

Community-based nurse researchers strive to develop collaborative partnerships that are meaningful to the health priorities of participants and relevant to their sociopolitical realities. Within the context of global inequity, intersecting forces of privilege and oppression inevitably shape the research process, resulting in tensions, contradictions, and challenges that must be addressed. This article has 3 purposes: to examine the political context of mining corporations, to describe common health threats and challenges faced by mining-affected communities, and to reflect on research with a mining-affected Indigenous community in Guatemala whose health and capacity for self-advocacy are impacted by a legacy of colonialism. Using an anti-colonial lens, the authors discuss 3 central tensions: community agency and community victimhood, common ground and distinct identities, and commitment to outcomes and awareness of limitations. They conclude by offering methodological suggestions for nurse researchers whose work is grounded in anti-colonial perspectives.