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Iglesias-Rios L, Kort A, Handal AJ. Precarious Work and Housing for Michigan Farmworkers During the COVID-19 Pandemic and Beyond. J Agromedicine 2024:1-19. [PMID: 38651537 DOI: 10.1080/1059924x.2024.2341803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVES Farmworkers in Michigan face precarious and exploitative labor conditions that affect their access to affordable, fair, and quality housing, which are key social determinants of health. We sought to assess the health, working conditions, and housing access, affordability, and quality of farmworkers living in and outside of employer-provided housing during the COVID-19 pandemic. METHODS We conducted a mixed methods cross-sectional study in collaboration with community partners from the Michigan Farmworker Project and the Michigan Department of Civil Rights. We assessed housing, labor conditions, and general health through in-depth phone interviews with seasonal, migrant, and H-2A farmworkers (n = 63) during the height of the COVID-19 pandemic (2020-2021) in Michigan. Descriptive analyses of these data included comparisons by type of farmworker and type of housing (employer-provided or other). RESULTS The majority of farmworkers interviewed were women and seasonal farmworkers and spoke primarily Spanish. A significant share of farmworker participants reported living in poverty (38.3%) and had low or very low food security (27.0%). Nearly half of farmworkers (47.6%) rated their health as "fair" or "poor" during the year prior to the interview, and more than a third reported 3 or more chronic conditions (39.6%) and lack of health insurance coverage (38.7%). Among the 43 workers tested, 25.6% reported testing positive for COVID-19. Farmworkers reported experiences of objectification and dehumanization. Three-quarters of workers reported feeling that they were treated as less than human by supervisors and one-third reported verbal abuse. Farmworkers also experienced challenges exacerbated by their social vulnerability that impeded them from finding affordable, quality housing. Regarding housing quality, the majority of workers (80.6%) reported one or more environmental hazards around their residence, and about a third reported not having air conditioning (33.%) and lacking a functioning washing machine (33.9%). Concerns about the quality of drinking water accessible to workers and exposure to chemicals were shared by participants. CONCLUSION This study adds valuable knowledge to the understanding of the systemic barriers to housing and work conditions for female and male seasonal, migrant, and H-2A farmworkers in Michigan. Shortcomings in the regulatory and policy environment result in precarious housing and work conditions, including exploitative labor practices. These conditions negate equality, fairness, and health equity, important tenants for public health.
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Affiliation(s)
- Lisbeth Iglesias-Rios
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Alexa Kort
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Alexis J Handal
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Iglesias-Rios L, O'Neill MS, Handal AJ. Climate Change, Heat, and Farmworker Health. Workplace Health Saf 2023; 71:43. [PMID: 36515206 DOI: 10.1177/21650799221135581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | - Marie S O'Neill
- Department of Epidemiology.,Department of Environmental Health Sciences, University of Michigan School of Public Health
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Iglesias-Rios L, Harlow SD, Burgard SA, Kiss L, Zimmerman C. Gender differences in the association of living and working conditions and the mental health of trafficking survivors. Int J Public Health 2019; 64:1015-1024. [PMID: 31243470 PMCID: PMC10506657 DOI: 10.1007/s00038-019-01269-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 06/05/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To assess the association of living and working conditions experienced during trafficking with mental health of female and male survivors. METHODS We analyzed a cross-sectional study of 1015 survivors who received post-trafficking services in Cambodia, Thailand, and Vietnam. Modified Poisson regression models were conducted by gender to estimate prevalence ratios. RESULTS For females, the elevated prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms was associated with adverse living conditions, while for males the prevalence of anxiety (PR = 2.21; 95% CI 1.24-3.96) and depression (PR = 2.63; 95% CI 1.62-4.26) more than doubled and almost tripled for PTSD (PR = 2.93; 95% CI 1.65-5.19) after adjustment. For males in particular, excessive and extreme working hours per day were associated with more than a four- and threefold greater prevalence of PTSD. Being in a detention center or jail was associated with all three mental health outcomes in males. CONCLUSIONS Providers and stakeholders need to consider the complex mental health trauma of the differential effects of living and working conditions for female and male survivors during trafficking to support treatment and recovery.
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Affiliation(s)
- Lisbeth Iglesias-Rios
- Department of Epidemiology, Center for Midlife Science, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
| | - Siobán D Harlow
- Department of Epidemiology, Center for Midlife Science, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Sarah A Burgard
- Department of Sociology, College of Literature Science, and the Arts, University of Michigan, 500 S State St, Ann Arbor, MI, 48109, USA
| | - Ligia Kiss
- Department of Global Health and Development, Gender Violence and Health Centre, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK
| | - Cathy Zimmerman
- Department of Global Health and Development, Gender Violence and Health Centre, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK
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Iglesias-Rios L, Harlow SD, Burgard SA, Kiss L, Zimmerman C. Mental health, violence and psychological coercion among female and male trafficking survivors in the greater Mekong sub-region: a cross-sectional study. BMC Psychol 2018; 6:56. [PMID: 30541612 PMCID: PMC6292017 DOI: 10.1186/s40359-018-0269-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/12/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Human trafficking is a pervasive global crime with important public health implications that entail fundamental human rights violations in the form of severe exploitation, violence and coercion. Sex-specific associations between types of violence or coercion and mental illness in survivors of trafficking have not been established. METHODS We conducted a cross-sectional study with 1015 female and male survivors of trafficking (adults, adolescents and children) who received post-trafficking assistance services in Cambodia, Thailand or Vietnam and had been exploited in various labor sectors. We assessed anxiety and depression with the Hopkins Symptoms Checklist (HSCL-25) and post-traumatic stress disorder (PTSD) symptoms with the Harvard Trauma Questionnaire (HTQ), and used validated questions from the World Health Organization International Study on Women's Health and Domestic Violence to measure physical and sexual violence. Sex-specific modified Poisson regression models were estimated to obtain prevalence ratios (PRs) and their 95% confidence intervals (CI) for the association between violence (sexual, physical or both), coercion, and mental health conditions (anxiety, depression and PTSD). RESULTS Adjusted models indicated that for females, experiencing both physical and sexual violence, compared to not being exposed to violence, was a strong predictor of symptoms of anxiety (PR = 2.08; 95% CI: 1.64-2.64), PTSD (PR = 1.55; 95% CI: 1.37-1.74), and depression (PR = 1.57; 95% CI: 1.33-1.85). Among males, experiencing physical violence with additional threats made with weapons, compared to not being exposed to violence, was associated with PTSD (PR = 1.59; 95% CI: 1.05-2.42) after adjustment. Coercion during the trafficking experience was strongly associated with anxiety, depression, and PTSD in both females and males. For females in particular, exposure to both personal and family threats was associated with a 96% elevated prevalence of PTSD (PR = 1.96; 95% CI: 1.32-2.91) and more than doubling of the prevalence of anxiety (PR = 2.11; 95% CI: 1.57-2.83). CONCLUSIONS The experiences of violence and coercion in female and male trafficking survivors differed and were associated with an elevated prevalence of anxiety, depression, and PTSD in both females and males. Mental health services must be an integral part of service provision, recovery and re-integration for trafficked females and males.
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Affiliation(s)
- Lisbeth Iglesias-Rios
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Siobán D Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Sarah A Burgard
- Department of Sociology, College of Literature Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
| | - Ligia Kiss
- Gender Violence and Health Centre, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Cathy Zimmerman
- Gender Violence and Health Centre, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Iglesias-Rios L, Bromberg JE, Moser RP, Augustson EM. Food insecurity, cigarette smoking, and acculturation among Latinos: data from NHANES 1999-2008. J Immigr Minor Health 2016; 17:349-57. [PMID: 24306283 DOI: 10.1007/s10903-013-9957-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Prevalence of food insecurity (FI) among Latinos in the United States is almost double the national average. To better understand FI among Latinos, potential risk factors beyond poverty, including acculturation indicators and smoking status, were explored. Cross-sectional data from 6,681 Latino adults from the 1999-2008 National Health and Nutrition Examination Surveys were used. Partial proportional odds (PPO) models were used to estimate associations of FI, including cigarette smoking and acculturation. The PPO models indicated that compared with never smokers, current smokers had significantly higher odds of FI (odds ratios ranged from 1.32 to 1.51 across models). Lower levels of acculturation and poverty and being a younger or middle-aged adult were also significantly associated with FI. Among Latinos, current smoking and low acculturation are important risk factors for FI. Current smoking and low acculturation may exacerbate nutritional deprivation in a population that is already disproportionally affected by poverty and poor health outcomes.
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Affiliation(s)
- Lisbeth Iglesias-Rios
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, MSC 9761, Bethesda, MD, 20892-9761, USA
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Iglesias-Rios L, Harlow SD, Reed BD. Depression and posttraumatic stress disorder among women with vulvodynia: evidence from the population-based woman to woman health study. J Womens Health (Larchmt) 2015; 24:557-62. [PMID: 25950702 DOI: 10.1089/jwh.2014.5001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Psychological disorders may affect the pain experience of women with vulvodynia, but evidence remains limited. The present study aimed to describe the magnitude of the association of depression and posttraumautic stress disorder (PTSD) with the presence of vulvodynia in a nonclinical population from southeastern Michigan. METHODS Baseline data from 1,795 women participating in the Woman to Woman Health Study, a multiethnic population-based study, was used for this analysis. Validated screening questionnaires were conducted to assess vulvodynia, depression, and PTSD. Modified Poisson regression models with a robust variance estimation were used to estimate prevalence ratios (PR) and their 95% confidence intervals (CI) for the association between vulvodynia status and two mental health conditions, depression and PTSD. RESULTS In the adjusted models, women who screened positive for depression had a 53% higher prevalence of having vulvodynia (PR=1.53; 95% CI: 1.12, 2.10) compared with women who screened negative for depression. Women who screened positive for PTSD had more than a two-fold increase in the prevalence of having vulvodynia (PR=2.37; 95% CI: 1.07, 5.25) compared with women who screened negative for PTSD. CONCLUSIONS The increased prevalence of vulvodynia among those screening positive for depression or PTSD suggests that these disorders may contribute to the likelihood of reporting vulvodynia. Alternatively, vulvodynia, depression, and PTSD may have a common pathophysiological and risk profile. Prospective studies are needed to improve our understanding of the temporal relation between mental health conditions and vulvar pain.
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Affiliation(s)
- Lisbeth Iglesias-Rios
- 1 Department of Epidemiology, School of Public Health, University of Michigan , Ann Arbor, Michigan
| | - Siobán D Harlow
- 1 Department of Epidemiology, School of Public Health, University of Michigan , Ann Arbor, Michigan
| | - Barbara D Reed
- 2 Department of Family Medicine, University of Michigan , Ann Arbor, Michigan
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Iglesias-Rios L, Parascandola M. A historical review of R.J. Reynolds' strategies for marketing tobacco to Hispanics in the United States. Am J Public Health 2013; 103:e15-27. [PMID: 23488493 DOI: 10.2105/ajph.2013.301256] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Hispanics are the fastest growing racial/ethnic group in the United States, and smoking is the leading preventable cause of morbidity and mortality among this population. We analyzed tobacco industry documents on R. J. Reynolds' marketing strategies toward the Hispanic population using tobacco industry document archives from the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) between February-July 2011 and April-August 2012. Our analysis revealed that by 1980 the company had developed a sophisticated surveillance system to track the market behavior of Hispanic smokers and understand their psychographics, cultural values, and attitudes. This information was translated into targeted marketing campaigns for the Winston and Camel brands. Marketing targeted toward Hispanics appealed to values and sponsored activities that could be perceived as legitimating. Greater understanding of tobacco industry marketing strategies has substantial relevance for addressing tobacco-related health disparities.
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Affiliation(s)
- Lisbeth Iglesias-Rios
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD 20892, USA.
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