RESUMO
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.
Assuntos
Praguicidas , Criança , Humanos , Renda , Praguicidas/efeitos adversos , População Rural , Racismo Sistêmico , Estados UnidosRESUMO
Resumen Con el propósito de prevenir lesiones y enfermedades ocupacionales, diseñamos un currículo de seguridad y salud para trabajadores inmigrantes en la industria lechera para aumentar el conocimiento, fomentar prácticas de seguridad, y reducir inequidades en la comunicación. El currículo se basa principalmente en la Taxonomía para el Aprendizaje Significativo-TAS ( Taxonomy of Significant Learning) e incorpora teorías de la conducta y de aprendizaje para adultos, así como también los principios de control de riesgos ocupacionales. Los entrenamientos se implementaron con 836 trabajadores de habla hispana de 67 lecherías en el estado de Wisconsin, en los Estados Unidos. El 67% de los trabajadores reportaron nunca haber recibido entrenamiento acerca de la seguridad en las lecherías, el 65% reportó haber trabajado en lecherías durante 5 años o menos, y el 26% de los trabajadores reportaron haber sufrido alguna lesión mientras trabajaban en la lechería. La evaluación cuantitativa y cualitativa de los entrenamientos sugiere que nuestro currículo efectivamente aumentó el conocimiento y fomentó la contemplación de prácticas de seguridad de los trabajadores. El aumento del conocimiento en general del 25% es estadísticamente significativo (p < .01). Los trabajadores recordaron al menos un concepto clave del contenido, expresaron sentirse confiados en adoptar al menos una conducta de seguridad, y mencionaron su intención de comunicar sus preocupaciones de seguridad a sus jefes en la lechería. De acuerdo a nuestro conocimiento, esta es la primera vez que se aplica la TAS en la educación acerca de seguridad y salud ocupacional. Este currículo puede ayudar a los productores en la industria lechera a cumplir con el entrenamiento anual de los trabajadores requerido por la Administración de Seguridad y Salud Ocupacional de los E. U. ( Occupational Safety and Health Administration-OSHA), ofreciendo este entrenamiento básico en seguridad y salud a sus trabajadores durante su etapa inicial de empleo.
RESUMO
We designed a safety and health curriculum for dairy immigrant workers aiming to increase knowledge, encourage safe behavior, and reduce worker communication inequalities to prevent occupational injury and diseases. The design is largely based on the Taxonomy of Significant Learning and incorporated behavioral and adult learning theories and principles of occupational hazard control. Trainings were implemented with 836 Spanish-speaking workers from 67 farms in Wisconsin. Sixty-seven percent of workers reported never being trained before in dairy safety, 65% of these worked in dairy for 5 or fewers years, and 26% of workers reported being ever injured while working on dairy. Quantitative and qualitative evaluation of the trainings suggest that our curriculum successfully increased worker knowledge and promoted contemplation of safe practices. The overall knowledge gain of 25% was statistically significant ( p < .01). Workers recalled at least one key concept, expressed confidence of adopting at least one safety behavior, and mentioned their intention to communicate safety concerns to farmers. To our knowledge, this is the first Taxonomy of Significant Learning application to occupational safety and health education. Our curriculum can support dairy farmers' compliance with Occupational Safety and Health Administration's annual training requirements by providing our basic safety and health training to workers at early job stages.
Assuntos
Indústria de Laticínios/organização & administração , Emigrantes e Imigrantes/educação , Hispânico ou Latino/educação , Capacitação em Serviço/organização & administração , Gestão da Segurança/organização & administração , Adolescente , Adulto , Indústria de Laticínios/normas , Feminino , Humanos , Conhecimento , Masculino , Pessoa de Meia-Idade , Saúde Ocupacional , Traumatismos Ocupacionais/prevenção & controle , Estados Unidos , United States Occupational Safety and Health Administration , Adulto JovemAssuntos
COVID-19/prevenção & controle , Participação da Comunidade/estatística & dados numéricos , Fazendeiros/estatística & dados numéricos , Saúde Ocupacional/estatística & dados numéricos , Gestão da Segurança/organização & administração , COVID-19/epidemiologia , Pesquisa Participativa Baseada na Comunidade , Relações Comunidade-Instituição , Humanos , Migrantes/estatística & dados numéricosRESUMO
BACKGROUND: Nearly one of every three workers in the United States is low-income. Low-income populations have a lower life expectancy and greater rates of chronic diseases compared to those with higher incomes. Low- income workers face hazards in their workplaces as well as in their communities. Developing integrated public health programs that address these combined health hazards, especially the interaction of occupational and non-occupational risk factors, can promote greater health equity. METHODS: We apply a social-ecological perspective in considering ways to improve the health of the low-income working population through integrated health protection and health promotion programs initiated in four different settings: the worksite, state and local health departments, community health centers, and community-based organizations. RESULTS: Examples of successful approaches to developing integrated programs are presented in each of these settings. These examples illustrate several complementary venues for public health programs that consider the complex interplay between work-related and non work-related factors, that integrate health protection with health promotion and that are delivered at multiple levels to improve health for low-income workers. CONCLUSIONS: Whether at the workplace or in the community, employers, workers, labor and community advocates, in partnership with public health practitioners, can deliver comprehensive and integrated health protection and health promotion programs. Recommendations for improved research, training, and coordination among health departments, health practitioners, worksites and community organizations are proposed.
Assuntos
Serviços de Saúde Comunitária/métodos , Promoção da Saúde/métodos , Disparidades nos Níveis de Saúde , Doenças Profissionais/prevenção & controle , Serviços de Saúde do Trabalhador/métodos , Pobreza , Saúde Pública , Adolescente , Adulto , Idoso , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento de Redução do Risco , Meio Social , Estados Unidos , Local de Trabalho , Adulto JovemRESUMO
BACKGROUND: The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the US is comprised primarily of Latino immigrants. Health care access for these workers is limited and increases health disparities. METHODS: This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers. CONTENTS: Immigrant workers bear a disproportionate burden of poverty and ill health and additionally face significant occupational hazards. AgFF laborers largely are uninsured, ineligible for benefits, and unable to afford health services. The new Affordable Care Act will likely not benefit such individuals. Community and Migrant Health Centers (C/MHCs) are the frontline of health care access for immigrant AgFF workers. C/MHCs offer discounted health services that are tailored to meet the special needs of their underserved clientele. C/MHCs struggle, however, with a shortage of primary care providers and staff prepared to treat occupational illness and injury among AgFF workers. A number of programs across the US aim to increase the number of primary care physicians and care givers trained in occupational health at C/MHCs. While such programs are beneficial, substantial action is needed at the national level to strengthen and expand the C/MHC system and to establish widely Medical Home models and Accountable Care Organizations. System-wide policy changes alone have the potential to reduce and eliminate the rampant health disparities experienced by the immigrant workers who sustain the vital Agricultural, Forestry, and Fishery sector in the US.
Assuntos
Agricultura , Centros Comunitários de Saúde , Emigrantes e Imigrantes , Agricultura Florestal , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde/etnologia , Serviços de Saúde do Trabalhador , Centros Comunitários de Saúde/organização & administração , Pesqueiros , Política de Saúde , Acessibilidade aos Serviços de Saúde/organização & administração , Disparidades nos Níveis de Saúde , Hispânico ou Latino , Humanos , Saúde das Minorias/etnologia , Doenças Profissionais/etnologia , Doenças Profissionais/terapia , Saúde Ocupacional/etnologia , Serviços de Saúde do Trabalhador/organização & administração , Traumatismos Ocupacionais/etnologia , Traumatismos Ocupacionais/terapia , Sudeste dos Estados Unidos , Recursos HumanosRESUMO
BACKGROUND: Immigrant workers make up an important portion of the hired workforce in the Agricultural, Forestry and Fishing (AgFF) sector, one of the most hazardous industry sectors in the US. Despite the inherent dangers associated with this sector, worker protection is limited. METHODS: This article describes the current occupational health and safety policies and regulatory standards in the AgFF sector and underscores the regulatory exceptions and limitations in worker protections. Immigration policies and their effects on worker health and safety are also discussed. Emphasis is placed on policies and practices in the Southeastern US. RESULTS: Worker protection in the AgFF sector is limited. Regulatory protections are generally weaker than other industrial sectors and enforcement of existing regulations is woefully inadequate. The vulnerability of the AgFF workforce is magnified by worker immigration status. Agricultural workers in particular are affected by a long history of "exceptionalism" under the law as many regulatory protections specifically exclude this workforce. CONCLUSIONS: A vulnerable workforce and high-hazard industries require regulatory protections that, at a minimum, are provided to workers in other industries. A systematic policy approach to strengthen occupational safety and health in the AgFF sector must address both immigration policy and worker protection regulations.
Assuntos
Agricultura/legislação & jurisprudência , Emigrantes e Imigrantes , Agricultura Florestal/legislação & jurisprudência , Regulamentação Governamental , Política de Saúde/legislação & jurisprudência , Saúde Ocupacional/legislação & jurisprudência , Emigração e Imigração/legislação & jurisprudência , Pesqueiros/legislação & jurisprudência , Disparidades nos Níveis de Saúde , Humanos , Saúde das Minorias , Doenças Profissionais/etnologia , Doenças Profissionais/prevenção & controle , Saúde Ocupacional/etnologia , Traumatismos Ocupacionais/etnologia , Traumatismos Ocupacionais/prevenção & controle , Sudeste dos Estados UnidosRESUMO
Climate change amplifies social inequities, disproportionately impacting the health and well-being of populations already vulnerable to social risk factors associated with race, ethnicity, immigration status, and occupation. Recent hurricanes, extreme temperatures, wildfires, and droughts have directly impacted vulnerable populations, including farmworkers in the US and its territories. Understanding how systems increase poor health outcomes for farmworkers is important to create solutions that are practical, feasible, and sustainable. In this commentary, we discuss a framework to assess the climate crisis and its impact on farmworkers. Although environmental stressors impact all populations, the difference in the systems or structures surrounding individuals can increase the risks and diseases of vulnerable populations when responding to the effects of the climate crisis. This framework presents policies and systems that could be limiting for agricultural workers when exposed to environmental stressors and the direct or indirect consequences of not addressing them.
Assuntos
Fazendeiros , Migrantes , Humanos , Mudança Climática , Meio Ambiente , Fatores de Risco , Desigualdades de SaúdeRESUMO
OBJECTIVES: The purpose of this study was to assess water quality in migrant farmworker camps in North Carolina and determine associations of water quality with migrant farmworker housing characteristics. METHODS: We collected data from 181 farmworker camps in eastern North Carolina during the 2010 agricultural season. Water samples were tested using the Total Coliform Rule (TCR) and housing characteristics were assessed using North Carolina Department of Labor standards. RESULTS: A total of 61 (34%) of 181 camps failed the TCR. Total coliform bacteria were found in all 61 camps, with Escherichia coli also being detected in 2. Water quality was not associated with farmworker housing characteristics or with access to registered public water supplies. Multiple official violations of water quality standards had been reported for the registered public water supplies. CONCLUSIONS: Water supplied to farmworker camps often does not comply with current standards and poses a great risk to the physical health of farmworkers and surrounding communities. Expansion of water monitoring to more camps and changes to the regulations such as testing during occupancy and stronger enforcement are needed to secure water safety.
Assuntos
Agricultura , Água Potável/normas , Saúde Ocupacional , Enterobacteriaceae/isolamento & purificação , Escherichia coli/isolamento & purificação , Humanos , North Carolina , Migrantes , Microbiologia da ÁguaRESUMO
OBJECTIVE: To understand COVID-19 vaccine perspectives among healthcare workers serving diverse communities. METHODS: A dual English/Spanish survey was distributed to healthcare workers in the United States from 3/12/2021-4/22/2021 by the Migrant Clinicians Network, Society of Refugee Healthcare Providers, a Federally Qualified Healthcare Center, and social media advertisement to general primary care workers. RESULTS: 517 responses were at least 50% complete and included in the analysis. Among these, 88% (457/517) indicated vaccine acceptance. Factors associated with acceptance included not reporting any vaccine concerns, identifying as male, ≥65 years of age, being a physician or advanced practice provider, and interacting directly with patients from refugee, immigrant, and migrant (RIM) communities. Participants identified educational information as most helpful for themselves when making a vaccine decision, but a healthcare provider's recommendation as most helpful for their patients. CONCLUSION: Healthcare workers, especially those serving RIM communities, are vaccine accepting. Tailoring vaccine-related information to healthcare workers may improve vaccine confidence for both themselves and patients who rely on them for information.
Assuntos
COVID-19 , Vacinas , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Estudos Transversais , Pessoal de Saúde , Humanos , MasculinoRESUMO
Migrant and immigrant farmworkers are cornerstones to food security and production in many nations. In the United States, farmworkers have been disproportionately impacted by COVID-19. Because they are considered essential workers, vaccines may be made imminently available to them and offer an opportunity to reduce these COVID-19-related impacts. It is essential for a successful vaccination campaign to address the unique challenges arising from this workforce's inherently mobile nature and limited access to healthcare. Proposed strategies to overcome these challenges include ensuring farmworkers are prioritized in vaccine allocation and provided cost-free vaccines at convenient locations through partnerships among health authorities, community- and faith-based groups, and health centers with trusted community relationships. Further, a portable immunization record should be used, and coordination of care continued when a farmworker moves to a new geographic location. If implemented well, vaccinating farmworkers can reduce the COVID-19 disease burden among these essential workers, improve public health, and protect food and agriculture production.
Assuntos
Vacinas contra COVID-19/provisão & distribuição , COVID-19/prevenção & controle , Fazendas , SARS-CoV-2 , Migrantes , COVID-19/epidemiologia , Emigrantes e Imigrantes , Abastecimento de Alimentos , Acessibilidade aos Serviços de Saúde , Humanos , Saúde Pública , Estados Unidos/epidemiologia , VacinaçãoRESUMO
Primary care clinicians may be the only source of occupational healthcare for many low-wage, high-risk workers who experience disproportionate occupational hazards. The authors explored barriers to providing occupational healthcare and recommendations for overcoming these challenges. The team conducted six focus groups and eleven key-informant interviews in two community health centers and among clinicians, community health workers, and other personnel from similar settings. Clinicians reported not utilizing occupational information during clinical encounters and identified competing priorities, limited appointment time, and lack of training as key barriers. They cited workers' compensation as a source of confusion and frustration. However, most participants recognized occupation as an important social determinant of health and expressed interest in additional training and resources. Participants agreed that referral mechanisms for occupational medicine specialists and worker centers and changes in quality performance measures and electronic health records would be useful and that workers' compensation and immigration policies need reform.
Assuntos
Centros Comunitários de Saúde/organização & administração , Serviços de Saúde do Trabalhador/organização & administração , Atenção Primária à Saúde/organização & administração , Determinantes Sociais da Saúde , Humanos , Capacitação em Serviço , Saúde Ocupacional , Encaminhamento e Consulta/organização & administração , Fatores de Tempo , Indenização aos Trabalhadores/organização & administraçãoRESUMO
The goal of this project was to protect children while parents work in agriculture by improving off-farm services for children of migrant and seasonal farm workers. Large agricultural enterprises have policies forbidding children in the worksite. At the same time, their employees, who are trying to generate income, seek as many work hours as possible but often lack viable options for childcare services. As employers strive to increase their labor pool, and workers seek off-farm childcare, there is mutual interest in improving access to childcare services in agricultural regions dependent on large numbers of full-time and seasonal workers. This report describes the employers' perspectives on childcare needs of hired farm workers' families and their barriers and motivators to facilitating off-farm childcare services. Using descriptive survey research methodology, data were collected from a convenience sample of 102 agribusiness owners and Human Resource directors attending an agricultural conference regarding labor laws or personnel management. Results revealed significant differences for those companies employing more than 25 workers compared to their counterparts. Primary motivators for offering childcare as an employment benefit were improved employee morale, enhanced company reputation, and a more stable workforce. A major barrier was that half of large-scale enterprises lack guidance on how to provide childcare options for their workers. Survey results are being used to facilitate collaboration among employers, farm workers, and childcare providers to offer a safe, nurturing environment for children while their parents work in agriculture.
Assuntos
Cuidado da Criança , Fazendas , Adolescente , Adulto , Criança , Cuidado da Criança/economia , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Migrantes , Recursos Humanos , Adulto JovemRESUMO
The Socio-Ecological Model (SEM) is a conceptual framework depicting spheres of influence over human behavior that has been applied in public health settings for nearly five decades. Core principles of all variations of the SEM are the multiple influences over an individual's behaviors, the interactions of those influences, and the multilevel approaches that can be applied to interventions intended to modify behaviors. A project team modified the standard SEM to address interventions for protecting children from agricultural disease and injury. The modified SEM placed the "child in the farm environment" at the core with five interrelated levels (spheres) of influence over the child. This framework provides guidance on how a multifaceted, multilevel intervention can maximize the potential for impact on behaviors and decisions made by parents/adults responsible for the safety of children on farms. An example of how this model could work to safeguard youth operating tractors is provided.
Assuntos
Acidentes de Trabalho/prevenção & controle , Saúde Ocupacional/normas , Acidentes de Trabalho/legislação & jurisprudência , Acidentes de Trabalho/psicologia , Acidentes de Trabalho/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Fazendas/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Modelos Teóricos , Saúde Ocupacional/legislação & jurisprudência , Saúde Ocupacional/estatística & dados numéricos , Recursos Humanos , Adulto JovemRESUMO
Access to safe, off-farm childcare is often a challenge for farmworkers with young children and is likely to become an increasingly salient barrier as more agricultural workers migrate together with families and as the number of women entering the agricultural workforce increases. Agriculture is one of the most hazardous industries, and the presence of young children in the workplace puts them at risk. To better understand the current nature of childcare for farmworker families and the challenges to accessing services, this project facilitated in-person surveys with 132 parents in three communities in Florida. A convenience sample that intentionally targeted parents living and working in areas with limited access to Migrant and Seasonal Head Start facilities was used to recruit participants. Most participants reported childcare access as a challenge. They expressed a desire to work in an area based on childcare availability. These findings offer agribusiness leaders important data to consider. They also suggest that industry support of childcare may be an important workforce investment. Findings indicate that high quality, affordable off-farm childcare services could serve as a means for attracting farmworkers to regions currently experiencing labor shortages. Additional research is warranted to explore this subject in diverse geographic areas.
Assuntos
Agricultura , Cuidado da Criança/estatística & dados numéricos , Adulto , Criança , Cuidado da Criança/psicologia , Pré-Escolar , Fazendeiros/psicologia , Fazendeiros/estatística & dados numéricos , Feminino , Florida , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pais/psicologia , Inquéritos e Questionários , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Recursos Humanos , Local de TrabalhoRESUMO
Agricultural work is one of the most dangerous jobs for adolescents. Through a university-community partnership, the authors surveyed young primarily acculturated Latino-American farmworkers 14 to 18 years of age regarding their agricultural work experience. Topics included occupational health and safety education, work history, and information sources. The authors also evaluated the Rapid Clinical Assessment Tool (RCAT), a pictorial tool for identifying agricultural tasks to enhance discussion with clinical providers. One hundred forty youth with farmwork experience completed the survey; 6% reported a previous work-related injury or illness and 53% reported receiving some workplace health and safety training. Correct identification of legally restricted duties for youth varied but were generally low: participants identified working alone past 8 pm (57%), driving a forklift (56%), doing roofing work (39%), working in freezers (34%), and driving a delivery vehicle (30%). The Internet was identified as the most likely and reliable place youth would go to find information on workplace health and safety. Few (15%) reported clinician-initiated conversations on occupational health; however, a high proportion responded positively to questions regarding the usefulness of the RCAT for this purpose. This study highlights the need for workplace health and safety guidance for youth employed in agriculture. The results support Internet-based outreach and use of the RCAT to help facilitate occupational health discussions in clinical settings.
Assuntos
Atitude Frente a Saúde , Fazendeiros , Hispânico ou Latino , Saúde Ocupacional , Segurança , Adolescente , Atitude Frente a Saúde/etnologia , Emprego/legislação & jurisprudência , Feminino , Humanos , Internet , Masculino , Exposição Ocupacional , Inquéritos e Questionários , Washington/etnologia , Local de TrabalhoRESUMO
Agricultural employers and work supervisors strive to keep children out of worksites, but oftentimes migrating farm worker parents lack accessible or affordable options for childcare in a trusted environment. Thus, children may not have a safe, appropriate place to be while their parents are conducting agricultural work. Redlands Christian Migrant Association (RCMA) of Florida is a community development organization that creates and fosters opportunities for the children of migrant and other low-income rural families. To better understand the RCMA system, an in-depth assessment of its program was undertaken to identify both its standard and unique features. Results revealed many attributes contributing to RCMA's success. Based upon RCMA's 48-year track record, employers, agribusinesses, and communities are encouraged to adopt strategies to meet local and regional childcare needs where parents are working in agriculture.