Rural, Urban and Migrant Health Flashcards
Current composition of US Migrant Workers
Mobile population with shifting numbers - Estimated at 3 to 5 million
Average age of 31; ½ under age 29; children as young as 10 y/o are employed
80% male; 84% speak Spanish
Median education: sixth grade
Income derived primarily from work in agriculture
Migrant farmworker
* Streams follow flow of work
* Sunrise to sunset 6 days a week
* Some groups use crew leaders to act as mediator with farmers.
* All family members work in the fields
Historical Background of Migrant Workers
Migrant Workers are nothing new.
* 1600s: Indentured servants were brought from England to work in the fields. They were guaranteed passage into the colonies in exchange for their labor.
* 1650s-1800s: When indentured servants weren’t providing enough labor, African people were brought to the U.S. as slaves to work in the fields and as domestic servants.
* 1860s-1930s: Farming became a large-scale industry. The U.S. began importing Asian labor as African Americans moved into other industries and as the need for labor increased.
* Timeline of Agricultural Labor in the US
Legislation
- The Bracero Agreement of 1942 enabled Mexicans to enter the United States for up to 6 months to provide agricultural assistance to farmers.
- Migrant Health Act of 1962 authorized delivery of primary and supplementary health services to migrant farmworkers.
Characteristics of Migrant workers
- Migrant lifestyle
- Housing
- Financial
- Many are immigrants
- Children often employed
- Male employment > females
Barriers to health care
- Lack of knowledge about services
- Inability to afford care
- Availability of services
- Transportation
- Hours of service
- Mobility and tracking
- Language barriers
- Discrimination
- Documentation
Socioeconomic Health Disparities for Migrant Workers
- Migrant adolescents more likely to abuse substances
- Exposure to violence and sexual abuse
- Children educationally, socially, and physically disadvantaged
- Substandard housing, crowding
- Poor sanitation
- Infectious disease
Health Disparities for Migrant Workers
Physical occupational hazards
* Heavy equipment, weather, lack of knowledge/safety, trauma
Environmental
* Pesticide and herbicide exposure
Limited health resources
* Fragmented health care
* Accessibility, affordability and availability of health care
Health Disparities for the Families of Migrant Workers
- Children as migrant workers
- Dental disease
- Incidence of TB
- Incidence of HIV/AIDS
- Depression
- Anxiety-related disorders
- Domestic violence
- Sexual abuse
Migrant Clinicians Network
- Focus is on mobile patients, case management
- A network of clinicians across the country and world wide (114 countries), interdisciplinary
- Exposure clinicians and farm worker safety team
- Communicable diseases
- Health justice and advocacy
- Violence prevention
- Continuity of care
- Disaster response for rebuild and continued care of acute/chronic health needs
- Evacuations, truck drivers, farmers, etc…
MCN’s Ventanilla de Salud
Ventanilla de Salud (VdS) is a network of health outreach programs operating out of each of the Mexican Consulates in the US.
Definitions of Rural and Urban Populations
Urban—> 1,000 persons/sq. mile; cities with population at least 2,500 but < 50,000 persons
Metropolitan Area- “core urban area” =/> 50K persons
Rural - < 10,000 residents or < 1,000 persons per square mile
Frontier—area with six or fewer persons per square mile, but others include not only population density but distance and travel time to market service areas
Migrant—a transit population, usually immigrants, that moves regularly to follow work opportunities usually found as farmworkers
Donut Effect: fastest growing rural counties in rural regions & along edges of larger metro counties; i.e. people moving away from highly populated areas to outlying suburbs
* More affordable housing
Healthy People 2030 Goals related to Migrant and Rural Healthcare
Access to healthcare
Diabetes
Environmental Health
Health communication and techology
Heart disease and Stroke
Rural Resident Cultural Characteristics
Age and gender
Marital status
Race and ethnicity
Education
Income, housing, and jobs
Mental Health Needs
Substance abuse
Domestic Violence
Left Behind: Health Care in Rural America
Other characteristics of rural population
- Less likely to engage in preventive behavior
- More likely to have one or more of the following chronic conditions: heart disease, COPD, hypertension, arthritis and rheumatism, diabetes, cardiovascular disease, and cancer
- Smoking, alcoholism and substance abuse rates are high
- Tend to have poorer health and less likely to seek medical care
- Traveling time and/or distance to ambulatory care services affects access to care
- With all-cause mortality rates higher in rural areas, it is no surprise that mortality related to certain causes are also higher in rural areas.
Rural Families & Mental Health
Healthcare providers in rural areas
US Rural Hospitals
Urban Health Disparities
- Income gap between city and suburban residents
- Poverty two times greater in cities
- Overcrowding and poor-quality housing leading to poor mental health, developmental delay, and shorter stature
- Violence
- Employment
- Shift in political power; change in money to cities
