Date of Award

2010-01-01

Degree Name

Master of Science

Department

Public Health

Advisor(s)

Mary M. Weigel

Second Advisor

Rodrigo X. Armijos

Abstract

Background and Significance

The estimated 1–3 million migrant and seasonal farmworkers (MSFW) employed in the U.S. play a crucial role in assuring the success of the multi-billion dollar agricultural industry and the nation's access to a safe and nutritious food supply. This predominantly Mexican immigrant occupational group is documented to be at–risk for chronic and infectious disease morbidity and premature mortality but published studies are limited which describe their reproductive/sexual health, mental health, substance abuse, and workplace violence situation. Prior studies are especially scant regarding U.S.–Mexico border MSFW.

Objectives and Hypothesis

The major objective of the pilot study was to explore health issues, health screening and health risk behaviors related to reproductive/sexual health, substance abuse, and workplace violence of MSFW working in the Paso Del Norte region of far west Texas and southeastern New Mexico. The first specific study aim was to characterize the reproductive and sexual health history and preventative behaviors, mental health and mental health treatment, substance abuse, and workplace violence. This aim was accomplished by analyzing data collected from in-depth interviews of adult MSFW regarding prevention of pregnancy and sexually transmitted infections, prenatal care, screening behaviors (i.e., cervical, breast, prostate cancer), mental health conditions and treatment, substance abuse (alcohol, illicit drugs, tobacco), and workplace violence including that associated with on the job alcohol consumption

The second specific aim was to investigate factors associated with reproductive and sexual health history and preventative behaviors, mental health and mental health treatment. This aim was carried out analyzing their association with participant sociodemographic, lifestyle, acculturation, and other predictors. It was hypothesized that age, poverty, low education, and other factors associated with low acculturation reduce health–related knowledge including the importance of cancer screening and other preventative health behaviors.

Methods

This study was part of a larger survey that investigated the health and nutrition of MSFW working in the Paso del Norte region. A site – based convenience sampling strategy was used to recruit prospective MSFW households. Prospective participants aged > 18 years who had performed paid farm work during the prior 12 – months and who did not have any sensory/developmental conditions that would interfere with their ability to understand and answer questions were eligible for participation. The data were collected from participants during face to face interviews using a modified version of the California Agricultural Worker Health Survey (CAWHS) main instrument and CAWHS male and female health supplements (CIRS, 2002). These contained both closed- and open-ended questions. Categorical data were described as % (n) or % (nl sample size) in cases where a subset of the study sample is used. Continuous data were described as means ± standard deviations (SD). Bivariate analysis of the differences between proportions was assessed using 2 x 2 contingency table, analyses with corrected X2 or Fisher's exact test, as appropriate. Students' independent t – test or oneway ANOVA were used to analyze mean differences. Content analysis was employed to analyze the qualitative data from the open –ended questions

Results

The 141 Hispanic study participants were mostly middle-aged ( = 42 ± 14.3 yrs; range 18-84 yrs). A majority were Mexican-born (87.2%) males (61.7%) with little formal education (6.2 ± 3.1 yrs) who had worked an average of 18.8 ± 11.7 years in the U.S. agricultural system (range: 0.8-58 yrs). Two-thirds (67.4%) reported that they were permanent residents of El Paso or Dona Ana counties. Only one – quarter of sexually active participants reported that they/their partners used protection against STI's, mostly male condoms. Non – married participants were more likely than married ones to use protection (P=0.004) as were more recent immigrants from Mexico (P=0.048). Fewer than half (43.3%) of the reproductive age participants reported that they used a pregnancy prevention method. Of these, most relied upon the male condom (31.5%), female sterilization (28.8%), or oral contraceptives to prevent pregnancy (21.9%). The single most frequent reason given for non – use of STI or pregnancy prevention methods was that the participant and/or their partner(s) don't like them or the side effects they cause.

The respective prevalence of lifetime cervical and breast cancer screening was relatively high, i.e., 87% and 61.1%. The two major reasons given by women who had never been screened for cervical or breast cancer was that they didn't like/want the exam and high cost. Only a small minority of men (14.9%) reported that they had ever been screened for prostate cancer. The major reasons that they gave for not undergoing prostate cancer screening was that they were too young or otherwise didn't need it (40.7%), they didn't have enough money, time, or access to health care in order to get it (22.2%), they lacked information on the exam (18.5%), or that they just did not want to have it (11.1%).

One – half (53.9%) of the study participants reported being current drinkers; 13% of these drank most days of the week. One-quarter reported they presently smoked cigarettes or used illicit drugs (6%), mostly marijuana and cocaine. One – sixth of participants reported that they had been diagnosed by a health professional as having a mental health condition, the most common of which was depression (14.2%). Two percent also report suicidal ideation within the past 12-months. Seven percent reported a personal experience of workplace violence some of which was due to on-the-job drinking in the agricultural fields.

Conclusions and Recommendations

The predominantly middle-aged Hispanic border MSFW in this study appeared to be at potential risk for STI's and unintended pregnancy. On the other hand, the prevalence of lifetime and recent cervical cancer screening, and to a lesser extent, breast cancer screening, was higher than that reported for many other farmworker groups. In contrast, the low prevalence of prostate screening among mostly middle-aged male group is of concern. Excessive use of alcohol including at their job sites places workers at risk for workplace violence and alcohol – related injuries and accidents. The data from this study can be used to develop health education and promotion interventions that are specific to this special immigrant occupational group.

Language

en

Provenance

Received from ProQuest

File Size

64 pages

File Format

application/pdf

Rights Holder

Claudia Delilah Saenz

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