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An ethnographic study of the social context of migrant health in the United States.

Holmes SM - PLoS Med. (2006)

Bottom Line: Structural racism and anti-immigrant practices determine the poor working conditions, living conditions, and health of migrant workers.Subtle racism serves to reduce awareness of this social context for all involved, including clinicians.The paper concludes with strategies toward improving migrant health in four areas: health disparities research, clinical interactions with migrant laborers, medical education, and policy making.

View Article: PubMed Central - PubMed

Affiliation: University of Birmingham, United Kingdom. seth.holmes@ucsf.edu

ABSTRACT

Background: Migrant workers in the United States have extremely poor health. This paper aims to identify ways in which the social context of migrant farm workers affects their health and health care.

Methods and findings: This qualitative study employs participant observation and interviews on farms and in clinics throughout 15 months of migration with a group of indigenous Triqui Mexicans in the western US and Mexico. Study participants include more than 130 farm workers and 30 clinicians. Data are analyzed utilizing grounded theory, accompanied by theories of structural violence, symbolic violence, and the clinical gaze. The study reveals that farm working and housing conditions are organized according to ethnicity and citizenship. This hierarchy determines health disparities, with undocumented indigenous Mexicans having the worst health. Yet, each group is understood to deserve its place in the hierarchy, migrant farm workers often being blamed for their own sicknesses.

Conclusions: Structural racism and anti-immigrant practices determine the poor working conditions, living conditions, and health of migrant workers. Subtle racism serves to reduce awareness of this social context for all involved, including clinicians. The paper concludes with strategies toward improving migrant health in four areas: health disparities research, clinical interactions with migrant laborers, medical education, and policy making.

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Related in: MedlinePlus

Map of Migration RouteThis map shows the route of migration field research followed by the anthropologist, from the Skagit Valley of Washington state to the central Valley of California, the mountains of Oaxaca, Mexico, the Arizona borderlands, and then back to central California and Washington state.(Illustration: Natalie Davis)
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pmed-0030448-g002: Map of Migration RouteThis map shows the route of migration field research followed by the anthropologist, from the Skagit Valley of Washington state to the central Valley of California, the mountains of Oaxaca, Mexico, the Arizona borderlands, and then back to central California and Washington state.(Illustration: Natalie Davis)

Mentions: The research was conducted along the lines of “follow the people” multi-sited fieldwork [39] full-time for 15 months throughout a migration circuit with a group of indigenous Triqui Mexicans starting in an agricultural community in Washington state, moving to central California, next moving to their hometown in the mountains of Oaxaca, migrating across the border into Arizona, and finally returning to Washington state (see Figure 1). Six months were spent living in a migrant camp, picking berries, as well as observing and interviewing in migrant clinics and hospitals in Washington state. Four months were spent living with Triqui migrant workers in a slum apartment, pruning vineyards, as well as observing and interviewing in migrant clinics and hospitals in central California. Four months were spent living with a family, planting and harvesting corn, and observing and interviewing staff in the local medical clinic in a village in the mountains of Oaxaca. One month was spent hiking through the desert, meeting with and interviewing Border Patrol agents, local residents, activists, and vigilante members in Arizona (Figures 1 and 2).


An ethnographic study of the social context of migrant health in the United States.

Holmes SM - PLoS Med. (2006)

Map of Migration RouteThis map shows the route of migration field research followed by the anthropologist, from the Skagit Valley of Washington state to the central Valley of California, the mountains of Oaxaca, Mexico, the Arizona borderlands, and then back to central California and Washington state.(Illustration: Natalie Davis)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC1621098&req=5

pmed-0030448-g002: Map of Migration RouteThis map shows the route of migration field research followed by the anthropologist, from the Skagit Valley of Washington state to the central Valley of California, the mountains of Oaxaca, Mexico, the Arizona borderlands, and then back to central California and Washington state.(Illustration: Natalie Davis)
Mentions: The research was conducted along the lines of “follow the people” multi-sited fieldwork [39] full-time for 15 months throughout a migration circuit with a group of indigenous Triqui Mexicans starting in an agricultural community in Washington state, moving to central California, next moving to their hometown in the mountains of Oaxaca, migrating across the border into Arizona, and finally returning to Washington state (see Figure 1). Six months were spent living in a migrant camp, picking berries, as well as observing and interviewing in migrant clinics and hospitals in Washington state. Four months were spent living with Triqui migrant workers in a slum apartment, pruning vineyards, as well as observing and interviewing in migrant clinics and hospitals in central California. Four months were spent living with a family, planting and harvesting corn, and observing and interviewing staff in the local medical clinic in a village in the mountains of Oaxaca. One month was spent hiking through the desert, meeting with and interviewing Border Patrol agents, local residents, activists, and vigilante members in Arizona (Figures 1 and 2).

Bottom Line: Structural racism and anti-immigrant practices determine the poor working conditions, living conditions, and health of migrant workers.Subtle racism serves to reduce awareness of this social context for all involved, including clinicians.The paper concludes with strategies toward improving migrant health in four areas: health disparities research, clinical interactions with migrant laborers, medical education, and policy making.

View Article: PubMed Central - PubMed

Affiliation: University of Birmingham, United Kingdom. seth.holmes@ucsf.edu

ABSTRACT

Background: Migrant workers in the United States have extremely poor health. This paper aims to identify ways in which the social context of migrant farm workers affects their health and health care.

Methods and findings: This qualitative study employs participant observation and interviews on farms and in clinics throughout 15 months of migration with a group of indigenous Triqui Mexicans in the western US and Mexico. Study participants include more than 130 farm workers and 30 clinicians. Data are analyzed utilizing grounded theory, accompanied by theories of structural violence, symbolic violence, and the clinical gaze. The study reveals that farm working and housing conditions are organized according to ethnicity and citizenship. This hierarchy determines health disparities, with undocumented indigenous Mexicans having the worst health. Yet, each group is understood to deserve its place in the hierarchy, migrant farm workers often being blamed for their own sicknesses.

Conclusions: Structural racism and anti-immigrant practices determine the poor working conditions, living conditions, and health of migrant workers. Subtle racism serves to reduce awareness of this social context for all involved, including clinicians. The paper concludes with strategies toward improving migrant health in four areas: health disparities research, clinical interactions with migrant laborers, medical education, and policy making.

Show MeSH
Related in: MedlinePlus