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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

Triqui People Bent Over Picking Strawberries in Washington StateTriqui laborers picking strawberries on the Tanaka Farm in Washington state.
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pmed-0030448-g007: Triqui People Bent Over Picking Strawberries in Washington StateTriqui laborers picking strawberries on the Tanaka Farm in Washington state.

Mentions: Strawberry pickers must bring in 50 pounds of de-leafed berries every hour. Otherwise, they will be fired and kicked out of the camp. In order to meet this minimum weight requirement, they take few or no breaks from 5:00 a.m. until the afternoon or evening when that particular field is completed. Often, they are reprimanded nonetheless and called perros (dogs), burros (burros), Oaxacos (a derogatory term for “Oaxacan”), or indios estupidos (stupid Indians). Many do not eat or drink anything before work so that they do not have to take time to use the outhouse. They work as hard and fast as they can, picking and running with their buckets of berries to the white teen checkers. Meanwhile, the white teenagers stand to the side, talking and laughing, sometimes throwing berries at each other in jest, and occasionally hurling berries at Triqui pickers with statements made at high volume such as, “Eat it!,” or simply, “No!”(Figure 6). One of the first Triqui pickers the investigator came to know, named Abelino, explained the experience of picking in the following way (Figure 7):


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

Holmes SM - PLoS Med. (2006)

Triqui People Bent Over Picking Strawberries in Washington StateTriqui laborers picking strawberries on the Tanaka Farm in Washington state.
© Copyright Policy
Related In: Results  -  Collection

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

pmed-0030448-g007: Triqui People Bent Over Picking Strawberries in Washington StateTriqui laborers picking strawberries on the Tanaka Farm in Washington state.
Mentions: Strawberry pickers must bring in 50 pounds of de-leafed berries every hour. Otherwise, they will be fired and kicked out of the camp. In order to meet this minimum weight requirement, they take few or no breaks from 5:00 a.m. until the afternoon or evening when that particular field is completed. Often, they are reprimanded nonetheless and called perros (dogs), burros (burros), Oaxacos (a derogatory term for “Oaxacan”), or indios estupidos (stupid Indians). Many do not eat or drink anything before work so that they do not have to take time to use the outhouse. They work as hard and fast as they can, picking and running with their buckets of berries to the white teen checkers. Meanwhile, the white teenagers stand to the side, talking and laughing, sometimes throwing berries at each other in jest, and occasionally hurling berries at Triqui pickers with statements made at high volume such as, “Eat it!,” or simply, “No!”(Figure 6). One of the first Triqui pickers the investigator came to know, named Abelino, explained the experience of picking in the following way (Figure 7):

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