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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

Conceptual Diagram of Hierarchies on the Farm
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Related In: Results  -  Collection


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pmed-0030448-g010: Conceptual Diagram of Hierarchies on the Farm

Mentions: Figure 10 summarizes, utilizing a conceptual diagram, many of the themes resulting from this field research. The y-axis represents respect, health, financial security, and control over one's own time as well as control over others' labor. The various columns along the x-axis show differences among types of work, citizenship statuses, languages, and ethnic groups. Gender is another important variable that is not considered here due to space constraints, but should be examined further in future research.


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

Holmes SM - PLoS Med. (2006)

Conceptual Diagram of Hierarchies on the Farm
© Copyright Policy
Related In: Results  -  Collection

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

pmed-0030448-g010: Conceptual Diagram of Hierarchies on the Farm
Mentions: Figure 10 summarizes, utilizing a conceptual diagram, many of the themes resulting from this field research. The y-axis represents respect, health, financial security, and control over one's own time as well as control over others' labor. The various columns along the x-axis show differences among types of work, citizenship statuses, languages, and ethnic groups. Gender is another important variable that is not considered here due to space constraints, but should be examined further in future research.

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