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No US Medical Care for Sick Farmworkers

No US Medical Care for Sick Farmworkers. Louise S. Ward, CRNP, Ph.D. Postdoctoral Research Fellow International Center of Research for Women, Children and Families School of Nursing University of Pennsylvania. Problem. Farmworker health important public health issue

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No US Medical Care for Sick Farmworkers

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  1. No US Medical Care for Sick Farmworkers Louise S. Ward, CRNP, Ph.D. Postdoctoral Research Fellow International Center of Research for Women, Children and Families School of Nursing University of Pennsylvania

  2. Problem • Farmworker health important public health issue • Population at risk for poor health outcomes • Federally funded Migrant Health Centers available • Many farmworkers do not use U.S. health services • May go without care • May self-treat • May return to country of origin

  3. Purpose • To describe factors that predict farmworkers’ not using U.S. medical care once health problem/ injury has been identified. • Biogenetic • Social • Cultural • Economic • Access-related

  4. Model Model derived from literature; supported by dissertation research

  5. Method: NAWS • 1998 Public Access data from National Agricultural Workers Survey • Representative sample of US farmworkers • Trained interviewers • Recruit workers @ job site and interview @ home • Hispanic workers who had identified health problems, pesticide problems, or injuries (n = 483)

  6. Method: Variables • Variables used directly from data or constructed from those available • Two proxies for working conditions: pay for ride, pay for equipment • US Medical care defined as public health department, Community Health Center, private physician, ER, hospital, or migrant clinic • All others = “no US medical care when sick”

  7. Findings: Sample • Mean age 34.3 years • 76% male • 62% married • Averaged 11 years in US farm work • Highest grade 6.3 • 57% legally documented • 41% spoke no English • Family income $9,500

  8. Findings: Logistic Regression Model

  9. Findings Farmworkers were LESS likely to receive care if they were • Men (half usage rate of women) • Workers who follow crops (1.8X) • Working with poor working conditions (2.5X) • More literate • Experiencing barriers • Unaccustomed to using government services (Medicaid, WIC)

  10. Discussion • Special attention to outreach • To men • To “follow-the-crop” workers • To those at farms where working conditions known to be poor • Nurses can reduce barriers • Language • Acceptance • Clinic hours • Universal, federally funded health coverage

  11. Acknowledgments • Dissertation chair A. Serdar Atav, Ph.D. and committee members Joyce Ferrario, RN, Ph.D. and David Brown, Ph.D. for advice and encouragement • T32 grant # T32 NR007100-06for support • T32 fellows and faculty at Penn for review

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