Transcript Slide 1

Lisbeth Iglesias-Rios, MS, LADAC
UT Health Sciences Center-STEER
2009
Objectives
 Brief historical context of immigration.
 Background and significance.
 Public health, environmental medicine and
policy implications.
 Strategies related to improved health care
access for farm workers.
 Conclusion.
Immigration Characteristics
 Context: past and current relations between
Mexico and the U.S.
 Type of immigration: circular, temporal or
permanent process.
 Social Networks (e.g. family & friends).
 Rural versus Urban areas from Mexico.
 First trip or several trips to the U.S.
 Level of enculturation and/or acculturation.
Background and Significance
Flower Petal Policy
 Social, Political &
Economical factors
 “I need you, I need you
not.”
 Law of supply and
demand
 Bracero Programs
 In early 1954, the
 Push factors & Pull
factors
American government
put in place “Operation
Wetback”
Social impacts
THINK ABOUT:
 What happens when migrants return home after
expanding their horizons and suffering traumas?
 What happens to their children in their absence?
 Children may be exposed to new opportunities but
also very tough social and psychological
environments and discrimination.
Overview
 12 million undocumented immigrants
(estimated) (Pew Hispanic Center, 2009).
 About 800,000 undocumented individuals
enter the U.S. per year under the current
immigration policy(Tarmann, 2005).
 The Mexican undocumented population
living in the U.S accounts for 7 million people
(Pew Hispanic Center, 2009).
Undocumented Population by Country or
Region of Birth
Estimated Undocumented Immigrants in
Texas
1.4 million and
1.6 million
Source: Pew Hispanic Center estimates based on March 2004 Current Population
Survey (Passel 2005) and 1990 Census.
Composition of the Undocumented
Population
Composition of the Undocumented
Population
General Demographic Characteristics
 High labor-force
participation rate (96%).
 Lower compensations.
 Undocumented
immigrants pay payroll
taxes and they contribute
$6–7 billion in Social
Security funds that they
will be unable to claim.
General Demographic Characteristics
 The vast majority of
undocumented
immigrant workers hold
blue collar jobs.
 50% of farm-workers in
the U.S. are
undocumented
immigrants.
 Farming has the highest
concentration of
undocumented workers
in Texas.
Public Health and Environmental
Medicine Implications
 The majority of Texas’
agricultural workers are
seasonal workers and are
some of the poorest
agricultural workers in the
nation.
• For 25 weeks a season, they
labor seven days a week, 10 to
14 hours per day, for an
average of $5,000-$7,000.
• Overwhelmingly uninsured.
Public Health and Environmental Medicine
Implications
 Nearly 60% of Texas farm workers reside in the four
southernmost counties of the Rio Grande Valley
 Most Valley farm workers live in rural colonias.
Public Health and Environmental
Medicine Implications
• Agriculture is the 2nd largest
industry in Texas, generating
$80 billion for the economy
annually.
• Agriculture consistently ranks
as one of the nation’s three
most hazardous industries.
Public Health and Environmental
Medicine Implications
 In an average year, 516 workers
in the United States die while
doing farm work and each day
about 243 workers suffer losttime injuries.
 The fatality rate for farming was
more than 7 times the overall
rate of 4.0 fatalities per 100,000
workers.
 The cost of farm-related injuries
is approximately more than five
billion dollars each year.
Public Health and Environmental
Medicine Implications
 Work‐related respiratory






and lung diseases from
exposure to pesticides.
Noise‐induced hearing loss.
Skin diseases (e.g. rashes).
Back pains from stooping
for long hours.
Heat exhaustion from sun
exposure.
Badly injured or amputated
limbs from machinery
accidents.
TB from sharing crowded
living quarters.
Risk Factors
 Racism and Discrimination
 Segregation
 Broad network of smugglers
(coyotes)
 Confront problems of social
adjustment and disruption
 Lack of sense of community
in the host country
 Susceptible to engage in
risky behaviors
Health Care Access and Barriers for
Undocumented Mexicans Immigrants
Critical factors that shape their relation with
the health care system are:
 Fear of deportation,
 Lack of health insurance,
 Language and cultural barriers,
 Lack of timely access to adequate health
care service interventions (preventive,
chronic, and acute) and options of health
care services as well as, quality of treatment.
Policy Implications and Strategies
Related to Health Care Access
 Progressive and comprehensive immigration
reform.
 Increasing affordable and comprehensive
health insurance access for minorities.
 Making cultural competency part of the
policy making, infrastructure, and daily
health care practice.
Policy Implications and Strategies
Related to Health Care Access
 To develop mutual aid
organizations or employing
immigrant health promoters
and outreach workers.
 Inter-state and bi-national
coordination and service
linkage that will allow
undocumented individuals
to continue to receive
uninterrupted services.
Policy Implications and Strategies Related
to Health Care Access
 Provide tax incentives for employers in low-skilled
industries and/or small businesses to provide
health insurance.
 Building “health care safety networks” to serve the
Latino population may decrease the fear
commonly reported by the undocumented
population of being discovered and deported by
Immigration Services.
Policy Implications and Strategies Related
to Health Care Access
 Bridge the gap between community members,
researchers, practitioners, stakeholders, and
policymakers.
 Empowerment and community basedparticipatory interventions.
 Key components while working with underserved
or excluded populations (Wallerstein, 2006).
Conclusion
 Multidisciplinary
work, partnership
and collaboration.
 Active support and
participation of the
whole immigrant
community.
Todos somos inmigrantes
We are all immigrants
Healthy workers keep us all healthy
• Immigrants and their children are our future
• They will be a major segment of the US
workforce in the coming years
THANK YOU!
Acknowledgements
 STEER Program: Dr. Miller, Pat Bortoni, Dr. Tapia, Dr.
Garza.
 UT Health Sciences Center-Regional Academic Health
Center: Faculty and Staff.
 Presenters from the STEER program.
 STEER colleagues
References












Levy, D. C., & Bruhn, K. (2006). Mexico: The Struggle for Democratic Development. Berkeley, LA: University
of California Press.
Passel, J. S. (2005, March 7). The Size and Characteristics of the Unauthorized Migrant Population in the U.S.
Estimates Based on the March 2005 Current Population Survey. Washington, DC: Pew Hispanic Center.
Pew Hispanic Center. (2004, March). Health Care Experiences. Pew Research Center Project, 1-5.
Pew Hispanic Center. (2007). Indicators from Recent Immigration Flows from Mexico. [Factsheet]. Pew
Research Center Project, 1-15.
Porter, E. (2005, April). Illegal Immigrants are Bolstering Social Security with Billions. The New York Times.
Retrieved on July 05, 2009, from http://www. nytimes.com/2005/04/05/business/05immigration.html
Posternak, M. A., and Zimmerman, M. (2005). Elevated rates of psychosis among treatment-seeking Hispanic
patients with major depression. Journal of Nervous and Mental Disease, 193, 66–69.
Ruiz-Beltran, M., Kamau, J. K. (2001). The socio-economic and cultural impediments to well-being along the
US-Mexico border. Journal of Community Health, 26, 123-132.
Rosenbaum, S., Shin, P. (2005). Migrant and seasonal farm workers: Health insurance coverage and access to
care. The Henry J. Kaiser Comission-Center for Health Services Research and Policy and The George
Washington University, 1-24.
Salgado de Snyder, V. N., González-Vázquez, T., Bojorquez-Chapela, I., Infante-Xibile, C. (2007).
Vulnerabilidad social, salud y migración México-Estados Unidos. Salud Pública de México, 49, 8-10.
Salgado de Snyder, V. N., Diaz-Perez, M de J., Acevedo, A., and Natera, L. X. (1996). Dios y el Norte: The
Perceptions of Wives of Documented and Undocumented Mexican Immigrants to the United States.
Hispanic Journal of Behavioral Sciences, 18, 283-296.
The Robert Wood Johnson Foundation. (2001 October-November). Hablamos Juntos: We Speak Together.
Wirthlin Worldwide, 1-11.
Wallerstein, N. (2006). What is the Evidence of Empowerment to Improve Health: Executive Summary,
World Health Organization, Geneva. Available at:
http://www.euro.who.int/HEN/Syntheses/empowerment/20060119_10