Why Do Farmworkers Delay Treatment After Debilitating Injuries Why Do Farmworkers Delay Treatment After Debilitating Injuries? If, When, and Why Farmworkers Are Treated for Injuries Shedra Amy Snipes, Ph.D., Assistant Professor Department of Biobehavioral Health Penn State University sas84@psu.edu

Thank You: The many farmers who have enriched my studies, and the world. “It is very nice to work in the field because all of the people that work in the field are producing food for the entire world. Because the entire world eats from the field and not from the offices, not from the warehouses, not from the stores, but from the field.” -Jose  

Our Time Overall Background (5 minutes) Research Exemplar (8 minutes) Food; Who are Farmworkers and Why Care? Injury for Hispanic Workers, Nationally Research Exemplar (8 minutes) Injury Narratives Why Workers Delay Treatment (Who) What Works Conclusions and Recommendations (2 Minutes)

Farmworkers play critical role in US food production

Farmworkers as Producers of Food Food and nutrition have been the foci of efforts to improve public health. In addition to nutritional content of food, the health of the people who produce it has emerged as a prominent health and social issue. Drawing on a broad range of social determinants of health.

Farmworkers as Producers of Food Food and nutrition have been the foci of efforts to improve public health. In addition to nutritional content of food, the health of the people who produce it has emerged as a prominent health and social issue. Drawing on a broad range of social determinants of health.

Background National Statistics on Injury

Injury and Latinos In 2012, the overall fatal injury rate for Hispanic workers across industries was higher than all other groups in the United States (Bureau of Labor Statistics, Byler, 2013). Even greater for Hispanic immigrants (non-US born). Lower for people who identify as Latino, but are US born (Bureau of Labor Statistics, Byler, 2013).

Injury and Latinos In 2012, the overall fatal injury rate for Hispanic workers across industries was higher than all other groups in the United States (Bureau of Labor Statistics, Byler, 2013). Even greater for Hispanic immigrants (non-US born). Lower for people who identify as Latino, but are US born (Bureau of Labor Statistics, Byler, 2013).

Injury and Latinos In 2012, the overall fatal injury rate for Hispanic workers across industries was higher than all other groups in the United States (Bureau of Labor Statistics, Byler, 2013). Even greater for Hispanic immigrants (non-US born). Lower for people who identify as Latino, but are US born (Bureau of Labor Statistics, Byler, 2013).

Study Example: Why do Farmworkers Delay Treatment After Debilitating Injuries? Thematic Analysis Explains If, When, and Why Farmworkers Were Treated for Injuries Thierry A.*, Snipes S.A. American Journal of Industrial Medicine 2015:58(2):178-92. doi:10.1002/ajim.22380. PMID: 25603940

A Mix of Issues: Injury rates among farmworkers are high Workers inconsistently seek out medical treatment after an injury. Treatment seeking associated with isolated injuries— particularly broken bones and eye injuries— which may have been perceived as more severe [Cooper et al., 2006; Brower et al., 2009].

Study Objectives: Weigel and Amijos (2011), 17% of farmworkers sought care for work injuries if they experienced injuries to multiple body parts rather than only one body part. Up to 75% of farmworkers receive care based in the injury context of persistent back injuries and 100% with persistent neck injuries [Wang et al., 2011].

Study Objectives: Together, this body of research shows two things: Treatment decisions are broad and not well characterized (there are inconsistencies in treatment-seeking). Care-seeking is dynamic and may be linked to specific injury circumstances.

Methods Data for this study were drawn from the National Agricultural Workers Survey (NAWS). The NAWS is an initiative of the US Department of Labor (DOL), and includes a nationally representative sampling of farmworkers in the US.

Findings

If Farmworkers Can Delay, They Will

Other Findings: The majority of injured farmworkers delayed treatment. Farmworkers who were employed by farm owners categorized as growers had a greater percentage of immediate treatment. Self treatment was highest for farmworkers who were employed by contractors.

Other Findings: One’ s employer providing healthcare coverage was not found to be associated with immediate treatment seeking. In fact, those farmworkers who indicated that they did not have healthcare provided for by their employer had a slightly greater percentage of overlap with the code for immediate treatment.

Other Findings: A greater proportion of text regarding self- treatment was indicated for women compared to men. Conversely, men had more coded text for immediate medical treatment seeking than women.

Other Findings: Those farmworkers paid by the piece had the least amount of coded text for delayed treatment.

Recommendations: Farmworkers’ first choice is to delay – despite pain. Other factors must be in place to encourage treatment. An environment where injuries are reported to supervisors encourages treatment, which may be associated with earlier return to work.

Thank you sas84@psu.edu