An ethnographic study of the social context of migrant health in the United States
An ethnographic study of the social context of migrant health in the United States
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DOI：
10.1371/journal.pmed.0030448
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发表时间：
2006-10-01
期刊：
影响因子：
15.8
通讯作者：
Holmes, Seth M.
中科院分区：
文献类型：
--
作者：
Holmes, Seth M.
背景美国的移民工人健康状况极差。本文旨在确定的方式，在社会背景下的移民农场工人影响他们的健康和healthcare.Methods和结果-这定性研究采用了参与观察和访谈农场和诊所在整个15个月的移民与一组土著Triqui墨西哥人在美国西部和墨西哥。研究参与者包括130多名农场工人和30名临床医生。数据分析利用扎根理论，伴随着结构性暴力，象征性暴力和临床凝视的理论。研究表明，农场工作和住房条件是根据族裔和公民身份组织的。这种等级制度决定了健康的不平等，无证土著墨西哥人的健康状况最差。然而，每个群体都被理解为值得在等级制度中占有一席之地，移民农场工人往往被指责为自己的sickness.Conclusions结构性种族主义和反移民的做法决定了恶劣的工作条件，生活条件和健康的移民工人。微妙的种族主义有助于降低所有相关人员（包括临床医生）对这一社会背景的认识。本文最后提出了改善流动人口健康的四个方面的策略：健康差异研究、与流动人口的临床互动、医学教育和政策制定。
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.