Research Employing Environmental Systems and Occupational Health Policy Analyses to Interrupt the Impact of Structural Racism on Agricultural Workers and Their Respiratory Health (RESPIRAR)

利用环境系统和职业健康政策分析来中断结构性种族主义对农业工人及其呼吸系统健康的影响的研究（RESPIRAR）

• 批准号: 10689054
• 负责人: Devon C Payne-Sturges
• 金额: $ 72.78万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10689054
• 关键词: 2019-nCoV; Address; Advocate; Affect; Agricultural Workers; Agriculture; Automobile Driving; Black race; COVID-19; COVID-19 disparity; COVID-19 impact; COVID-19 outbreak; COVID-19 pandemic; Communicable Diseases; Communities; County; Crowding; Crows; Decision Making; Detection; Disparity; Employment; Environment; Environmental Health; Equity; Ethnic Population; Exclusion; Exposure to; Farm; Fright; Goals; Government; Hand; Health; Health protection; Healthcare; Housing; Hygiene; Immigration; Indoor Air Quality; Industry; Inequity; Institution; Interruption; Latinx; Laws; Legal; Linguistics; Longitudinal Studies; Medical; Migrant; Modeling; Occupational Health; Outcome; Pathway interactions; Pattern; Pilot Projects; Policies; Policy Analysis; Policy Maker; Policy Making; Population; Population Surveillance; Preventive care; Preventive measure; Process; Public Health; Public Housing; Quasi-experiment; Race; Regulation; Reporting; Research; Research Design; Research Priority; Respiratory Disease; Risk; Role; SARS-CoV-2 B.1.617.2; Safety; Seasons; Shapes; Social Distance; Social Policies; Statistical Data Interpretation; Structural Racism; Structure; System; Technical Expertise; Testing; Time; United States; United States National Institutes of Health; Virus; Vision; Vulnerable Populations; Water; Work; built environment; care outcomes; care seeking; design; disorder risk; dynamic system; farm worker; future outbreak; future pandemic; health care availability; health care disparity; health inequalities; innovation; interdisciplinary approach; lens; marginalization; minority health; minority health disparity; multidisciplinary; novel; prevent; public health intervention; racial health disparity; racial population; racism; respiratory health; respiratory virus; response; segregation; social; theories; trend

Structural racism (SR) has been defined as the macro level systems, social forces, institutions, ideologies, and processes that interact with one another to generate and reinforce inequities among racial/ethnic groups. The mechanisms of SR are “unseen” and thus understudied and typically not incorporated into public health interventions. For example, 2.5 million hired farmworkers in the U.S., who overwhelmingly are Black and/or Latinx, live in economically segregated communities with substandard and crowded housing conditions, unsafe or limited water that render COVID-19 preventive measures such hand hygiene and social distancing challenging, if not impossible. Additionally, migrant and seasonal farmworkers (MSFWs) are among the lowest paid, lack access to health information, preventive care and medical treatment. These patterns of vulnerability reflect historical exclusion, motivated by anti-Black racism, of farmworkers from federally protected right to organize and other labor protections, labor practices traced to the Jim Crow era, and an immigration and labor policy environment in which MSFWs avoid reporting illness or seeking care for fear of retaliation from employers. COVID-19 has only exacerbated these vulnerabilities; outbreaks of COVID-19 have been reported among farmworkers and agricultural counties in the U.S. have seen disproportionately high rates of COVID-19. Structures of marginalization of MSFWs are not widely considered through the lens of SR. To better protect the health of Black and/or Latinx MSFWs and design an equitable response to the inevitable next pandemic, research is needed to understand and dismantle the structural and institutional drivers of health inequities. Our proposed work aims address this critical need through an innovative community-driven, multilevel and multidisciplinary approach study to: examine the relationships between migrant labor housing policy regimes, indoor air quality, exposure to viruses (e.g., SARS-CoV-2) and respiratory health of MSFWs over time (Aim1); characterize structural pathways through which COVID-19 policy and regulatory responses interact and influence racialized health outcomes among MSFWs through a community-based system dynamics group modeling approach (Aim2); and evaluate the influence of agricultural migrant employment, public health and housing law and policy on COVID-19 epidemics across selected agricultural states using a quasi-experimental study design (Aim 3). These aims address two NIH research priorities:1) understand the impact of SR on minority health and health disparities and 2) inform health care and social policies at all levels on mitigating SR’s impacts on the health of vulnerable populations. Results from our proposed study will inform the design of policies and best practices to counter long-standing mechanisms of SR impacting MSFWs, optimize living and working conditions for better health protections and to control future outbreaks of infectious disease among these invisible and vulnerable workers.

结构性种族主义（SR）被定义为宏观层面的制度、社会力量、制度、意识形态和 相互影响而产生并加剧种族/族裔群体之间不平等的过程。这 SR 机制是“看不见的”，因此研究不足，通常不会纳入公共卫生 干预措施。例如，美国有 250 万雇佣农场工人，其中绝大多数是黑人和/或 拉丁裔，生活在经济隔离的社区，住房条件不合格且拥挤，不安全 或有限的水，以采取手部卫生和社交距离等 COVID-19 预防措施 即使不是不可能，也是具有挑战性的。此外，移民和季节性农场工人 (MSFW) 属于最低水平之列。 付费，无法获得健康信息、预防保健和医疗。这些脆弱性模式 反映了历史上出于反黑人种族主义的动机，农场工人被排除在联邦保护的权利之外 组织和其他劳工保护、劳工实践可追溯到种族隔离时代，以及移民和劳工 无国界医生因害怕遭到报复而避免报告疾病或寻求护理的政策环境 雇主。 COVID-19 只会加剧这些脆弱性；据报道有 COVID-19 疫情爆发 美国农场工人和农业县的 COVID-19 感染率异常高。 MSFW 的边缘化结构并未通过 SR 的视角得到广泛考虑。为了更好地保护 黑人和/或拉丁裔 MSFW 的健康，并针对不可避免的下一次大流行设计公平的应对措施， 需要进行研究来了解和消除健康不平等的结构性和制度性驱动因素。我们的 拟议的工作目标通过创新的社区驱动、多层次和 多学科方法研究：审查移民劳工住房政策制度之间的关系， 随着时间的推移，室内空气质量、接触病毒（例如 SARS-CoV-2）和无家可归工人的呼吸系统健康状况（目标 1）； 描述 COVID-19 政策和监管反应相互作用的结构路径 通过基于社区的系统动力学小组影响 MSFW 的种族化健康结果 建模方法（目标2）；评估农业转移人口就业、公共卫生和健康状况的影响 使用准实验性方法，在选定的农业州制定有关 COVID-19 流行病的住房法和政策 研究设计（目标 3）。这些目标涉及 NIH 的两个研究重点：1) 了解 SR 对 少数群体的健康和健康差异，以及 2) 为各级医疗保健和社会政策提供有关缓解的信息 SR 对弱势群体健康的影响。我们提出的研究结果将为设计提供信息 政策和最佳实践，以应对影响 MSFW 的 SR 长期机制，优化生活和 工作条件，以更好地保护健康并控制未来传染病的爆发 这些看不见的、脆弱的工人。