Navigating the Waters of the US Healthcare System: Improving the Biopsychosocial Health of Fishing Industry Workers

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PROJECT SUMMARY/ABSTRACT Work-related injuries have been shown to predict physical illness, mental wellbeing, and substance misuse, and these latter factors are known contributors to high rates of occupational injury. This bidirectional relationship is particularly strong for people exposed to social determinants of health (SDoH) like dangerous work conditions and limited sick leave benefits, as well as those who lack ready access to preventive healthcare. One occupation suspectable to potentially high rates of injury and substance misuse is commercial fishing. Primary and secondary prevention interventions, such as increasing the use of healthcare navigators and emphasizing the SDoH have been shown to effectively improve biopsychosocial health disparities among historically marginalized populations. Healthcare navigators are connected to the community (e.g., wife or child of fishermen) and establish and maintain relationships with the participants who are receiving healthcare services or need assistance finding social services. A more nuanced paradigm can build on previous SDoH research that engages healthcare navigators to facilitate biopsychosocial well-being for fishermen, including studying the relationship between workplace hazards and substance misuse; screening for physical, psychological, and behavioral health problems; and referring to relevant healthcare professionals or paraprofessionals. Specifically, we will 1) examine the link between and mechanisms underlying occupational injuries and substance misuse to inform clinical needs by conducting semi-structured interviews and participant observation 2) implement and study the feasibility of healthcare navigators by identifying and addressing biopsychosocial factors that lead to increased injury and substance misuse, and 3) evaluate whether and how commercial fishermen use and access the healthcare navigators to reduce injury and substance use. In addition to extending collaborations among fishing partnership agencies on addressing injury and substance misuse, this is among the first projects to implement and evaluate the feasibility of using healthcare navigators with Gulf Coast shrimp fishermen to improve biopsychosocial health.