Achieving Equity in Farmworker Health Through Community-Led Research

摘要 亚利桑那州尤马市和全国各地的农场工人面临着许多社会和健康风险，这些风险源于农场工作的性质和管理它的劳动法。农活是一种体力劳动和低工资劳动，白天非常长，暴露在环境中，没有加班或病假工资。很少有农场工人有医疗保险。农业工作的季节性导致夏季失业率达到创纪录水平，增加了农场工人及其家庭的经济压力。因此，农场工人遭受高工伤和高发病率、压力和抑郁以及慢性病的困扰。在数十年为农场工人社区提供服务的基础上，Campeinos Sin Fronteras(CSF)将使用以社区为基础的参与式研究方法来制定、实施和评估干预措施，解决与1)劳动实践有关的结构性因素；2)住房质量和负担能力；以及3)农场工人社区的医疗保健机会。在实现农民工健康公平项目中，CSF将与一个学术研究伙伴合作，利用其与不同的多部门组织的现有关系，召开一个健康公平研究大会(HERA)，该大会将监督研究过程的所有方面。CSF社区卫生工作者(CHWS)将通过一系列参与性参与战略招募农场工人参与研究过程。将使用社区主导和参与者响应的定性和定量方法评估整个社区在结构因素和健康成果方面的变化。在分析健康的结构性决定因素以及制定和实施干预措施时，HERA成员将建设他们在解决农场工人健康问题方面的研究能力和结构性能力。

ABSTRACT Farmworkers in Yuma, Arizona, and across the nation face numerous social and health risks stemming from the nature of farmwork and the labor laws that govern it. Farmwork is physically punishing and low-wage labor, with extremely long days, environmental exposures, and no overtime or sick pay. Few farmworkers have health insurance. The seasonal nature of farmwork results in record levels of summer unemployment, increasing the economic stress on farmworkers and their families. As a result, farmworkers suffer from high work-related injury and illness rates, stress and depression, and chronic disease. Building on decades of service to the farmworker community, Campesinos Sin Fronteras (CSF) will use a community-based participatory research approach to develop, implement and evaluate an intervention addressing structural factors related to 1) labor practices; 2) housing quality and affordability; and 3) health care access for the farmworker community. In the Achieving Equity in Farmworker Health project, in collaboration with an academic research partner, CSF will leverage its existing relationships with diverse, multi-sector organizations to convene a health equity research assembly (HERA) that will oversee all aspects of the research process. CSF Community health workers (CHWs) will enlist farmworkers in the research process through a series of participatory engagement strategies. Community-wide changes in structural factors and health outcomes will be evaluated using community-led and participant-responsive qualitative and quantitative methods. In analyzing structural determinants of health and developing and implementing the intervention, HERA members will build their research capacity and structural competence in addressing health issues among farmworkers.