Objective. Homeless and migrant workers and their families work unseen in the barns and stables of Boston’s thoroughbred racetrack. Typical of “backstretch” workers who labor arduously on racetracks throughout the country under wretched and obscure conditions, this hard working group eschews public welfare and has no access to health care. Since 1993, the Boston Health Care for the Homeless Program has provided direct primary care and substance abuse services at the racetrack. Methods. A culturally-sensitive, bilingual MD/RN team conducts an onsite clinic after the morning chores are completed and before the races begin. Screening, immunizations, and episodic and primary care are offered in a small trailer adjacent to the stables. Referrals are made to BHCHP’s hospital-based clinic at Boston Medical Center, where this racetrack team holds regular clinic hours with access to the hospital’s laboratory, radiology, specialty, and inpatient services. Referrals are also facilitated to BHCHPs Dental Clinic. Results. 300 individuals received services from BHCHP’s racetrack team, with 831 total encounters during 1999. 248 (83%) were men and 52 (17%) female. 106 (35%) were white and 79 (26%) identified themselves as Latino, primarily from Central America. The average age was 43 years. The primary reasons for medical visits included immunizations and preventive care (14%), hypertension (13%), pulmonary illnesses (9%), and diabetes (7%). Conclusion. Primary and preventive care can be delivered to backstretch workers through an innovative outreach team that integrates direct care services at the racetrack with BHCHP’s continuum of medical, oral, and mental health care services
Learning Objectives: 1. Describe the life of backstretch workers in the barns and stables of thoroughbred racetracks in Boston and throughout the country. 2. Understand the special needs and barriers to health care services of this group of migrant and homeless workers
Keywords: Homeless Health Care, Migrant Workers
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.