Focusing the needs of highly vulnerable women: Freelisting as a needs assessment technique

The protection of migrating people is a currently escalating challenge in public health. The social and political environment of the U.S. – Mexico border has served to further isolate migrating women, deepening their risk to harm in critical circumstances. Freelisting is suggested as a theoretically sophisticated and easily implemented methodology frequently used by social scientists to collect information from vulnerable and hard to reach populations. This study explores freelisting as a means to capture the way migrating women express and evaluate their unique risks to personhood as they attempt to cross the border between Mexico and the United States. While comprehensive public health planning is limited by the ability of practitioners to capture the experiences of those most vulnerable, cross-disciplinary approaches to conducting needs assessments are poised to engage individual-level assessments of risk among highly vulnerable groups as a means of informing policies that are well-aligned with the goals of Healthy People 2010 and with the international conventions affirming the rights of migrants and women. As an area facing multiple challenges ecologically and politically, the situation on the U.S. – Mexico border between Sonora and Arizona is such that increasing risks to life and health are creating vacuums of vulnerability, isolating migrating women beyond reach. As public health policies develop to address the specific needs of vulnerable populations through participatory and cross-disciplinary partnerships, it is vitally important to consider how researchers and policy-makers can adequately assess the unique risks facing migrating women, and translate these understandings into harm-mitigating strategies.