240723 Empowering MSFW Female Reproductive Health through Goverment Intervention: A Policy Strategy for State Offices of Rural Health

Monday, October 31, 2011

Grace Iona Jama-Adan, MPH, CHES , Woodruff Health Sciences Center, Emory University, Atlanta, GA
Winifred W. Thompson, PhD, MSW , Department of Behavioral Sciences and Health Education Rollins School of Public Health, Emory University Winship Cancer Institute at Grady Health System, Atlanta, GA
The Department of Health and Human Services prioritized rural health as early as the mid-20th century by gradually incorporating state-level offices of rural health. The goal of this document is to draw attention to the reproductive health outcomes of MSFW (migrant and seasonal farm worker) women, whom represent 20% of the MSFW population in the United States. Throughout a MSFW woman's adult life span, epidemiologic evidence highlights reproductive cancers, HIV/AIDS, domestic violence, infant mortality, and sexual assault as reproductive health disparities she may face during her life in the United States. These roughly 700,000 women nationwide can see improved access to healthcare through policy change enacted at the state level of government, which can counteract the triple bind of having immigrant status, being female, and living in a rural area. The availability of health promotion services for MSFW women can be enhanced by prioritizing health education programming provided by lay health workers and clinicians within both farm workplaces and in Migrant Health Centers. State offices of rural health are key stakeholders in such an initiative, and can oversee the implementation of such primary, secondary, and tertiary prevention measures. Collaborative efforts among clinicians, state offices of rural health, lay health workers, and farm employers are explored in this policy strategy by reexamining the Migrant Health Act of 1962, the Migrant and Seasonal Agricultural Worker Protection Act, and Section 330 of the Public Health Service Act. The MSFW female population is not currently addressed in federal women's health legislation or within nationwide governmental women's health promotion program initiatives. Thus, it is appropriate for rural health governmental entities to be cognizant of the relevance of immediate policy analysis in improving the health status of this vulnerable immigrant population.

Learning Areas:
Advocacy for health and health education
Chronic disease management and prevention
Occupational health and safety
Protection of the public in relation to communicable diseases including prevention or control
Public health or related laws, regulations, standards, or guidelines
Social and behavioral sciences

Learning Objectives:
1. Assess strategies for state rural health offices to allocate cost-efficient funding for operational expenses of Migrant Health Centers. 2. Identify collaborative methods lay health workers, rural clinical professionals (physicians and nurses), farm employers, and state rural health offices can use to plan and implement health education programming aimed at primary and secondary prevention in the workplace. 3. Identify collaborative methods lay health workers, rural clinical professionals (physicians and nurses), and state rural health offices can use to plan and implement health education programming aimed at tertiary prevention within Migrant Health Centers. 4. Analyze the scope of three pieces of legislation devised in the 20th century, which require revisions in order to incorporate the unique needs of MSFW women who deal with the structural barriers of racism, sexism, classism, and nativism. 5. Differentiate between the (reproductive) health risk factors affecting migrant farm worker women versus seasonal farm worker women. 6. List the six public health concerns for optimal reproductive health among MSFW women (three chronic diseases; three other health disparities affecting MSFW women’s natal outcomes). 7. Explain why behavioral change is limiting as a tool in prevention of MSFW women’s reproductive health concerns. 8. Compare the predisposing and enabling behavioral factors affecting MSFW female reproductive health across both the traditional domain and vulnerable domain using the Behavioral Model for Vulnerable Populations (Andersen-Gelberg-Leake). 9. Discuss areas for future research on MSFW women’s health, which will need to explore the currently underrepresented needs of non-Latina/Hispanic MSFW women in the United States.

Keywords: Migrant Farm Workers, Reproductive Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed my MPH program in Behavioral Sciences and Health Education last May, where I learned through a course on ethnoracial health disparities the importance of policy strategies for public health planning and acquired the skills to develop this paper.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.