The Intersection of Workplace and Environmental Exposure on Health in Latinx Farm Working Communities in Rural Inland Southern California.

Workplace and environmental exposures pose health risks for racial/ethnic minorities in rural agricultural communities, placing them at a disadvantage in accessing needed health care. Over three fourths (76%) of the 2.4 million farmworkers in the United States are immigrants, mostly from Mexico. However, little is known of the community health concerns and barriers to care of Latinx farmworkers in inland southern California. This qualitative study used a community-based participatory research approach, conducting nine in-home meetings to obtain meaningful community input on health concerns and barriers to access healthcare services among rural residents of the Eastern Coachella Valley, who are also located near the desert-bound Salton Sea of inland southern California. All interviews were audio-recorded and analyzed via listening to the audio recordings and summarizing data in templates and matrices. Participants discussed health concerns related to agricultural labor, including heat-related illness, musculoskeletal ailments and injuries, skin disorders, respiratory illness, and trauma. Participants raised concerns about environmental exposures related to agriculture and the nearby Salton Sea, a highly saline lakebed, and proposed solutions to improve the health of their communities. The findings from this study suggest farmworkers are aware of the health risks posed by living and working in rural farmlands but lack resources and information to act upon and advocate for improved public health.

Using Deliberative and Qualitative Methods to Recommend Revisions to the Medicaid Sterilization Waiting Period.

BACKGROUND: Sterilization is used by one-quarter of women in the United States for contraception and is a preferred birth control method among women with Medicaid. A history of coercive sterilization practices in the United States led to federal regulation of consent for Medicaid sterilization (including a mandated waiting period); this regulation can be a barrier to sterilization in Medicaid-insured women. This study aimed to develop a revised model of Medicaid sterilization policy grounded in the experiences of women impacted by current regulations. METHODS: This prospective study used in-depth interviews with 32 Medicaid-insured women who had obtained or tried to obtain sterilization to elicit recommendations regarding the Medicaid waiting period. Deliberative methods (a planning cell including 20 key community stakeholders) were used to evaluate women's recommendations and propose a revised policy for sterilization under Medicaid. RESULTS: In-depth interview data demonstrated that women were often not made aware of the 30-day waiting period during informed consent before sterilization. Once informed about the policy, women described the Medicaid waiting period as "unfair," because it did not apply to all women. After deliberating women's recommendations to change the policy, key stakeholders came to a consensus around replacing the current waiting period policy with an improved consent process that would acknowledge the problematic history of coercive sterilization. Participants could not endorse removing the waiting period altogether without evidence that the health system had shifted away from coercive sterilization practices. CONCLUSIONS: Using deliberative methods and the recommendations of women with Medicaid insurance, community stakeholders recommended developing a revised Medicaid sterilization consent policy that acknowledged the historical context of this procedure.

Inequality and health among foreign-born latinos in rural borderland communities.

Thousands of Mexicans and Central Americans settle in communities along the borderlands between Mexico and the United States. Many live and work in rural communities characterized by poverty and limited access to basic resources. Drawing on qualitative research, this article reports on inequalities and health among foreign-born Latinos in rural borderland communities. From 2015 to 2016, the study team conducted research in Inland Southern California's Eastern Coachella Valley with Mexican farmworkers, farmworker advocates, community leaders, healthcare service providers, and local political leaders. The analysis of field notes and interviews demonstrates how situational and temporal factors position this foreign-born population as vulnerable to inequalities across multiple social systems resulting in low social status, lack of employment and housing stability, and limited access to healthcare services. Over time, the experience of both situational life events and persistent and daily chronic strain infringes on self-concept, including mastery or control over life and self-worth, and contributes to stress and subsequent poor mental health outcomes (e.g., depression). The research calls for local community action, healthcare policy change, and further in-depth research on structural inequalities in health among foreign-born Latinos.

Psychometric Properties of the Resilience Inventory for Pregnant Mexican Women / Propiedades Psicometricas del inventario de Resiliencia para Mujeres embarazadas Mexicanas

La resilencia ha estado relacionada a la salud mental durante el período perinatal. Sin embargo, hasta donde sabemos, no hay intrumentos para medir la resilencia que hayan sido validados en esta población. El propósito de este estudio fué examinar las propiedades psicométricas del Inventario de Resilencia en mujeres embarazadas mexicanas. Se evaluó una muestra de 280 mujeres usando el Inventario de Resilencia, el Cuestionario de Salud del Paciente y un cuestionario de situaciones de estrés. El coeficiente de confiabilidad del Inventario de Resilencia fué de 0.88 para la escala completa. El análisis factorial exploratorio resultó en una estructura de resilencia de tres factores (capacidad personal, religiosidad y actitud positiva) para mujeres embarazadas. La validez consistente fué respaldada por correlaciones negativas con síntomas prenatales depresivos y situaciones de estrés. El Inventario de Resilencia podría ser potencialmente una medida fiable válida. Es necesario continuar explorando el rol de la resilencia en el período perinatal e identificar los factores que la determinan.

Resilience has been related to mental health during the perinatal period. However, to our knowledge, there are no instruments for measuring resilience that have been validated in this population. The purpose of this study was to examine the psychometric properties of the Resilience Inventory in Mexican pregnant women. A sample of 280 women was evaluated using the Resilience Inventory, Patient Health Questionnaire and a stressful life events questionnaire. The reliability coefficient of the Resilience Inventory was 0.88 for the complete scale. Exploratory factor analysis resulted in a three-factor structure of resilience (personal competence, religiosity and positive attitude) for pregnant women. Concurrent validity was supported by negative correlations with prenatal depressive symptoms and stressful life events. The Resilience Inventory could potentially be a valid reliable measure. It is necessary to continue exploring the role of resilience in the perinatal period and identify the factors that shape it.