An informative blog about workers' compensation, risk management, business insurance, workplace health & safety, occupational medicine, injured workers, and related topics.
This webinar is the fifth in a series of seven in our Clinician Orienatation to Migration Health.
DATE RECORDED: Wednesday, June 12th, 2013
PRESENTED BY: Dr. Jennie McLaurin, MD, MPH, Specialist in Child and Migrant Health, Migrant Clinicians Network
To view the recorded version of this webinar, click here.
Much of the medical home model is predicated on a relatively stable population that can access regular care at a single network of providers. So how can this model effectively transfer to a mobile population? One of the key elements needed is a more expansive vision of a medical home beyond a single geographic location. This session will explore strategies to create a patient centered medical home for patients on the move. The session will include an update and overview of MCN’s Health Network to manage critical health care issues such as infectious disease, Cancer, Diabetes and Pre-natal patient navigations. Participants will also be engaged in a discussion around best practices in tracking outcomes and reporting test results to patients. Presenters will highlight innovative promising practices in the creation of patient centered medical homes for migrant patients.
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The Diabetes and Healthy Eyes Toolkit provides community health workers with tools to inform people with diabetes about diabetic eye disease and maintaining healthy vision. The toolkit has a flipchart that is easy to use in community settings and can be incorporated into existing diabetes classes or information sessions. It is available in English andSpanish.
California Poison Control System developed an online game that focuses on poison prevention through the use of "look-a-like" pills and candy. There are other resources on the site. The game is available as an app on itunes and in the android marketplace. Search for 'Choose your Poison.'
This website and training material were developed to give communities and promotores ways to help farm workers learn how to protect themselves from pesticide exposure.
The project and all materials on the website were developed by the California Poison Control System in collaboration with the the Western Center for Agricultural Health and Safety at the University of California, Davis and the California Department of Pesticide Regulation.
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- DPR_Facilitator_Manual_EN.pdf (4.77 MB)
- DPR_Participant_Manual_EN.pdf (4.91 MB)
Part 4 of 7 webinars in the CLINICIAN ORIENTATION TO MIGRATION HEALTH series.
DATE RECORDED: May 15, 2013
PRESENTERS: Amy K. Leibman, MPA, MA, Director of Environmental and Occupational Health, Migrant Clinicians Network
Dr. Mike Rowland, MD, MPH, Vice President, Medical Affairs and Medical Director, Occupational Health, Franklin Memorial Hospital
OBJECTIVES:
- Recognize the unique health risks of migrants due to their working conditions and environment
- Identify promising practices in environmental and occupational health that are feasible to implement in Migrant and Community Health Centers
- Utilize online clinical and patient education tools and resources to recognize, prevent and manage environmental and occupaional illnesses and injuries
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- EOHPrimaryCareProviders_webinar.pdf (4.37 MB)
Sherry L. Baron, MD, MPH, Sharon Beard, MS, Letitia K. Davis, ScD, EdM, Linda Delp, PhD, MPH, Linda Forst, MD, MPH, Andrea Kidd-Taylor, PHD, Amy K. Liebman, MPA, MA, Laura Linnan, ScD, Laura Punnett, ScD, and Laura S. Welch, MD
Background: Nearly one of every three workers in the United States is low-income. Low-income populations have a lower life expectancy and greater rates of chronic diseases compared to those with higher incomes. Low- income workers face hazards in their workplaces as well as in their communities. Developing integrated public health programs that address these combined health hazards, especially the interaction of occupational and non-occupational risk factors, can promote greater health equity.
Methods: We apply a social-ecological perspective in considering ways to improve the health of the low-income working population through integrated health protection and health promotion programs initiated in four different settings: the worksite, state and local health departments, community health centers, and community-based organizations.
Results: Examples of successful approaches to developing integrated programs are presented in each of these settings. These examples illustrate several complementary venues for public health programs that consider the complex interplay between work related and non work-related factors, that integrate health protection with health promotion and that are delivered at multiple levels to improve health for low-income workers.
Conclusions: Whether at the workplace or in the community, employers, workers, labor and community advocates, in partnership with public health practitioners, can deliver comprehensive and integrated health protection and health promotion programs. Recommendations for improved research, training, and coordination among health departments, health practitioners, worksites and community organizations are proposed.
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- final PDF.pdf (195.08 KB)
Carlos Eduardo Siqueira, MD, ScD, Megan Gaydos, MPH, Celeste Monforton, Dr PH, MPH, Craig Slatin, ScD, MPH, Liz Borkowski, BA, Peter Dooley, MS, CIH, CSP, Amy Liebman, MPA, MA, Erica Rosenberg, JD, Glenn Shor, PhD, MPP, and Matthew Keifer, MD, MPH
Background This article introduces some key labor, economic, and social policies that historically and currently impact occupational health disparities in the United States.
Methods We conducted a broad review of the peer-reviewed and gray literature on the effects of social, economic, and labor policies on occupational health disparities.
Results Many populations such as tipped workers, public employees, immigrant workers, and misclassified workers are not protected by current laws and policies, including worker’s compensation or Occupational Safety and Health Administration enforcement of standards. Local and state initiatives, such as living wage laws and community benefit agreements, as well as multiagency law enforcement contribute to reducing occupational health disparities.
Conclusions There is a need to build coalitions and collaborations to command the resources necessary to identify, and then reduce and eliminate occupational disparities by establishing healthy, safe, and just work for all.
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Sara A. Quandt, PhD, Kristen L. Kucera, PhD, Courtney Haynes, MS, Bradley G. Klein, PhD, Ricky Langley, MD, Michael Agnew, PhD, Jeffrey L. Levin, MD, Timothy Howard, PhD, and Maury A. Nussbaum, PhD
Background Workers in the Agriculture, Forestry, and Fisheries (AgFF) sector experience exposures directly related to the work itself, as well as the physical environment in which the work occurs. Health outcomes vary from immediate to delayed, and from acute to chronic.
Methods We reviewed existing literature on the health outcomes of work in the AgFF sector and identified areas where further research is needed to understand the impact of these exposures on immigrant Latino workers in the southeastern US.
Results Outcomes related to specific body systems (e.g., musculoskeletal, respiratory) as well as particular exposure sources (e.g., pesticides, noise) were reviewed. The most extensive evidence exists for agriculture, with a particular focus on chemical exposures. Little research in the southeastern US has examined health outcomes of exposures of immigrant workers in forestry or fisheries.
Conclusion As the AgFF labor force includes a growing number of Latino immigrants, more research is needed to characterize a broad range of exposures and health outcomes experienced by this population, particularly in forestry and fisheries.
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- 3 Quandt et al Occupational health outcomes.pdf (183.18 KB)
Arthur L. Frank, MD, PhD, Amy K. Liebman, MPH, MA, Bobbi Ryder, BA, Maria Weir, MAA, MPH, and Thomas A. Arcury, PhD
Background The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the
US is comprised primarily of Latino immigrants. Health care access for these workers
is limited and increases health disparities.
Background The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in theUS is comprised primarily of Latino immigrants. Health care access for these workersis limited and increases health disparities.
Methods This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers.
Contents Immigrant workers bear a disproportionate burden of poverty and ill health and additionally face significant occupational hazards. AgFF laborers largely are uninsured, ineligible for benefits, and unable to afford health services. The new Affordable Care Act will likely not benefit such individuals. Community and Migrant Health Centers (C/MHCs) are the frontline of health care access for immigrant AgFF workers.C/MHCs offer discounted health services that are tailored to meet the special needs of their underserved clientele. C/MHCs struggle, however, with a shortage of primary care providers and staff prepared to treat occupational illness and injury among AgFF workers. A number of programs across the US aim to increase the number of primary care physicians and care givers trained in occupational health at C/MHCs. While such programs are beneficial, substantial action is needed at the national level to strengthen and expand the C/MHC system and to establish widely Medical Home models and Accountable Care Organizations. System-wide policy changes alone have the potential to reduce and eliminate the rampant health disparities experienced by the immigrant workers who sustain the vital Agricultural, Forestry, and Fishery sector in the US. Am. J. Ind. Med.
By Amy K. Liebman, MPA, MA, Melinda F. Wiggins, MTS, Clermont Fraser, JD, Jeffrey Levin, MD, MSPH, Jill Sidebottom, PhD, and Thomas A. Arcury, PhD
Background Immigrant workers make up an important portion of the hired workforce inthe Agricultural, Forestry and Fishing (AgFF) sector, one of the most hazardous industrysectors in the US. Despite the inherent dangers associated with this sector, workerprotection is limited.
Methods This article describes the current occupational health and safety policies andregulatory standards in theAgFF sector and underscores the regulatory exceptions and limitationsin worker protections. Immigration policies and their effects on worker health and safety arealso discussed. Emphasis is placed on policies and practices in the Southeastern US.
Results Worker protection in the AgFF sector is limited. Regulatory protections are generallyweaker than other industrial sectors and enforcement of existing regulations is woefullyinadequate. The vulnerability of the AgFF workforce is magnified by worker immigrationstatus. Agricultural workers in particular are affected by a long history of “exceptionalism”under the law as many regulatory protections specifically exclude this workforce.
Conclusions A vulnerable workforce and high-hazard industries require regulatoryprotections that, at a minimum, are provided to workers in other industries. A systematicpolicy approach to strengthen occupational safety and health in the AgFF sector mustaddress both immigration policy and worker protection regulations.
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- 5 Liebman et al Occupational health policy.pdf (123.07 KB)
CDC’s US-Mexico Unit (USMU) works to prevent the spread of infectious disease across borders and improve and promote the health of travelers, migrants, and other mobile border and binational populations. USMU’s main activities include collaborating on the US-Mexico Binational Technical Working Group, overseeing the operation of the Binational Border Infectious Disease Surveillance Program (BIDS), migrant health and binational tuberculosis programs, and international regulatory responsibilities. Their website on US-Mexico health provides a brief overview of the public health issues unique to the border region, our key partners, the guidelines for cooperation, and a resources page complete with health education/communication resources and publications.
To learn more, please visit http://www.cdc.gov/USMexicoHealth/index.html and check back for updates and a Spanish mirror site which should launch this summer.
This webinar is the third in a series of seven in our Clinician Orienatation to Migration Health.
DATE RECORDED: Wednesday, April 17, 2013
PRESENTED BY: Edward Zuroweste, MD, Chief Medical Officer, Migrant Clinicians Network
To view the recorded version of this webinar, click here.
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- ChronicInfDisWebApr2013_MCN.pdf (3.97 MB)
The West Virginia Rural Health Research Center (WVRHRC) pursues a multi-disciplinary research effort directed to improve environmental health for rural populations. Collaborators from public health, geographic information systems, nursing, pharmacy, environmental science, health policy and other disciplines work together to conduct policy-relevant research to achieve this goal.
This study, conducted by the West Virginia Rural Health Research Center, identified the availability and characteristics of agricultural medicine training opportunities for health care professionals. Agricultural workers and their families face numerous threats to health and safety, and yet there is limited information on health care expertise in place to recognize and prevent threats, and to diagnosis and treat agriculturally-related injury and illness.
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- WVRHRC Ag Health Training Policy Brief.pdf (437.33 KB)
- WVRHRC Ag Health Training Final Report.pdf (477.87 KB)
This webinar is the second in a series of seven in our Clinician Orientation to Migration Health.
DATE RECORDED: Wednesday, March 13, 2013
PRESENTED BY: Jennie McLaurin, MD, MPH, Specialist in Child and Migrant Health, Migrant Clinicians Network
To view the recorded version of this webinar, click here.
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- cxprofMCN2013.pdf (2.18 MB)
Good article on cultural humility--basically the groundbreaking one used to propose the term
Journal of Health Care for the Poor and Underserved; May 1998; 9, 2; Research Library
Melanie Tervalon; Jann Murray-Garcia
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Objectives. We assessed implicit and explicit bias against both Latinos and
African Americans among experienced primary care providers (PCPs) and
community members (CMs) in the same geographic area.
Methods. Two hundred ten PCPs and 190 CMs from 3 health care organizations
in the Denver, Colorado, metropolitan area completed Implicit Association
Tests and self-report measures of implicit and explicit bias, respectively.
Results. With a 60% participation rate, the PCPs demonstrated substantial
implicit bias against both Latinos and African Americans, but this was no
different from CMs. Explicit bias was largely absent in both groups. Adjustment
for background characteristics showed the PCPs had slightly weaker ethnic/racial
bias than CMs.
Conclusions. This research provided the first evidence of implicit bias against
Latinos in health care, as well as confirming previous findings of implicit bias
against African Americans. Lack of substantive differences in bias between the
experienced PCPs and CMs suggested a wider societal problem. At the same
time, the wide range of implicit bias suggested that bias in health care is neither
uniform nor inevitable, and important lessons might be learned from providers
who do not exhibit bias. (Am J Public Health. 2013;103:92–98. doi:10.2105/AJPH.
2012.300812)
This article from the American Journal of Public Health is on implicit bias.
Authors: Irene V. Blair, PhD, Edward P. Havranek, MD, David W. Price, MD, Rebecca Hanratty, MD, Diane L. Fairclough, DrPH, Tillman Farley, MD, Holen K. Hirsh, PhD, and John F. Steiner, MD, MPH
Objectives. We assessed implicit and explicit bias against both Latinos and African Americans among experienced primary care providers (PCPs) and community members (CMs) in the same geographic area.
Methods. Two hundred ten PCPs and 190 CMs from 3 health care organizationsin the Denver, Colorado, metropolitan area completed Implicit Association Tests and self-report measures of implicit and explicit bias, respectively.
Results. With a 60% participation rate, the PCPs demonstrated substantial implicit bias against both Latinos and African Americans, but this was no different from CMs. Explicit bias was largely absent in both groups. Adjustment for background characteristics showed the PCPs had slightly weaker ethnic/racial bias than CMs.
Conclusions. This research provided the first evidence of implicit bias against Latinos in health care, as well as confirming previous findings of implicit bias against African Americans. Lack of substantive differences in bias between the experienced PCPs and CMs suggested a wider societal problem. At the same time, the wide range of implicit bias suggested that bias in health care is neither uniform nor inevitable, and important lessons might be learned from providers who do not exhibit bias.
(Am J Public Health. 2013;103:92–98. doi:10.2105/AJPH.2012.300812)
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- AJPH 2012Bias.pdf (528.21 KB)
This webinar is the first in a series of seven in our Clinician Orienatation to Migration Health.
DATE RECORDED: Wednesday, February 13, 2013
PRESENTED BY: Deliana Garcia, MA, International Research and Development, Migrant Clinicians Network
To view the recorded version of this webinar, click here.
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- OverviewMigrationHealth.pdf (3.58 MB)
University of Minnesota's Global Health training program is offering free short courses on immigrant and refugee health.
This web site houses a collection of information, contacts and resources to assist health practitioners in providing care to migrant farm workers. Although the primary intended audience is health care providers in Ontario, much of the information may be useful to other parties.
This website contains information on the 156 health centers that get federal funds to provide primary care to migrant and seasonal farmworkers regardless of immigration status. Most are part of community health centers that also receive additional federal funding to serve all low-income people. They offer services on a sliding fee scale.
A preliminary total of fatal work injuries recorded in the United States. According to results from the
Census of Fatal Occupational Injuries (CFOI) program conducted by the U.S. Bureau of Labor
Statistics.
At Workers' Comp Hub we provide basic information for workers with job-related injuries and illnesses. We also share resources to advance pro-worker advocacy and action.
The Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) provides for federal regulation of pesticide distribution, sale, and use. All pesticides distributed or sold in the United States must be registered (licensed) by EPA. Before EPA may register a pesticide under FIFRA, the applicant must show, among other things, that using the pesticide according to specifications "will not generally cause unreasonable adverse effects on the environment.''
Haz-Map® is an occupational health database designed for health and safety professionals and for consumers seeking information about the adverse effects of workplace exposures to chemical and biological agents. The main links in Haz-Map are between chemicals and occupational diseases. These links have been established using current scientific evidence.
Links
The purpose of this course is to prepare providers to diagnose and treat acute pesticide poisoning and to increase their awareness of health problems associated with chronic pesticide exposure. While the focus of the course is on workers in agricultural settings, the course contents are also applicable for treating all pesticide related illness.
Children encounter pesticides daily and have unique susceptibilities to their potential toxicity. Acute poisoning risks are clear, and understanding of chronic health implications from both acute and chronic exposure are emerging. Epidemiologic evidence demonstrates associations between early life exposure to pesticides and pediatric cancers, decreased cognitive function, and behavioral problems.
In this policy statement, the American Association of Pediatrics outlines the symptoms and suggested course of treatment for acute exposure pesticides belonging to the eight most predominant classes of pesticides. The policy statement also makes recommendations for both pediatricians and government to take measures to improve pesticide safety.
© AAP - 2012; This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors.
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- PestExposureChild_Policy_AAP.pdf (523.63 KB)
This archived webinar originally presented by Jennie McLaurin, MD and Tillman Farley, MD, provides an overview of effective strategies to integrate behavioral health into health center operations. The presenters come with many years of experience in providing culturally appropriate and high quality health care to migrants and other underserved populations. This page includes links to other SAMHSA-HRSA sponsored archived webinars in additional topics.