Migrant Health Issues
The health issues that face migrant and other mobile underserved populations are similar to those faced by other disadvantaged groups, including the poor, and especially rural poor, and recent immigrants. These illnesses are caused by poor nutrition, lack of resources to seek care early in the disease process, and infectious diseases from overcrowding and poor sanitation. However, the health problems migrants and their families face because of their low-income status and unfamiliarity with the culture are compounded by a migratory lifestyle and the inherent dangers and health risks involved in their occupations.
Migrants and their dependents experience more frequent and more severe health problems than the general United States population. Only a limited number of scientific studies have been made on the health status of migrants and other mobile underserved populations. Many of the studies conducted on migrant health have relied primarily on self-reporting of problems, retrospective recall of illnesses, or have focused primarily on the social barriers that hinder the delivery of health care to migrants.
High Risk General Problems
The overall medical and dental problems encountered in migrant populations are not dramatic, except on a quantitative basis. There seems to be more of everything, and common conditions have been allowed to progress to very serious stages. Migrants experience a large number of minor ailments. They also identify and treat some conditions as ailments which are actually underlying symptoms of other illnesses and which would be taken as signs of more serious health problems if they were clearly presented to health professionals. The potential lack of awareness that a condition, such as diarrhea or fever, might indicate a more serious underlying problem will sometimes cause delays in seeking professional medical attention: an earache is a minor condition if treated properly, but it can lead to deafness if not treated. Deafness is in no way a minor problem, and is one of the frequently mentioned major health problems in the migrant population.
All of the health care problems found in the general population are found in migrant groups. Some, however, occur more frequently. These include diabetes, cardiovascular disease, and asthma. Tuberculosis deserves special mention. Active cases are consistently found, and there are a high proportion of reactors among migrants, consequently it is necessary to be selective in choosing which patients will follow conventional therapy.
Dental problems abound in migrant populations, yet dental care takes very low priority in the help-seeking behavior of migrants. Routine examinations of both children and adults reveal catastrophic dental sequelae. Bottle mouth caries is a relatively common problem, and gingivitis is rampant among adults.
Prenatal care for migrant mothers is difficult, and many of the pregnancies are high risk. There are high numbers of pregnancies in both very young and much older women. The absence of prenatal care, especially early in the pregnancy, is common, as are multigravida females. These conditions lead to a high incidence of premature births, preeclampsia, and other complications.
There is probably no other population in the United States that has had simultaneously high incidences of both over-immunization and under-immunization of children. Many pediatric migrant patients have been immunized four or five times in the same season, due to the problems of continuity of care, while others have been missed completely for the same reason. The primary list of minor pediatric health problems most frequently encountered includes rashes, strains, sprains, upper respiratory infections, otitis media, abdominal discomfort, diarrhea, urinary tract infections, anemia, lacerations, headaches, and dizziness.
Depression is another concern among adult migrants which may be related to isolation, economic hardship or weather conditions which can hamper work. Adult men are vulnerable to substance abuse that can be related to poverty, stress, lack of mobility or recreational opportunities.
Migrant Info
Migrant Specific Health Concerns
Migrants and other mobile underserved populations suffer some diseases and injuries that are not common to other poor groups in the United States. These conditions are related to their occupation. Clinicians working with migrants will see patients with muscle strains and more aggravated over-use/repetitive motion disorders. There may be eye problems related to too much sun or irritants in the eyes from the fields. Clinicians should be attentive to signs of pesticide exposure in all age groups, since housing is sometimes located near the worksite, and children sometimes accompany parents to the fields.
While the majority of medical conditions seen in migrant health care settings are common, it is not unusual to encounter diseases that would be seen once in a lifetime, if ever, in other groups of the U.S. population. Migrants not only live in Third World conditions, they are subjected to Third World diseases. Diseases of the past are commonly encountered, dominated by infectious diseases. Parasitic diseases and other gastrointestinal infections, including shistosomiasis, shigella, and salmonella, which are rare in the rest of the U.S. population, are found in the migrant population. Other exotic diseases such as amoebic liver disease, brucellosis, yellow fever and echinococcal cyst disease are not uncommon. Many of the cases of polio encountered in the United States in recent times have been found in the migrant population, with the majority coming from Texas migrants. Nor is it uncommon for encephalitis, typhus, or even Hansen’s disease to be seen in some migrant populations. AIDS is also present in migrant populations.
Certain groups pose special health problems and risks. Haitian farmworkers in the East Coast Stream comprise one such group. They often have active cases of diseases that have not been seen in the United States since widespread vaccination programs were begun. They may also present tropical diseases which have virtually never been encountered. Since Haitians are in contact with other migrants, those diseases can show up in both homebase and upstream areas that have never had a single Haitian resident in them. On the West Coast and in the Midwest, a similar condition occurs with some Southeast Asian workers. They sometimes bring with them diseases which were common in their homeland, but are very rare in the United States.