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Environmental Medicine Needs Assessments Among
Migrant Clinicians
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[Forwarded to Steve from a List-Serve]
The following post was very interesting.
When I was working in clinics for migrant workers in Colorado and
California in the 1960's, the most serious problem was the inability to
specialists to see them or even to get hospitals to see them in emergency
rooms or to admit them. Right now we are seeing the implementation of
anti-dumping legislation (hospitals can't turn away patients).
That was a serious problem for migrants who were really ill back then,
and I suspect it must still be widespread today.
Mike Gochfeld
Occasionally a finding comes from an unexpected place that reminds me why we do our (academic) jobs. Last fall the Migrant Clinicians Network (MCN) conducted a needs assessment among clinicians and clinic administrators seeking information about the most important environmental and occupational health (EOH) problems, and EOH training needs. The authors, Amy Liebman and Susan Harper, reported that among the 164 responses, the top 5 EOH problems facing farmworkers were: pesticides (59%); water/sanitation and related conditions (45%); other health concerns--diabetes, education, nonwater sanitation, hyperlipidemia, alcoholism & poverty (24%); accidents & injuries (21%); and musculoskelatal-ergonomics problems (21%). Their top 5 training needs were as follows: pesticides (59%); other--see above (40%); water/sanitation conditions (34%); PB poisoning (19%); and skin/eye problems (14%).
Although respondents have used many types of educational media (such as audio/video tape, internet; live broadcasts, and CD Roms) they prefer live, in person workshops on specific topics or on multiple subjects.
The very awkward finding was that 83% (!) of respondents said they had had either 1 or zero training courses pertaining to EOH. However, they had had some success in obtaining resources from local health departments, university and ag extension services, EPA, and other nonprofit groups (such as MCN).
More information on the survey is available at http://www.migrantclinician.org/pdfs/Streamline_MayJune01.pdf or directly from Ms. Liebman <aliebman@intercom.net>.
David F. Goldsmith, MSPH, PhD
Associate Research Professor
Department of Environmental & Occupational Health
George Washington University
2300 K Street NW, Suite 201
Washington DC 20037 USA
Tel: 202-994-1734; fax 202-994-0011
email: eohdfg@gwumc.edu
website: http://www.OccupationalEpi.com