Research Employing Environmental Systems and Occupational Health Policy Analyses to Interrupt the Impact of Structural Racism on Agricultural Workers and Their Respiratory Health (RESPIRAR)

利用环境系统和职业健康政策分析来中断结构性种族主义对农业工人及其呼吸系统健康的影响的研究（RESPIRAR）

• 批准号: 10474690
• 负责人: Devon C Payne-Sturges
• 金额: $ 76.71万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10474690
• 关键词: 2019-nCoV; Address; Advocate; Affect; Agricultural Workers; Agriculture; Automobile Driving; Black race; COVID-19; COVID-19 disparity; COVID-19 impact; COVID-19 outbreak; COVID-19 pandemic; Communicable Diseases; Communities; County; Crowding; Crows; Decision Making; Detection; Disease Outbreaks; Employment; Environment; Environmental Health; Ethnic group; Exclusion; Exposure to; Farm; Fright; Future; Goals; Government; Hand; Health; Health protection; Healthcare; Housing; Hygiene; Immigration; Indoor Air Quality; Industry; Institution; Interruption; Latinx; Laws; Legal; Linguistics; Longitudinal Studies; Medical; Migrant; Modeling; Occupational Health; Outcome; Pathway interactions; Pattern; Pilot Projects; Policies; Policy Analysis; Policy Maker; Policy Making; Population; Population Surveillance; Preventive care; Preventive measure; Process; Public Health; Public Housing; Quasi-experiment; Regulation; Reporting; Research; Research Design; Research Priority; Respiratory Disease; Risk; Role; SARS-CoV-2 B.1.617.2; Safety; Shapes; Social Distance; Social Policies; Statistical Data Interpretation; Structural Racism; Structure; System; Technical Expertise; Testing; Time; United States; United States National Institutes of Health; Virus; Vision; Vulnerable Populations; Water; Work; base; built environment; care outcomes; care seeking; design; disorder risk; farm worker; health care availability; health disparity; health inequalities; innovation; interdisciplinary approach; lens; minority health disparity; multidisciplinary; novel; pandemic disease; prevent; public health intervention; racial and ethnic; racial health disparity; racism; respiratory health; respiratory virus; response; social; social exclusion; theories; trend

Structural racism (SR) has been defined as the macro level systems, social forces, institutions, ideologies, and processes that interact with one another to generate and reinforce inequities among racial/ethnic groups. The mechanisms of SR are “unseen” and thus understudied and typically not incorporated into public health interventions. For example, 2.5 million hired farmworkers in the U.S., who overwhelmingly are Black and/or Latinx, live in economically segregated communities with substandard and crowded housing conditions, unsafe or limited water that render COVID-19 preventive measures such hand hygiene and social distancing challenging, if not impossible. Additionally, migrant and seasonal farmworkers (MSFWs) are among the lowest paid, lack access to health information, preventive care and medical treatment. These patterns of vulnerability reflect historical exclusion, motivated by anti-Black racism, of farmworkers from federally protected right to organize and other labor protections, labor practices traced to the Jim Crow era, and an immigration and labor policy environment in which MSFWs avoid reporting illness or seeking care for fear of retaliation from employers. COVID-19 has only exacerbated these vulnerabilities; outbreaks of COVID-19 have been reported among farmworkers and agricultural counties in the U.S. have seen disproportionately high rates of COVID-19. Structures of marginalization of MSFWs are not widely considered through the lens of SR. To better protect the health of Black and/or Latinx MSFWs and design an equitable response to the inevitable next pandemic, research is needed to understand and dismantle the structural and institutional drivers of health inequities. Our proposed work aims address this critical need through an innovative community-driven, multilevel and multidisciplinary approach study to: examine the relationships between migrant labor housing policy regimes, indoor air quality, exposure to viruses (e.g., SARS-CoV-2) and respiratory health of MSFWs over time (Aim1); characterize structural pathways through which COVID-19 policy and regulatory responses interact and influence racialized health outcomes among MSFWs through a community-based system dynamics group modeling approach (Aim2); and evaluate the influence of agricultural migrant employment, public health and housing law and policy on COVID-19 epidemics across selected agricultural states using a quasi-experimental study design (Aim 3). These aims address two NIH research priorities:1) understand the impact of SR on minority health and health disparities and 2) inform health care and social policies at all levels on mitigating SR’s impacts on the health of vulnerable populations. Results from our proposed study will inform the design of policies and best practices to counter long-standing mechanisms of SR impacting MSFWs, optimize living and working conditions for better health protections and to control future outbreaks of infectious disease among these invisible and vulnerable workers.

结构性种族主义（SR）已被定义为宏观系统，社会力量，机构，意识形态和 彼此相互作用以产生和加强种族/族裔群体之间的不平等的过程。这 SR的机制是“看不见的”，因此被理解，通常不纳入公共卫生 干预措施。例如，美国有250万雇用的农场工人是黑人和/或 拉丁裔，生活在经济隔离的社区，不合格和拥挤的住房条件，不安全 或有限的水使COVID-19进行预防措施，例如手动卫生和社会疏远 具有挑战性的，即使不是不可能的。此外，移民和季节性农场工人（MSFW）是最低的 付费，无法获得健康信息，预防性护理和医疗。这些脆弱性模式 反映由反黑种族主义的历史排斥，农场工人受到联邦保护的权利的反映 组织和其他劳动保护，追溯到吉姆·克劳时代的劳动惯例以及移民和劳动 MSFWS避免报告疾病或寻求护理的政策环境，因为担心要报复 雇主。 Covid-19仅加剧了这些漏洞。据报道，Covid-19的爆发 在美国的农场工人和农业县中，Covid-19的比例不成比例。 MSFW的边缘化结构并未通过SR的镜头广泛考虑。更好地保护 黑色和/或拉丁文MSFW的健康状况，并设计对不可避免的下一个大流行的公平反应， 需要研究以了解和拆除健康不平等的结构和机构驱动力。我们的 拟议的工作旨在通过创新的社区驱动，多层次和 多学科方法研究：检查移民劳动住房政策制度之间的关系， 随着时间的推移，室内空气质量，暴露于病毒（例如SARS-COV-2）和MSFW的呼吸健康（AIM1）； 特征结构途径，通过这些途径，COVID-19政策和监管响应相互作用以及 通过基于社区的系统动态小组影响MSFW之间的种族健康结果 建模方法（AIM2）;并评估农业移民就业，公共卫生和 使用准实验 研究设计（目标3）。这些目的解决了两个NIH研究的重点：1）了解SR的影响 少数族裔健康和健康差异以及2）为各种级别的医疗保健和社会政策提供依据 SR对脆弱人群的健康有影响。我们拟议的研究的结果将为设计 政策和最佳实践来应对影响MSFW的SR长期机制，优化生活和 改善健康保护的工作条件，并控制未来的传染病暴发 这些无形且脆弱的工人。