Research Employing Environmental Systems and Occupational Health Policy Analyses to Interrupt the Impact of Social and Structural Relationships on Agricultural Workers and Their Respiratory Health

Social causal structures (SCS) can be defined as the macro level systems, social forces, institutions, practices, norms, and processes that interact with one another to generate and reinforce health differences among population groups. The mechanisms of SCS are “unseen” and thus understudied and typically not incorporated into public health interventions. For example, 2.5 million hired farmworkers in the U.S. live in communities with substandard and crowded housing conditions, unsafe or limited water that render infectious respiratory disease 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. Periods of increased infectious respiratory disease outbreaks have only exacerbated health vulnerabilities among farmworkers and others in agricultural counties. To better protect the health of MSFWs and design an effective response to the inevitable respiratory disease emergencies, research is needed to understand the social and structural and institutional drivers of health. 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, indoor air quality, exposure to respiratory viruses and respiratory health of MSFWs over time (Aim1); characterize pathways through which various policy and regulatory responses interact and influence health outcomes among MSFWs through a community-based system dynamics group modeling approach (Aim 2); and evaluate the influence of labor and occupational health and safety laws and policies on infectious respiratory disease outcomes across selected agricultural states using a quasi-experimental study design (Aim 3). Results from our proposed study will be important to counter long-standing negative health outcomes 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.