Studying tobacco use in migrant farmworker populations: Challenges and recommendations
The Commission of Agricultural Workers estimated that there were roughly 2.5 million migrant farmworkers in the United States in 1990. These farmworkers face significant health hazards, including:
- housing that is often inadequate and overcrowded
- increased on-the-job risk of injury and other health problems
- mental health challenges from the migratory nature of the work, anti-immigrant sentiment, and racism
At the same time, migrant farmworkers often have diminished access to health care resources:
- 30% live below federal poverty line
- 81% speak Spanish as a first language
- About half report an inability to speak and read English
The extent to which tobacco use can compound health problems is well known, but tobacco use among migrant farmworkers remains insufficiently understood. This is in a large part due to the challenges of applying standard methodologies to a mobile, seasonal population widely considered by researchers to be "hard to reach."
In 2008, researchers from a number of disciplines whose work touches on migrant farmworkers gathered to address the following questions:
- How can we design research strategies that not only reach potential subjects, but also follow them over time?
- How can we develop methodologies that will allow us to assess the impact of tobacco on this population?
- How can these methodologies account for the differences within populations within various regions of the U.S.?
The following recommendations were presented to the group:
Challenge: Identify barriers to achieving adequate sampling of migrant farmworkers in research
- Develop a tool (such as a checklist or matrix) with standard definitions and descriptions of key terms to support variability of research aims and comparability of results
- Seek out new sources of funding
- Build awareness of migrant farmworkers within the public health research community
- Promote collaborations between researchers, institutions, community groups, NGO's, and advocacy groups
Challenge: Provide recommendations for the best methodologies
- Establish ongoing working group on sampling methodologies
- Test Respondent-Driven-Sampling (RDS)
Challenge: Generate recommendations for carrying out robust research on migrant farmworkers
- Develop relationships and funding for international, longitudinal studies in the U.S. and in the "sending" communities Test Respondent-Driven-Sampling (RDS)
- Develop effective and innovative tracking strategies
Challenge: Address the question of whether methods need to be modified for tobacco
- Consider cultural attitudes towards tobacco, political context, and access to health care
- Develop standard tobacco use questions to ensure comparability between studies
Innovative methodological approaches, a broader base of support, and cultural sensitivity and training for researchers will provide the flexibility to conduct research in a way that is congruent with the lives of the migrant farmworker population they wish to study. It is hoped that information gleaned from research in this area will help shed light on questions such as how immigration affects smoking behavior, and that nascent methodologies will be useful to other researchers whose work involves mobile populations.
"Migrant Farmworker Sampling Methodology: Strategies for Collecting Data in Migratory/Mobile Groups to Reduce Tobacco-Related Health Disparities" (March 14, 2008, California Endowment, Los Angeles, CA): Sponsored by the American Legacy Foundation, the National Cancer Institute/Division of Cancer Control and Population Sciences, the Tobacco Research Network on Disparities (TReND), the California Endowment and ETR Associates.
