“A Healthy Dose of Culture Equals
An Ounce of Prevention:”
Using Cultural Ethnography to Inform Intervention
Design for Mexican Immigrant Farmworkers
Shedra Amy Snipes, Ph.D., Assistant Professor
Department of Biobehavioral Health
College of Health and Human Development
Penn State University
Our Time
Background
• Farmworker Health Risks (Pesticide Exposure)
• Ethnography as a Research Tool
Research
Study 1: Qualitative Study about Pesticide Beliefs and
Behaviors
Study 2: Ethnographic Study of Pesticide Exposure and
Personal Protective Equipment (PPE) Use
Interactive Game!!
Application/Discussion
•
Can you offer intervention solutions using ethnography +
risk reduction to protect farmworkers from pesticides?
•
My ideas for intervention design
Background
Pesticides are the
only chemical legally
released into the
environment with the
purpose to kill!
Keifer M.C. (2000). Journal of Rural Health 12:301-310.
Background
National Estimates (Environmental
Protection Agency - EPA)
3.2 to 4 Million Exposed Annually
300,000 acute cases/year
Chronic: diarrhea, headache,
weakness, blurred vision, coughing,
sneezing, trouble breathing, dizziness,
sweating, nausea/vomiting,
Severe: abdominal pain, muscle
twitching, incontinence, hypotension,
coma, death
US Environmental Protection Agency. (1992) The Worker Protection Standard.
US General Accounting Office. (1992) Hired Farmworkers: Health and Well-Being at Risk
Farmworker Demographics
Primarily Mexican
• Central Mexico
• Michoacan
• Jalisco
• Gaunajuato
• Primarily Male
• Median age 25-34
• Spanish Language
•
National Agricultural Workers Survey (NAWS). (2005) A Demographic
and Employment Profile of United States Farm Workers,
Farmworker Demographics
• Work Piece-Rate
• Seasonal Employment
• Migrant vs. Seasonal
• Many Farmworkers are
Documented and
Authorized to Work in
the US!
National Agricultural Workers Survey (NAWS). (2005) A Demographic
and Employment Profile of United States Farm Workers,
Migrant Farmworker Health Disparities
Work-related Burdens:
• Hazardous working
conditions
• Transient and uncertain
lifestyles
• Long hours
Health-related Disparities:
• Limited healthcare access
• Substandard housing
• Working Poor
• Perils go unrecognized
Arcury T.A., Quandt, S.A. (2006) Annual Review of
and untreated
Public Health 28:345-363.
Cultural Ethnography:
Ethnography
Definition

The scientific approach to discovering details of
how beliefs are coupled with behaviors.

Multiple tools:
o

Interviews, Observation, Focus groups/Group Interviews,
Rapid Assessments.
Critical component:
o
Taking on the daily lifestyle of a community or people.
Ethnography
Explanatory

Explain:

Cause-Effect Relationship of coupled beliefs and
behaviors

What the phenomenon “looks like”

Plausible Causal Networks

Shaping the Phenomenon
Ethnography
“Real Life” Level of analytic interest
 Salient Behaviors
 Individual
 Events
 Group
 Attitudes
 Program
 Structures
 Organization
 Processes
 Inter-organization
Study 1:
Cultural Beliefs about
Pesticide Exposure
Setting: Yakima Valley, WA
Study 1: Beliefs About Pesticides
Powder (versus liquid “sprays”)
“Yes, yes what is the powder… well what the dirt
is. Like when the dirt gets loose the wind blows
and the dirt raises and the trees get full. And
when we are cutting the fruit we are working
and we move the powder and it all falls on
us.”
Snipes S.A., Thompson, B., O’Connor, K., Shell-Duncan, B., King, D., Herrera, A.P.,
Navarro, B. . (2009) American Journal of Public Health 99:s16-s21.
Study 1: Beliefs About Pesticides
Allergies
“Well there are some that say that their vision
gets irritated in their eyes. Others have
allergies like a cold. Only during the time of
the thinning… or their eyes get red sometimes.
That is what I have noticed in my coworkers.”
Snipes S.A., Thompson, B., O’Connor, K., Shell-Duncan, B., King, D., Herrera, A.P.,
Navarro, B. . (2009) American Journal of Public Health 99:s16-s21.
Study 1: Beliefs about Pesticides
Insight about how embedded concepts might be used…
Of 99 Farmworkers in Washington State


75% said pesticides NEVER touched skin (14 days)
87% said pesticides NEVER touched eyes (14 days)
Concept of “powder”, which is different from conceptions of liquid
pesticides, touches the skin
However,


54% reported smelling pesticides (14 days)
40% reported breathing in pesticides (14 days)
Increase in response to this question may be influenced by conception that
pesticides, or “sprays”, are liquid forms of agricultural chemicals
Study 2:
Ethno-Occupational
Health Assessment
Personal Protective Equipment (PPE)
PPE
Mandated and Enforced by EPA
Aim of Study 2:
Explore Barriers to PPE, including
* Language barriers
* Not enforced by owners
* Difficult to wear
US Environmental Protection Agency. (1992) The Worker Protection Standard.
Study Location: Lubbock, TX
USDA, National Agricultural Statisitics Service
Study 2: Ethno-Occupational Health
Assessment
Cotton
(Primary Crop – Lubbock, TX)
•
•
•
•
Five of the top nine most toxic pesticides used on
cotton in the U.S. (cyanide, dicofol, naled, propargite,
and trifluralin)
KNOWN cancer-causing chemicals.
All nine are classified by the U.S. EPA as Category I
and II— the most dangerous chemicals
#1 Producer of Cotton in the U.S.!
Study 2: Ethno-Occupational Risks
Age
5-85 years old
Migrant Status
Year-round 60%
Migrant
40%
Work Tenure
1-70 years
Work Introduction
5-25 years of age
Ethnographic data collection from 173 persons over 3 months.
Study 2: Ethno-Occupational Health
Assessment
Study 2: Ethno-Occupational Health
Assessment
Study 2: Ethno-Occupational Health
Qualitative and Ethnographic Themes:
Personal Protective Equipment (PPE)
•
Low Provision
•
Slows Speed of Work
•
Hot
•
Uncomfortable
•
Risk May Increase from PPE Use:
 Loss of Income
 Additional Hazards (Snakes, Injury/Amputation)
Snipes S.A., Cooper, S., Shipp, E. (in preparation) Injury as an Elusive Concept: Cultural
Conceptualizations of Risk Inform Epidemiological Injury Definitions among Farmworkers.
Interactive Game
Prevention Solutions Discussion
•
How might we use what
we know to more
appropriately train
workers?
•
Can we protect workers
without slowing speed of
work?
•
What PPE does not impose
additional risk?
•
What are some solutions
based on our game?
Increasing PPE Use to Protect Workers
Multiple-Component Intervention
1. Tailored Education
Culturally-appropriate/Relevant messages
E.g. “powder” or “allergies”
2. Provision of PPE
Emphasis on Practical PPE
E.g. Touch sensitive gloves
3. Farmworkers are a part of the research team!
Take on Role of “Problem Solvers”
Balance Risk with Productivity
Increasing PPE Use to Protect Workers
Multi-Component Intervention Setting:
TX-Mexico Border
Community-Engagement:
Texas Migrant Council/Migrant Seasonal Head Start
Program
Pilot testing, including:
1. Education
2. Provision and testing of practical PPE solutions
3. Ethnographic field observation + questionnaire
4. Biomarker Assessment?
5. Evaluate increased use of PPE over 12 weeks
Acknowledgements
•
Participants: Washington, Texas
•
Partners (WA): Dr. Gloria Coronado, Bridgett Navarro,
Ilda Islas, Genoveva Ibarra, Field staff
•
Partners (TX): Ramona Barron, Monica Gonzales, Texas
Migrant Council/Migrant and Seasonal Head Start
•
Funding Sources: National Cancer Institute (R25-CA57712); W.K. Kellogg Foundation (P0117943); Southwest
Center for Agricultural Health, Safety and Prevention
(5U50OH007541-07); EXPORT/National Center on
Minority Health and Health Disparities (5 P60
MD000503); National Science Foundation (BCS0424447),
National Institutes of Health (ES09601); Environmental
Protection Agency (R826886)
Questions
Shedra Amy Snipes, Ph.D., Assistant Professor
Penn State University
Department of Biobehavioral Health
sas84@psu.edu