Jennifer E. Swanberg

Occupational Health Among Latino Horse and Crop Workers in Kentucky: The Role of Work Organization Factors

ABSTRACT Agriculture is a dangerous industry often reliant on Latino workers, a vulnerable population. Using a work organization framework, this cross-sectional study analyzes the relationship between work organization variables and the occupational health of Latino crop (n = 49) and horse breeding (n = 54) workers in Kentucky. Increased levels of abusive supervision were associated with occupational injury (odds ratio [OR] = 2.97; 95% confidence interval [CI]: 1.0–8.77) and increased awkward postures were associated with occupational illness (OR = 3.85; 95% CI: 1.06–13.98). Although not statistically significant, abusive supervision increased the odds and a high safety climate score decreased the odds of injury, illness, and missed work. These findings suggest that the supervisor-subordinate relationship may play a critical role in the occupational health of Latino farmworkers.

Individual and occupational characteristics associated with respiratory symptoms among latino horse farm workers

BACKGROUND Latino workers are likely exposed to a variety of respiratory hazards in the horse barn, yet the potential impact of these exposures on respiratory health has not been investigated. METHODS Using a community-based sample of 225 Latino horse farmworkers we investigated the prevalence of upper and lower respiratory symptoms and occupational characteristics associated with them. Multivariable logistic regression was used to identify factors associated with respiratory symptomology. RESULTS Upper respiratory symptoms prevalence ranged from 24% to 45%. Half of workers reported lower respiratory symptoms. Workers with symptoms were more likely to be female and have lower levels of English understanding. Workers who never/rarely used dust masks while working in the barn experienced over two times the odds of reporting upper respiratory symptoms. CONCLUSIONS Many Latino horse workers experienced upper and lower respiratory symptoms. Dust mask use may protect workers in this and other enclosed livestock operations from respiratory symptoms.

Scheduling challenges among workers in low-wage hourly jobs: similarities and differences among workers in standard- and nonstandard-hour jobs

Work schedules are a central theme in the work–family challenges of low-wage hourly workers. Yet, research on scheduling patterns among this worker population has primarily focused on nonstandard schedules. We know very little about the scheduling patterns of workers in hourly jobs with standard fixed schedules. Knowledge about the key scheduling challenges by schedule type is necessary to develop targeted workplace solutions, such as flexible work arrangements, to enhance work–life fit among workers in low-wage hourly jobs. Using the 2008 National Study of the Changing Workforce, bivariate and multivariate analyses were employed to determine (1) the prevalence of rigid, unpredictable and unstable work schedules among low-wage hourly workers employed in jobs with standard and nonstandard schedules and whether there is variation in these scheduling practices among full- and part-time workers; and (2) the individual or job characteristics that influence the odds of experiencing rigid, unpredictable or unstable work schedules. Results indicate that rigid and unpredictable schedule practices are most prevalent among low-wage hourly workers in full-time standard-hour jobs and part-time nonstandard-hour jobs, while unstable scheduling practices are most prevalent among hourly workers in full- and part-time nonstandard-hour jobs. Implications and limitations of the research are discussed.

A Narrative Review of the Confluence of Breast Cancer and Low-wage Employment and Its Impact on Receipt of Guideline-recommended Treatment

Breast cancer is the leading cause of cancer among women in the United States, costing the healthcare system, employers, and society billions of dollars each year. Despite improvements in screening and treatment, significant breast cancer treatment and survivorship disparities exist among various groups of women. One variable that has not been explored extensively as a possible contributor to breast cancer treatment disparities is employment. This is concerning, given the changing economic and employment trends in the United States favoring low-wage employment. Currently, one-quarter to one-third of all US workers are considered to be working poor, and women are disproportionally represented in this group. Characteristics of low-wage work—limited paid time off, minimal health benefits, schedule inflexibility, and economic insecurity—may become even more significant in the event of a breast cancer diagnosis. To date, there has been limited research into how job conditions inherent to low-wage work may influence working poor survivors’ receipt of guideline-recommended breast cancer treatment. Therefore, the purpose of this narrative review was to critically examine the current literature to further our understanding of how employment context may impact treatment decisions and adherence—and therefore receipt of guideline-recommended care—among newly diagnosed, working poor breast cancer survivors. After under-taking a comprehensive review, we failed to identify any published literature that explicitly addressed low-wage employment and receipt of guideline-recommended breast cancer treatment. Four articles reported circumstances where women delayed, missed, or quit treatments due to work interference, or alternatively, developed strategies that allowed them to continue to work and obtain their breast cancer treatment concurrent with medical and economic challenges. An additional five articles, while focused on other cancer and employment outcomes, described the need for increased patient-provider communication about the influence of work on treatment decisions and the development of alternative treatment plans. Due to the paucity of research in this area, future policy, practice, and research efforts should focus on the employment context of working poor breast cancer survivors as a potential contributor to cancer disparities. Engagement of women, employers, oncology providers, healthcare systems, and interdisciplinary researchers is warranted to improve cancer outcomes among this disparate population of working women.

From the Horse Worker’s Mouth: A Detailed Account of Injuries Experienced by Latino Horse Workers

Horse breeding farms are hazardous. Yet, little is known about the injuries of Latino horse workers. This study assesses Latino horse workers’ injury prevalence, describes their injuries, and analyzes differences between injuries receiving medical versus those receiving first aid care. Data were gathered from 225 Latino thoroughbred workers via a community-based purposive sampling strategy. Questions included injury experiences in the past year and details about each person’s two most severe injuries. Univariate and bivariate analyses were conducted. Nearly half of workers experienced an injury in the past year, often involving a horse. Bruises and sprains/strains were most common, as were injuries to upper/lower appendages. Head/face injuries more often resulted in medical care. The injury burden in this Latino worker population is high. Personal protective equipment (PPE) and training is advised due to the high prevalence of horse-related injuries. Future research should investigate aspects of the work environment that may influence injury risk.

Managing cancer and employment: Decisions and strategies used by breast cancer survivors employed in low-wage jobs

ABSTRACT Advances in breast cancer screening and treatment have led to an overall 5-year survival rate of 90%. Many of these cancer cases are diagnosed in working women. Few studies have explicitly examined the cancer–work interface, as experienced by low-wage earning women with breast cancer. This study uses in-depth, semistructured interviews with 24 low-wage breast cancer survivors to identify employment decisions and factors that influenced or enabled these decisions, and examine the individual strategies and workplace supports used to manage the cancer–work interface among a subset of women (n = 13) who continued to work. Future research areas and clinical implications are discussed.

Collecting Comparative Data on Farmworker Housing and Health: Recommendations for Collecting Housing and Health Data Across Places and Time.

The substandard nature of the housing in which most farmworkers live has detrimental effects on their health, as well as on their children’s health and development. However, little research has directly documented associations between farmworker housing and health; existing research is not always comparable due to differences in design and measurement. Comparative data can help determine actual causal links between housing characteristics and farmworker health and help to evaluate the efficacy of current housing policy. The goal of this paper is to provide guidelines promoting comparable research on farmworker housing and the association of this housing with health. This paper reviews general concepts relevant to measuring farmworker housing and health, issues that should be considered in designing farmworker housing and health research, data collection methods, and measures. It concludes with recommendations for a research agenda on farmworker housing and health.

The Voices of Kentucky Employers: Benefits, Challenges, and Promising Practices for an Aging Workforce

This study explored Kentucky employers’ preparedness for the aging workforce using focus groups and a survey. Although employers perceived many benefits of older workers, five key challenges of an aging workforce emerged: institutional knowledge loss, older workers’ dependent care commitments, health and safety problems, generation gaps, and lack of technical skills. The results also suggested potential solutions and organizational practices to address each of these challenges. These practices include succession planning, meaningful work, flexible work, safety climate, wellness programs, generational empathy training, technology training, and intergenerational mentoring.

Associations of Work Stress, Supervisor Unfairness, and Supervisor Inability to Speak Spanish with Occupational Injury among Latino Farmworkers

Little is known about how psychosocial work factors such as work stress, supervisor fairness, and language barriers affect risk of occupational injury among Latino farmworkers. This study attempts to address these questions. Surveys were administered via interviews to 225 Latino thoroughbred farmworkers. Multivariable logistic regression analyses were performed to calculate odds ratios (OR) and 95% confidence intervals (CI) of occupational injury in the past year in relation to occupational characteristics. Work stress (OR 6.70, 95% CI 1.84–24.31), supervisor unfairness (OR 3.34, 95% CI 1.14–9.73), longer tenure at farm (OR 2.67, 95% CI 1.13–6.34), and supervisor inability to speak Spanish (OR 2.29, 95% CI 1.05–5.00) were significantly associated with increased odds of occupational injury. Due to the associations between work stress, supervisor unfairness, supervisor inability to speak Spanish and injury, supervisor training to improve Spanish language ability and equitable management practices is merited. Future research is needed to understand the antecedents of work stress for Latino farmworkers.

Poor safety climate, long work hours, and musculoskeletal discomfort among Latino horse farm workers

ABSTRACT This study investigated the prevalence of self-reported musculoskeletal discomfort (MSD) and work-related factors associated with elevated MSD among Latino thoroughbred farm workers. Participants (N = 225) were recruited using a community-based purposive sampling approach to participate in in-person interviews. Of these workers, 85% experienced MSD. MSD was divided into tertiles; the upper tertile was defined as elevated. Multivariable Poisson regression revealed associations between any elevated MSD and longer tenure on horse farms, longer work hours, and poor safety climate. Elevated neck/back MSD was associated with longer tenure, longer work hours, and poor safety climate. Elevated upper extremity MSD was associated with age and poor safety climate. Elevated lower extremity MSD was associated with longer tenure, longer work hours, and being female. Musculoskeletal discomfort is common among these workers. Improving safety climate and minimizing long work hours is recommended.