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Community-Based Participatory Approach to Farmworker Housing, Exposures &Health

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Adequate housing is a fundamental human right. However, the limited research that has been conducted demonstrates that inadequate housing is the most basic of all of the unjust and inequitable conditions that farmworkers in North Carolina and the southeast US endure. None of this research has examined how inadequate housing, as an environmental health risk, is related to the health of farmworkers or their families. The proposed research builds directly on our successful project Occupational Skin Disease among Minority Farmworkers (R01 ES012358), as well as several other community-based participatory research (CBPR) projects that have addressed the environmental health risks of farmworkers. Our results document the most prevalence skin problems experienced by farmworkers, particularly infectious diseases, are caused by exposures in houses. Other analyses document that farmworkers and the members of their family are exposed to pesticides in their homes. Together, this work indicates a need for research focused on farmworker housing. The North Carolina Farmworker Advocacy Network has identified farmworker housing as a major concern. The CBPR orientation of our research group requires a focus on farmworker housing conditions and their effects on farmworker health as a response to major concerns voiced by farmworkers, farmworker health care providers, and farmworker advocates. This project is based on a15 year collaboration among farmworkers, farmworker community-based organizations, farmworker advocates, and health science investigators. Within this collaboration, this research study will achieve five specific aims: (1) describe the experiences and perceptions of farmworkers concerning the quality of housing in which they live and how they relate housing quality to their health;(2) evaluate farmworker housing and delineate the associations of farmworker housing with exposures as moderated by resident characteristics and behaviors;(3) delineate the association of exposures in farmworker housing with indicators of farmworker health;(4) disseminate the results of this research to farmworkers in culturally and educationally appropriate formats that farmworkers can use to improve their housing or reduce their health risks;and (5) collaborate with farmworker advocates to affect public health, occupational safety and housing policy to improve the quality of housing in which farmworkers live and reduce the negative health outcomes of substandard housing. The project has four major components. First, it will use a systematic qualitative research design to document farmworker experiences and perceptions of housing quality and its association with health. Second, it will document housing quality in 200 farmworker camps and 200 farmworker family homes, and examine the association of housing quality with health indicators. Third, it will implement a plan to return information to farmworkers. Fourth, it will implement a plan to address state and national farmworker housing policy. PUBLIC HEALTH RELEVANCE: Migrant and seasonal farmworkers and their families are exposed to numerous environmental and occupational health hazards, and they experience high rates of injuries and illnesses. A major source of exposure for farmworkers and their families is the housing in which they live. This community-based participatory research project will be based on a collaboration of North Carolina Farmworkers Project, Student Action with Farmworkers, Farmworker Advocacy Network, several migrant clinics, and Wake Forest University School of Medicine. It will document the housing conditions of farmworkers, determine associations of housing conditions with health outcomes, disseminate information to farmworkers that they can use to improve their housing, and address policy changes needed to improve farmworker housing.

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