Basic HTML Version
Healthcare Journal of NEW ORLEANS
I
JUL / AUG 2013
15
heat-induced illness and other hazards more
specific to NewOrleans. Tulane researchers
Rabito et al. tested the blood lead levels of
migrant construction workers and screened
them for various health symptoms. They
found that respiratory, headache, and sino-
nasal symptoms were unusually common
among the workers. Furthermore, these
symptoms improved when the workers took
time off work, suggesting a causal relation-
ship with work conditions. They also found
elevated blood lead levels in the workers,
some severely elevated. About half of the
men in the cohort had blood levels that, if
persistent, have been shown to be associated
with increasedmortality, chronic kidney dis-
ease, and cardiovascular effects.
Besides the health risks related to work-
ing in construction in New Orleans, the
migrant status of this population creates
its own difficulties. For example, this group
is the fastest-growing HIV-positive minority,
but because of their mobility, unique health-
care outreach strategies are required. Marco
Ruiz and Carlo Sebastian Briones-Chavez
outlined several such strategies to address
this issue, including the use of mobile clin-
ics, social networks such as Facebook,
disseminating information in Latino gro-
cery stores, and training volunteers who
teach English or provide other services to
also provide healthcare information. Fur-
ther complicating healthcare for this group
is the undocumented status of many of these
workers. Fear of deportation if the system
should “get to know” them prevents many
from seeking care in all but the most dire
situations. The BMHA’s Latino Commission
is currently reviewing new immigration rul-
ings by the courts, and how they may affect
the health of this community. In addition,
this commission is engaged in numerous
efforts to obtain and analyze Latino health
data and improve healthcare access, includ-
ing to preventative care. Even workers who
have legal status can feel somarginalized by
the different language, culture, and system
that they assume that they cannot get care
for medical conditions, let alone preventa-
tive care. One SouthAmerican construction
worker, who agreed to be interviewed for this
article on condition of anonymity, exempli-
fies the issues experienced by many newly
arrived Latin American workers. He had
looked into purchasing health insurance,
but found it prohibitively expensive. Over-
whelmed by the complexity of the health-
care systemhere, he had simply given up on
seeking care. Though he suffers from severe
ulcer-like symptoms, especially when under
stress, he has not seen a doctor, even when
the symptoms were severe enough to pre-
clude all eating and even make drinking
water difficult. He had simply concluded that
it was not possible to obtain healthcare here.
With limited English skills, he had no idea
there were any options for people without
health insurance, even in case of emergency.
Race vs. class: socioeconomic
and ethnic factors in healthcare
disparities
Finally, the issue of teasing out disparities
based on inadequate or suboptimal treat-
ment because of race or ethnicity from
those based on lifestyle or socioeconomic
factors must be addressed. Lifestyle fac-
tors certainly contribute to different health