RESUMO
PURPOSE: Farmworkers frequently live in rural areas and experience high rates of depressive symptoms. This study examines the association between elevated depressive symptoms and health care utilization among Latino farmworkers. METHODS: Data were obtained from 2,905 Latino farmworkers interviewed for the National Agricultural Workers Survey. Elevated depressive symptoms were measured using the Center for Epidemiologic Studies Depression short-form. A dichotomous health care utilization variable was constructed from self-reported use of health care services in the United States. A categorical measure of provider type was constructed for those reporting use of health care. RESULTS: Over 50% of farmworkers reported at least 1 health care visit in the United States during the past 2 years; most visits occurred in a private practice. The odds of reporting health care utilization in the United States were 45% higher among farmworkers with elevated depressive symptoms. Type of provider was not associated with depressive symptoms. Women were more likely to seek health care; education and family relationships were associated with health care utilization. CONCLUSIONS: Latino farmworkers who live and work in rural areas seek care from private practices or migrant/Community Health Clinics. Farmworkers with elevated depressive symptoms are more likely to access health care. Rural health care providers need to be prepared to recognize, screen, and treat mental health problems among Latino farmworkers. Outreach focused on protecting farmworker mental health may be useful in reducing health care utilization while improving farmworker quality of life.
Assuntos
Agricultura/estatística & dados numéricos , Depressão/epidemiologia , Emigrantes e Imigrantes , Serviços de Saúde/estatística & dados numéricos , Meio Social , Adolescente , Adulto , Depressão/etnologia , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Pesquisa Qualitativa , Serviços de Saúde Rural/estatística & dados numéricos , Fatores Sexuais , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: To determine whether an association exists between reported birth weight and oedematous forms of severe protein energy malnutrition (PEM). METHODS: Severe PEM continues to be a major public health problem worldwide. However, the causes of oedematous PEM (OPEM) have not yet been elucidated. Recently, birth weight was reported to be associated with risk of ischaemic heart disease and Type 2 diabetes mellitus in adults. It is possible that the examination of the relationship between birth weight and OPEM in children may give clues, not only about the mechanisms underlying the developing of OPEM, but also about the mechanism by which associations between birth weight and adult disease may arise. As part of a larger project to create a database containing information on children admitted to the ward of the Tropical Metabolism Research Unit, the authors reviewed the clinical records of 884 children. Children were categorised as having either OPEM or non-OPEM. Multiple logisitic regression was used to examine the relationship between reported birth weight and the odds ratio (OR) for having OPEM. RESULTS: In this sample of children, the OR for having OPEM was 1.40 (95 percent CI 1.15 - 1.70) for each increase of 1 pound in birth weight. Birth weight remained significant even after inclusion of gender, mother's age and birth rank in the mutliple logistic regression model. CONCLUSION: These results suggest that among children with severe PEM, higher birth weights are associated withan increased risk of oedematous malnutrition. Replication of this result in a large sample is required.(Au)