PBS高端访谈:农场工人与卫生保健

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JUDY WOODRUFF: Finally: Farm workers face major challenges accessing health care. But a group in Southeastern Arizona has a unique solution that appears to be working. From the Cronkite School of Journalism¹ at Arizona State University, Anikka Abbott reports.

ANIKKA ABBOTT: Bend, pluck, place, repeat. For hours a day, workers at NatureSweet farms in Southeast Arizona pick tomatoes. It's work that requires strength, skill, and good health. Public health expert Jill Guernsey de Zapien says farmwork often causes muscle and back issues.

JILL GUERNSEY DE ZAPIEN, University of Arizona: Everything for harvesting crops, for packaging them, et cetera, and stuff, it is built to make it happen fast. It's not built to protect the body of the workers.

ANIKKA ABBOTT: The National Center for Farmworker Health says the top three things farm workers suffer from are obesity², hypertension, and diabetes³. Workers like Dillon Valenzuela do what they can to get ready for the day.

DILLON VALENZUELA, Farmworker (through translator): When we enter, first, we have to exercise, stretch out. Then we put all the protective clothes on for the greenhouse.

ANIKKA ABBOTT: Even though they prepare for the work, some farmworkers struggle to maintain their own health. Four hundred people work in this tomato plant. The majority of them work here in the greenhouses. And almost 95 percent of them speak Spanish primarily. Language is one barrier to health care. Access is another, says Gail Emrick, executive director of the Southeast Arizona Area Health Education Center, or SEAHEC.

GAIL EMRICK, Executive Director, Southeast Arizona Area Health Education Center: Particularly precarious⁴ with farmworkers is the type of labor⁵ they're involved in, if it's shift work vs. ongoing⁶ or formal employment. And so some people might have health insurance and health coverage⁷, and others may not.

ANIKKA ABBOTT: The National Center for Farmworker Health says almost 53 percent of farmworkers across the country are uninsured. Even some with health insurance have limited access. The ratio of people to doctors in rural areas is 2,500 to one.

JILL GUERNSEY DE ZAPIEN: It's not saying necessarily that we don't have enough health professionals. It's saying that they're not distributed well throughout the country.

ANIKKA ABBOTT: Here in Winchester Heights, an unincorporated Latino neighborhood just 10 minutes from the farm, there are no doctors. The closest town with a medical facility is 20 minutes away. Enter the Southeast Arizona Area Health Education Center, whose goal is to help residents in rural areas gain access to health care. In Winchester Heights, they helped build a community center where public health interns⁸ train resident volunteers, known as promotoras de salud. After receiving training, health care workers, like Aida Dominguez, go door to door in Winchester Heights to teach their neighbors about better health, like nutrition and sun protection.

AIDA DOMINGUEZ, Health Care Volunteer (through translator): And then she told me, I am so grateful because, I didn't know, but now I know that you have to use a hat.

ANIKKA ABBOTT: Latino farmworkers say the community center and health workers have made an impact on their health. Having promotoras who speak their own language and come from their own community make a difference.

AIDA DOMINGUEZ (through translator): It's important to have a social environment and also to be able to help the children, the youth, the adults, the elders, so we will be united.

ANIKKA ABBOTT: Along with health care, the health education group is now also teaching residents how to run their own nonprofit. They plan to turn the community center over to the people in Winchester Heights next year. For the PBS NewsHour, I'm Anikka Abbott with Cronkite News in Winchester Heights, Arizona.

朱迪·伍德拉夫：今天，咱们来聊聊农场工人与卫生保健有关的一些重大挑战。但亚利桑那州东南部的一个组织有一个独特的解决方案，似乎有作用。下面请听阿妮卡·阿伯特从亚利桑那州立大学克朗凯特新闻学院发回的报道。

阿妮卡·阿伯特：弯腰、采摘、放好位置，重复刚才的过程。每天有数小时的时间里，亚利桑那州东南部自然甜农场的工人们都会采摘土豆。这项工作需要力气、技巧和健康的身体。公共卫生领域的专家吉尔·格恩西表示，农场的工作经常会引发肌肉和背部的一些问题。

吉尔·格恩西，亚利桑那大学：这个方法让所有工作都变得更加快捷了，比如收庄稼、打包等等。这个方法不是为了保护工人们的身体健康。

阿妮卡·阿伯特：国家农业工人健康中心表示，农场工人的3大健康问题是：肥胖、高血压、糖尿病。狄龙·巴伦苏埃拉等工人竭尽所能为这一天做着准备。

狄龙·巴伦苏埃拉，农场工人（以下内容经过翻译）：我们进来的第一件事就是锻炼和拉伸。然后，我们会穿上防护性服装来应对温室里的天气。

阿妮卡·阿伯特：虽然他们要为工作而做准备，但一些农场工人依然很难保证健康。该土豆工厂里有400名工人。其中大多数人都在温室里工作。而且近95%的人都说西班牙语。语言成为了卫生保健的一大障碍。获取卫生保健服务难，这是另一个障碍，盖尔·埃姆里克是亚利桑那东南部卫生教育中心的执行理事。

盖尔·埃姆里克，亚利桑那东南部卫生教育中心的执行理事：农场工人有一个难确定的要素是他们参与的工种，问题在于他们做的是倒班的工作还是正式工作。所以可能有些人有卫生保健，有些人却没有。

阿妮卡·阿伯特：国家农业工人健康中心表示，近53%的农场工人都没有这方面的保障。即便是有卫生保障的人获取的服务也很有限。农村地区的就诊率在1/2500。

吉尔·格恩西：这并不是说我们没有足够的卫生专家。只是说明全国范围内的分配不够均匀。

阿妮卡·阿伯特：在温彻斯特高地有一个居住着拉丁人的农村地区，距离农场只有10分钟，这里没有医生。带有医疗设备的城镇，最近的也需要20分钟的路程。走进亚利桑那东南部卫生教育中心。该中心的目标是帮助当地农村居民获取卫生服务。在温彻斯特高地，他们助力打造了一个社区中心，这里的公共卫生实习生会给当地志愿者做培训，人们都管他们叫promotoras de salud。在获得培训之后，像艾达等医疗人员会挨家挨户地教大家如何更好地做保健，比如获取营养和防晒。

艾达，卫生保健志愿者（以下内容经过翻译）：然后她告诉我说，我很感激，因为我之前不知道，但我现在知道要戴帽子了。

阿妮卡·阿伯特：拉丁农场工人说，社区中心和卫生工作人员对他们的健康产生了影响。有了这些会说当地语言且来自本地的志愿者之后，情况大有不同。

艾达（以下内容经过翻译）：有社会环境是很重要的，也要有能力帮助孩子、青少年、成年人、老年人，这样我们才能团结在一起。

阿妮卡·阿伯特：除了卫生保健之外，该组织现在也在教当地居民如何运营自己的非盈利组织。他们打算明年将该社群中心交由温彻斯特高地的居民来打理。感谢收听阿妮卡·阿伯特从亚利桑那州温彻斯特高地克朗凯特新闻发回的《新闻一小时》。