The Migrant Clinicians Network engages in healthcare delivery and healthcare research for low income workers including but not exclusively migrant workers. Their new Saving Lives by Changing Practice project is attempting to improve the quality of service to work injured clients. Amy Liebman is coordinating the program. She provided me with this introduction to the program.
For an earlier posting on community health clinic services to injured workers, go here.
Amy K. Liebman, MPA
Migrant Clinicians Network
410.860.9850 aliebman@migrantclincian.org
There are numerous barriers to recognizing and treating environmental and occupational health (EOH) problems in the primary care setting. Some of the underlying reasons are the limited EOH training front line providers receive as well as institutional challenges that prevent clinicians from adequately addressing EOH problems.
Category: Health & Safety
Inconsistent quality of healthcare for work injured immigrant workers
Many low income immigrant workers go to hospital emergency departments and to free care community health clinics with their work injuries. Emergency departments and community health clinics typically do not understand how to determine the occupational cause of injury, and do not try to contact the employer and to make sure that an injured worker accesses the workers comp system.
The clinics in particular often appear to be tone deaf to the special needs of injured workers. Example: I contacted the Joseph Smith Community Health Center in Boston, which actively serves low income immigrants, a dozen times to ask them about how they handle work injuries. To get a response i finally conducted a sit-in in the reception area, refusing to leave until I spoke with some one. Eventually the director of the clinic came downstairs. While pleasant, she showed zero interest in the special needs of injured workers, and in investigating them further.
My several contacts with the Health Resources and Services Administration, the federal agency responsible for providing financial and technical assistance to community health clinics, revealed that this agency has little interest in addressing the special needs of injured workers.
Avian flu and immigrant workers in poultry plants
A noted occupational health expect warns of avian flu coming into the United States via poultry plants and the largely immigrant work population. He warns that these workers should not be treated as canaries in the mine shaft.
Gary Greenberg MD manages a new non-profit aimed at speeding up transmission of time sensitive information on occupational risks: OHDEN, or the Occupational Health Disaster Expert Network.
Greenberg says the following scenarios could occur. Twoinvolve the arrival in the United States of a migratory bird with the avian flu:
1. a person could pick up a dead bird by the roadside
2. a local — not corporate –chicken farm serves as a way station for a migratory bird. The corporate chicken farms appear to have invested in bio-safety measures.
3. an individual arrives by plane from another, with the flu still in gestation.
Greenberg says that the avian flu does not transmit easily amomng people — it is not like the flu of 1918 – 1919, which swept through army camps, among ship crews, and onto city streets, and took years to eventually dissappear.
serious worker injuries by ethnic group, job and diagnosis
A commentor wrote to ask if I have for work fatalities of immigrants a breakdown by types of jobs, particular immigrant group most effected, etc. I have an indirect positive answer to this question, in the form of an ethnic analysis of work related hospitalizations. Researchers published in October 2005 a study of work related hospitalizations by ethnic groups in Massachusetts.
According to the authors,
This article reports on the use of statewide hospital discharge data to describe patterns of serious occupational injuries (that is, injuries requiring hospitalization) among racial and ethnic groups in Massachusetts.
The authors present a breakdown of hospitalizations by medical diagnosis, job and ethnic breakdown: white, black, Asian, American Indian, Hispanic, and other or unknown. They were able to show a relationship between the type of job and the type of injury (for instance: burns = restaurant work).
In a later posting I will summerize their findings.
Occupational fatalities of immigrants
The June, 2004 issue of the Monthly Labor Review published Foreign-born workers: trends in fatal occupational injuries, 1996–2001 by Katherine Loh and Scott Richardson. From the text:
New immigrants who arrived in the United States during the 1990-2001 period accounted for 50.3 percent of the growth in the Nation’s civilian labor force. That is, one out of every two net new labor force participants during this period was a new foreign immigrant. Historically, Current Population Survey (CPS) figures show that foreign-born workers, who accounted for 1 in every 17 workers in 1960, increased their share of the labor force to one in eight by 2000.
As the share of foreign-born employment has increased, so has the share of fatal occupational injuries to foreign-born workers. Yet, while the share of foreign-born employment increased by 22 percent from 1996 to 2000 the share of fatal occupational injuries for this population increased by 43 percent. This increase in fatal work injuries among foreign-born workers occurred at a time when the overall number of fatal occupational injuries to U.S. workers declined by 5 percent. As a result, the fatality rate for foreign-born workers has not mirrored the improvement seen in the overall fatality rate over this period. In 2001, the fatality rate for all U.S. workers decreased to a series low of 4.3 per 100,000 workers, but the fatality rate for foreign-born workers recorded a series high of 5.7 per 100,000 workers.
Oakland garment workers and failure to file claims
This is a hot research topic. I recently entered a posting of 2002 study of Asian garment worker injuries in Oakland. I mentioned in the posting that while it offers useful insights into how immigrant workers experience injury risks at work, the study is flawed in its interpretation of the self-reported injury data. The research team was, simply stated, unaware of how injury experiences turn into workers comp claims.
Two researchers at Michigan State University, Jeff Biddle and Karen Roberts, published an article based on a large survey of Michigan workers. I use this study as a benchmark for how American citizens working for established large employer file workers comp claims (or do not). Immigrant worker experience should be contrasted with the MSU findings. Many in this study do not file, even for disabling injury. Some of them could access other benefits. But that’s not the whole complex and engaging picture. If you need to understand underreporting by immigrants compared to the norm, get their analysis in the December 2003 issue of Journal of Risk & Insurance.
RAND issued in 2005 a study of the effect of health insurance coverage on work injury claiming behavior of workers. Both the Rand and the Biddle and Roberts study reflect a more sophisticated understanding of workers comp.
IL Governor supports Panel on Latino Work Safety
In late 2005 Governor Rod Blagojevich of Illinois gave his support to the findings and recommendations of a Panel on Latino Workplace Injuries and Fatalities. I will be delivering more information in the future about this panel, the first such major state panel on immigrant work safety to my knowledge. It is a model for other states to emulate.
Go here for the 11/9/05 press release.
According to the press release the Panel’s top five recommendations are:
Creating a Worker Safety Fund to support a collaborative partnership and outreach strategy statewide between community-based organizations and government agencies to, among other things, develop worker safety materials in Spanish and provide health and safety training in Spanish.
Streamlining and coordinating government services for workers and business in the state by relocating the On-Site Safety and Health Consultation team to the Illinois Department of Labor (IDOL) from the Department of Commerce and Economic Opportunity (DCEO).
Strengthening enforcement of the existing Day Labor Services Act, including increased penalties against unlawful day labor agencies, and allowing workers to sue employers for damages.
Developing a statewide data collection system to help centralize and analyze occupational injury and fatality data among Latinos gathered by agencies, community-based organizations, and educational institutions and convene in annual conferences to assess and review data.
Supporting further reforms to the Illinois Workers’ Compensation Act, including 1) establishing a stop-work order when an employer is uninsured; 2) establishing an injured workers’ benefit fund; 3) providing workers’ compensation to agricultural workers; and 4) ensuring adequate workers’ compensation coverage at worksites that use temporary labor.
Whom day laborers work for, what they do
A snapshot from On the Corner: Day Labor in the United States:
Principal employers of day laborers are (1) contractors in the construction and landscape gardening business and (2) private individuals. Two thirds of day laborers are hired repeatedly by the same employer.
At least three quarters of day laborers have work in most or all of the following occupations: construction labor, mover, gardner/landscaper, and painter. About two thirds have worked as roofers. Other common occupations are house cleaner, carpenter, and drywall installer.
The vast majority –- 83% — rely on day labor as their sole source of income, and 70% seek work at least five days a week. One third seek work seven days a week.
Go here for a full copy of On The Corner.
Florida construction injuries and Hispanics (2005)
Construction Up, Injuries Up, but Workers’ Comp Payouts Down
This article by Jessica M. Walker first appeared in the Daily Business Review on 10/20/2005. The following is an excerpt, and the full article can be acessed at the link above. We will be carrying on a regular basis will researched journalism.
This particular articles talks about the toxic cocktail one mixes with undocumented workers with employers in high injjry industries.
In his mid-teens, Hector Noriega moved from Mexico to Miami to find work in South Florida’s booming construction industry. The immigrant followed his two brothers, who previously had found construction work there.
In August of last year, while he was pouring concrete at a residential construction site on Key Biscayne, the teenager was seriously injured when he came into contact with an electrical line. He survived the accident but suffered severe burns.
His attorney, Judson Cohen of Cohen Law Offices in Miami, said Noriega might lose his leg from the accident. No longer employable, Noriega, now 16, is living with family in Miami.
Most workers in Florida would have filed a workers’ compensation claim, collected a payout, and that would have been the end of it. Noriega, however, is an undocumented alien and was not listed on the workers’ comp policy of the subcontractor, C&C Concrete Pumping, or the Miami-based general contractor, Mackle Construction Co.
Ironically, Noriega’s illegal status may allow him to proceed with a negligence lawsuit in Miami-Dade Circuit Court when a U.S. citizen or other legal worker generally could not. That could allow him to recover more than he could through a workers’ comp claim. There are a growing number of undocumented workers like Noriega laboring in the South Florida construction industry, and experts say the legal situation could arise more often.
As South Florida’s construction boom continues, more workers are pouring into the area in search of work. For both legal and illegal workers, the ability to recover damages for on-the-job injuries has been constrained due to a sweeping 2003 revision in the state’s workers’ comp law that was pushed through by business and insurance groups to curb workers’ comp costs, experts say.
Steven Field, a retired University of South Florida professor who formerly directed the Florida Association of Occupational and Environmental Medicine, said he’s seen a rising number of construction-related injuries over the past eight years in Florida. But despite the increase, workers’ comp payouts are declining.
The total amount of workers’ comp claims payouts reported to the state Department of Financial Services fell in Miami-Dade County from $5.9 million in 2002 to $2.8 million in 2004. In Broward County, payouts declined from $4.2 million in 2002 to $2.3 million in 2004. In Palm Beach County, they fell from $4.2 million in 2002 to $2.1 million in 2004.
Michael Haggard, a plaintiffs attorney who is a partner at Haggard Parks Haggard & Lewis in Coral Gables, said, “You’re seeing more accidents but not more lawsuits because of the changes in the workers’ comp law.”
Field said the construction industry has little oversight when it comes to safety. “You see situations were no safety precautions are taken,” he said. The federal Occupational Safety and Health Administration, which is supposed to enforce job safety rules, “has no standing with construction industry.”
More on Nationwide survey of day labor hiring sites
Previously, I posted about a story reporting on a national survey about day labor hiring sites. I have just obtained the Internet location of the complete National survey: On the Corner: Day Labor in the United States.. (PDF)