A B ST R A C
T
F
a rm i
ng
is o n e o
f
t
h
em
o st
h
a z a rd
o u sp
r of
e s si
o n sS
e v e r al
st
ud i
e s of
f
a rm
w
o rk
e r sh
a v ei
d
e nti
fi
ed
v ari
o u s ri
sk f
a cto r s a s s o c
i
at
ed
w
it
h
i
nj
u rie s a n
d i
l l
n e s s e si
ns e v e r a
l
f
a rm w
o rk
e rp
op
ul
ati
o n s,b
ut
fe
w
st
ud i
e sh
a v ef
o c u s ed
o nH i
sp
a ni
cm
i
g
r a nt
f
a rm
w
o rk
e r s.T h i
s st
ud y
a n al y
z ed f
a rm
w
o rk
e r em
p
l
oy
m
e nt
d
at
a a nd
ag
ri
c ul
t
u r al i
nj
u ry
a nd
il l
n e s sin c
i d
e n c ed
ata u s
i
ng P
oi
s s o n r eg
r e s si
o nt
od
et
e rm
i
n ei f
a n a s s o ci
at
i
o n e xi
st
sb
et
w
e e nt
h
e n um
b
e r of H i
sp
a ni
cm i
g
r a nt
f
a rm
w
o rk
e r s a nd
ag ri
c ul
t
u r al
i
nj
u ry
a nd
i l
l
n e s sin c
i d
e n c ei
nN
ort
h
C
a r ol i
n ab
et
w
e e n1 9
9
2
a nd 2 0 0 1
N
o si g
ni
fi
c a nt
a s s o ci
at i
o nw
a sf
o u nd
b
etw
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e n um
b
e r of
th
e s ew
o rk
e r s a nd
t
h
ei
nj
u ry
a nd i l
l
n e s si
n ci d
e n c e r at
eT h
e r em
ay
b
ep
r ob l
em
sw
i
t
h f
ul l
a nd
a c c u r at
e r ep
ort
in
g
of i
nj
u rie s a n
d i l l
n e s s e sin
t
h
eH
i
sp
a nic
m i
g
r a nt
f
a rm
w
o rk
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op
ul
at
i
o nM
o r e r ep
r e s e nt
at
i
v ein
j
u ry
a nd i l
l
n e s sd
at
ai
sA C
K
N
O
W
L E D
G
E
M
E
N
T S
I w
o ul
d l i k
eto
th
a nk m
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ad
vi
s o r,L
e e n aN y l
a nd
e r-
F
r e n ch
, a n
d
c om m i
t t
e em
em b
e r sD
a n aL
o om
i
s a nd R
eg
i
n aL
ug i
nb
uh l
,f
o rth
ei
r ad
vi
c e a nd
s up p
o rt t
h
r o ug h
o ut
t
h
e c o u r s e of
th i
s st
ud
y
T h i
sp
r oj
e ct
w
o ul d
n ot
h
a v eb
e e np
o s si
b l
ew
i
th
o ut t
h
em
.I
w
o ul d
al
s ol i k
et
o e xp
r e s sm
y g
r ati
t
ud
et
om
y g
o od f
rie n
d
,K
a r e nJ
o n e s,w h
o s ee n c o u r a
g
em
e nt
w
h i l
ew
rit
in
g
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hi
sp
ap
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p
r e ci
ate
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am
al
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nd
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t
ed
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ot
h
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ta
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at t
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ri
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u r eE
m
p
l
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Se r v
i
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iv
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h
eN
o rt
h C
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m
p
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e c u ri
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om m i
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a nd
th
eR
e s e a r ch
a nd P
ol
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sio n
at t
h
eN
o rth C
a r ol
i
n aD
ep
a rt
m
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of L
ab
o r,w
h
o s ew i l l i
ng
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o r et
ri
e v e ob
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at
a a nd
a n sw
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i
o n sa
b
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h is
d
at
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ed
th i
s st
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of
r ui
t
io n
.A
nd fi
n al l
y
,
I
w
o ul d l i k
eto
th
a nk
m
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f
ri
e nd
sw i
t
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i
nt
h
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h
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of
P
ub
l
ic
H
e al
th
f
o rl i
f
ti
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m
y
sp
ir
i
t
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a ny
o c c a si
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w
o rk
ed
o nt
h
i
sp
r oj
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T A B L E
O
F C
O N
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N
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S
I
I
nt
r od
u ct
i
o n1
I I
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a ck
g
r o u nd
4
I I I
M
at
e ri
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d
M
et
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od
s1 3
A
St
ud
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op
ul
at
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1 3
B
I
nj
u ry
a nd
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l l
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at
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C
.S
t
ati
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n al y
si
s1 5
I V
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e s ul
t
s1 7
V
D i
s c u s si
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V I I
R
ef
e r e n c e s2 7
L I S T O F F I G U R E
S
F
i
g
u r e1
N
C
F
a rm
W
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e rP
op
ul
at
i
o n ,1 9
8
8
-
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1 7
F i g
u r e2
I
nj
u ry
a nd I l l
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n ci
d
e n c eR
at
e,1 9 9 2
L I S T
O
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T
ab l
e1
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oi
s s o nR
eg
r e s si
o nR
e s ul t
s1 8
L I S T O F A B B R E V I A T I O
N
S
B L
S
B
u r e a u of
L
ab
o rSt
at
i
st
ic s
C
D C
C
e nt
e r sf
o rD i
s e a s eC
o nt
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C
I
c o nfi
d
e n c ei
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e r v al
D O A
D
ep
a rt
m
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of A g
ri
c ul
t
u r eD
O
L
D
ep
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m
e nt
of L
ab
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E
m
p
l
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m
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S
e c u ri
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C
om m i
s si
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in c
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r at
i
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N
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C
a r ol
in a
N
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ati
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n st
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c c up
at
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Sa
f
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a nd H
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R
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i
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A
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c c up
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l S
af
et
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a nd
H
e alt
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m
in
i
st
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ris
k
r ati
oSE
st
a nd
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e r r o rI
.I
nt
r od
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i
o nA g
ri
c ul
t
u r ei
s c o n si d
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t
ob
e o n e of
t
h
em
o st
h
a z a rd
o u si
nd
u st
ri
e sin
t
h
eU
ni
t
ed
S
t
at
e s(
N I
O
S H
,2 0 0 4 ; F
e n sk
e a nd
Si
m
c o x,2 0 0 0
)
.A g
ri
c ul
t
u r al w
o rk
,w h
i
ch
i
sp h y
si
c al
l
y
d
em
a nd i
ng
,p
ut
sw
o rk
e r s at
ri
sk
f
o rin
j
u ri
e s s u ch
a s sp
r ai
n s, st
r ain s
, a nd d i
sl
o c at
i
o n s, a nd
i l
ln e s s e s
i
n cl
ud i
ng
aw
i
d
e v a ri
et
y
of
c a n c e r s(M
cCu r
d
y
et
al
,2 0
0
3
;
M
i
l l
s a nd
K
w
o ng
,2 0 0 1
)
A d d
i
t
i
o n al l y
,w
o rk
e r s a r e e xp
o s ed
t
oh
a z a rd
si
n cl
ud
in
g
m
a ch i
n e ry
, el
e ct
ri
ci
t
y
,a n
d
ch
em i
c al
c om
p
o u nd
sP
o v e rt
y
,l
a ck
of
a c c e s st
oh
e al
t
h
c a r e, a nd
s e a s o n al m i
g
r at
i
o na
l
s o c o nt
ri b
ut
et
oi
n c r e a s ed
ri
sk
of i
nj
u rie s a n
d
i
l
l
n e s s e s(
O SH A
,2
0
0 4
)
H
i
sp
a ni
cm i
g
r a nt
w
o rk
e r s a r e a ni m
p
o rt
a nt
s o u r c e of
l
ab
o rf
o rt
h
e ag
ric u
l
t
u r al
i
nd
u st
ry b
e c a u s e of
t
h
ei
rw
i
l li
ng
n e s st
ow
o rk
in
ch
al l
e ng i
ng
e n vir o n
m
e nt
sf
o rl
ow w
ag
e sI
nN
o rt
h C
a r ol
i
n a,t
h
ei
rl
ab
o ri
s e s s e nt
i
al f
o rt
h
ep l
a nt
i
ng
,t
e nd i
ng
, a nd h
a r v e st
i
ng
of
c r o
p
s s u ch
a st
ob
a c c o, sw
e et
p
ot
at
o e s, c u c um
b
e r s, ap
p
l
e s, a nd C h
ris
t
m
a st
r e e sN
e a rl y
t
l
i r e e-q
u a rt
e r s of
f
a rm
w
o rk
e r si
nt
h
eU
ni
t
ed S
t
at
e s e a r n ed l
e s st
h
a n$
1 0
,0 0 0 p
e ry
e a r(
M
eh
t
a et
al
,2 0
0
0
)
.I
nN
o rt
h
C
a r ol
in a
,H
i
sp
a ni
cm i
g
r a nt
w
o rk
e r s c om
p
ri
s ed 3
5
%
of
t
h
et
ot
al
f
a rm
w
o rk
e rp
op
ul
at
io n
in
2 0 0 2 ;
af
ig
u r et
h
at
i
n c r e a s ed f
r om
1 5
% i
n19
8
8
(
N C
E
S C
,2
0
0 3
)
I
n cl
ud
i
ng
d
ep
e nd
e nt
s,N
o rt
h C
a r ol
i
n a 's
f
a rm
w
o rk
e rp
op
ula
t
i
o n e x c e ed
s2 0 0
,0 0 0
, r a nk i
ng
fi
f
t
h l
a rg
e st
i
nt
h
eU
ni
t
ed S
t
at
e s(
M
eh
t
a et
al
,2 0 0 0
)
.P
ri
o r st
ud ie s o n
ag
ri
c ul
t
u r al i
nj
u rie s a n
d
i
l l
n e s s e sh
a v e n ot t
y p i
c al
l y
f
o c u s ed
o nH i
sp
a ni
cm i
g
r a nt
w
o rk
e r s(
M
cC
u rd
y
a nd C
a r r ol l
,2
0
0 0
)
T
h i
sp
op
ula
t
io n
i
sd
i
f fi
c ul
t t
os
t
ud y d
u et
ow
o rk
e r s 'd i
sp
e r s ed
o v e r aw
i d
eg
e og
r ap
h
i
c a r e a a nd
ch
a ng
e s e a s o n al l y
F
u rt
h
e rm
o r e, ag
ri
c ul
t
u r eis
e x e
m
p
t
fr
om m
a ny
o c c up
at
io n a
l
s af
et
y
a nd h
e al
t
h
r eg
ul
at
i
o n s(
M
cC
u rd y
a nd C
a r r ol l
,2 0 0 0
)
.P
ri
o r r e s e a r ch h
a sf
o c u s ed
o nA fr
i
c a n -A
m
e ri
c a nf
a rm
w
o rk
e r s a nd f
a rm
ow
n e r s(
M
cG
w
in
et
al
,2 0 0 0 ; L y
m
a n et
al
,1 9 9 9
)
o rp
op
ul
at
i
o n s c om
p
ri
s ed
of
w
h i
t
ef
am
i l y
f
a rm
e r s(
L
ew i
s et
al
.,1 9 9 8
)
.I
nt h
e s e st
ud i
e s, v a ri
o u sd
em
og
r ap h i
c,m
ed
i
c al
, a nd
p
e r s o n al
ri
sk
f
a ct
o r s a s s o ci
at
ed w i
t
h
f
a rm
w
o rk
e ri
nj
u ry w
e r ei d
e nt
i f i
ed
I
n ap
r e vi
o u s st
ud
y
of
ag
ri
c ul
t
u r al i
nj
u ri
e sin
C
al
i f
o r nia
w
h
e r e o nl
y H
i
sp
a ni
cm
i g
r a nt
w
o rk
e r sl i
vi
ng i
n st
at
e-o
p
e r at
ed h
o u si
ng w
e r ein c
l
ud
ed
, a n ag
ri
c ul
t
u r al i
nj
u ry
r
i
sk
c om
p
a r ab l
et
ot
h
at
s e e nin
ot h
e rl
a rg
e-s c ale s
t
ud
i
e s of
ag
ric u
l
t
u r al
w
o rk
e r sw
a so
b
s e r v ed
(
M
cC
u rd
y
et
al
.,2
0
0 3
)
H
ow
e v e r,t
h
e a ut
h
o r s c o n c ed
ed
t
h
at
i
t
is
l i k
el
y t
h
at
t
h
et
r u ei
nj
u ry
ri
sk
of H i
sp
a ni
cm i
g
r a nt
f
an n
w
o rk
e r si
sh
i g h
e r,b
e c a u s et
h
e st
ud y p
op
ul
at
i
o nw
a s n ot
b
r o ad
l
y
r ep
r e s e nt
at
i
v e of
t
h
e al l H i
sp
a ni
cm
i g
r a nt
f
a rm
w
o rk
e r sR
i
sk f
a ct
o r s a s s o cia
t
ed
w
i
t
h i l l
n e s sh
a v e al
s ob
e e n st
ud ie
d
(
E l
m
o r e a nd
A
r c u ry
,2
0 0
1 ;
M
i
l
l
s a nd K
w
o ng
,2 0 0 1
)
.M
i
l
l
s a nd K
w
o ng
(
2 0 0 1
)
f
o u nd
t
h
at t
h
e ri
sk
of
c e rt
ain
c a n c e r s
w
a s el
e v at
ed
i
nH
is
p
a ni
cf
a rm
w
o rk
e r sin
C
al i f
o r ni
a r el
at
i
v et
ot
h
e e nt
i
r eH i
sp
a ni
cp
op
ul
at
i
o ni
nC
al i f
o r ni
a.U
nl
i
k
ei
nj
u ri
e s,w h
i
ch
r e s ul
t
f
r om
a si
ng l
e e v e nt
o re x
p
o s u r e,i l l
n e s s e s u s u al
l
y d
e v el
op
o v e r al
o ng
e rp
e ri
od
of
t
i
m
e a nd
a r em
ul
t
i
f
a ct
o ri
al i
nn a
t
u r e a s a v a ri
et
y
of f
a ct
o r s c a n c o nt
ri b
ut
et
ot
h
ed
e v el
op
m
e nt
of i
l
ln e s s
.T
h
e r ef
o r e ,t
h
er e
l
at
i
o n sh i
p b
et
w
e e n e xp
o s u r e a nd
t
h
ei
l
l
n e s si
s of
t
e nl
e s s cl
e a r.A
s a r e s ul
t
,i l l
n e s s e s a r eb
el i
e v ed
t
ob
e u nd
e r r ep
o rt
ed
(
B
L S
,2 0
0
3
)
A
sd
e s c ri
b
ed
ab
o v e,t
h
el i
t
e r at
u r e s ug g
e st
st
h
at
a ni
n c r e a s ed
n um b
e r of
H
i
sp
a ni
cm i
g
r a nt
f
a rm w
o rk
e r si
nt
h
ew
o rk
f
o r c em
ay b
e a s s o ci
at
ed w i
t
h
ah i
g
h
e rin
j
u ry
a nd i l l
n e s sa
t g
r e at
e r ri
sk f
o ri
nj
u ri
e s a nd
i
l l
n e s s e s,t
h
ey
a r e r el
u ct
a nt t
o s e ek
m
ed i
c al
c a r ei
nt
h
eU
ni
t
ed St
at
e s(
L
at
i
n oH
e al
t
h T
a sk F
o r c e,2 0 0 3
;
V i
l
l
a r ej
o,2 0 0 3
)
T
h
e r ef
o r e,th
e r ep
o rt
ed
i
nj
u ry
a nd i l l
n e s sin c
i d
e n c e r at
el
i
k
el y w
o ul
d
b
e u nd
e r e st
i m
at
ed
.T h
ep
u rp
o s e of
t
h i
ss
t
ud y w
a st
oi
n v e st
i g
at
ei f
,i
nf
a ct
,t
h
e r ei
s a r el
ati
o n sh
i
p b
et
w
e e nt
h
e n um
b
e r of H i
sp
a ni
cm
i g
r a nt
w
o rk
e r s a nd
ag
ri
c ul
t
u r al
i
nj
u ry
a nd
i
l l
n e s si
n ci
d
e n c e r at
e si
nN
o rt
h
C
a r ol
i
n aI I
.B
a ck g
r o u nd
W
h
i
l
e c o n si
d
e r ab l
ei
nf
o rm
at
i
o n e xi
st
s ab
o ut th
ed
em
og
r ap
h i
c ch
a r a ct
e ri
st
i
c s of
a
g
ri
c ul
t
u r al w
o rk
e r s a s aw h
ol
e,l
e s si
sk
n ow
n ab
o ut th
eH i
sp
a ni
c s e ct
o ri
np
a rt
i
c ul
a rI
nt
h
e19 9
7
-1 9
9
8 N
at
i
o n al A g
ri
c ul t
u r al
W
o rk
e r sS
u r v ey
,f
o rw h
i
ch d
at
aw
a s c ol l
e ct
ed
t
h
r o ug h
a n at
i
o nw i d
e, r a nd
om
s u r v ey
of w
o rk
e r si
np
e ri
sh
ab
l
e c r op
ag
ri
c ul
t
u r e,h
alf
of
al
l
f
a rm w
o rk
e r sw
e r e r ep
o rt
ed
t
ob
e u nd
e r2 9 y
e a r s of
ag
e(
M
eh
t
a et
al
,2 0 0 0
)
.T h
em
ed
i
a nn u
m b
e r of
y
e a r s of
s ch
o ol i
ng
am
o ng
th
e s ew
o rk
e r sw
a s si
x, a n
d
j
u st
10 %
of f
o r ei
g
n -b
om
f
a rm w
o rk
e r s r e ad
o r sp
ok
eE
ng l i
sh f l
u e nt
l y
.N
i
n et
e e np
erc e nt
of f
arm
w
o rk
ersw
eree
m
p l
oy
ed b
y f
a rm
l
ab
o r c o nt
r a ct
o r s,w h
o s e r v e a si
nt
e rm
ed i
a ri
e sb
etw
e e nt
h
ef
a rm
e r a nd
f
a rm w
o rk
e r, a nd
a r e r e sp
o n si b l
ef
o rh
i
ri
ng
,f
iri
ng
, an
d
s up
e r vi
si
ng
th
ew
o rk
e r s.T
h
r e e-q
u a rt
e r s of f
a rm
w
o rk
e r sw
e r ep
ai
d b
y t
h
eh
o u r;
t
h
e r e st
w
e r ep
ai
d p
i
e c e-r at
eE
m
p
l
oy
e r-p
r o vi d
ed h
e al
t
h
i
n s u r a n c e c o v e r ed f
ew
e rt
h
a nf
i v ep
e r c e nt
of
w
o rk
e r s.V i l l
a r ej
o(
2 0 0 3
)
d i
s c u s s ed
th
ed
if f i
c ul
t
i
e s a s s o ci
at
ed w i
t
h
a c c u r at
el y
m
e a s u ri
ng
t
h
eh
e al
th
st
at
u s of
M
e xi
c a n-b
om
f
a r
m w
o rk
e r s, a s a n u nk
n ow
ny
et
p
r e s um
ab l
y l
a rg
es
h
a r e of
th
e s ew
o rk
e r s r et
urn
t
oM
e xi
c o at t
h
e e nd
of
e a ch g
r ow i
ng
s e a s o nM
a ny
w
o rk
e r sm
ay
r e c ei
v eh
e al
th
c a r ei
nt
h
ei
rh
om
el
a nd
,w h
e r et
h
ei
r c o nd
i
t
i
o n s a r e u nl i
k
el
y
t
ob
e r ep
ort
ed
t
ot
h
ei
r em
p
l
oy
e r sSi
n c em
a ny
i
nj
u ri
e s a nd i ll
n e s s a r e n ot
r ep
ort
ed
t
of
a rm
w
o rk
e r s'
e
m
p l
oy
e r s,th
ey
a r e n e v e r r ep
ort
ed
t
ot
h
eO
c c up
at
i
o n al S
af
et
y
a nd
H
e al
t
h
A d m i
ni
st
r at
i
o n(
O SH A
)
V
i
l l
a r ej
op
oi
nt
ed
o ut t
h
at
m
a ny
h i
r ed
f
a rm
w
o rk
e r sw
h
o r e si d
ec o
m m
u ni
t y
cl i
ni
c s o rh
o sp i
t
al
em
e rg
e n cy
ro om
sT h
el
a ck
of h
e al
th i
n s ur an c e, al
o ng
w
i
t h
c ul
tu r a
l
a nd
l
a ng
u ag
eb
a r ri
e r s,d
i
s c o u r ag
em
a ny f
a rm
w
o rk
e r sf
r om
s e ek i
ng
m
ed i
c al
c a r e
i
nth
eU
ni
te
d S
ta
t
e s.B
u e s ch
e r(
2 0 0 3
)
r e vi
ew
ed
a v ai l
ab l
ed
at
at
o a s s e s st
h
eh
e al
t
h
st
at
u s of
t
h
eL
at
i
n op
op
ul
at
i
o ni
nN
o rt
h C
a r ol
i
n a.D
at
af
r om
th
eC h i
ef
M
ed i
c al E
x am i
n e r'
s
O
f f
i c efr o
m
1 9 9 6
-2
0
0 0
sh
ow
ed
t
h
at
m
o r eth
a n4 5
%
of L
at
i
n o s ag
e1 5
a nd
ol d
e r,w h
od
i
ed f
r om
u n
i
nte n
t
i
o n al i
nj
u ri
e s, s u ch
a sm
oto r v e
h i
cl
e a nd w
o rk p l
a c ei
nj
u ri
e s, a nd
w
e r et
e st
ed f
o ra
l
c oh
ol
,h
ad
ab
l
o od
al
c oh
ol
c o n c e nt
r at
i
o n of
0
.0 8
m
g / d L
o rh
i
g h
e rN
e a rl y 3 1
%
of
L
at
i
n o sh
ad
a v e ry
h i
g
h b
l
o od
al
c oh
ol
c o n c e nt
r at
i
o n(
m
o r et
h
a nt
w
i
c et
h
el
eg
al l
i m i
t
of
0
0
8
m
g / d L
)
, c om
p
a r ed
t
o1 8
%
of w h
i
t
e s a nd A f
ri
c a n-
A
m
e ri
c a n s.
D
at
af
r om
t
h
eC
e nte r s
f
o rD i
s e a s eC
o ntr o
l
(
C D C
)
sp
o n s o r ed B
eh
a vi
o r al R i
sk F
a ct
o rS
u r v ei l l
a n c eS
y
st
em
f
r om
1 9 9 7
-2
0 0
2
i
nd i
c at
ed
t
h
at
1
9 %
of S
p
a ni
sh
- sp
e ak i
ng L
at
i
n o sh
ad
c o n s um
ed fi
v e o rm
o r ed
ri
nk
si
n o n e si
t ti
ng
i
nt
h
ep
a st
m
o nt
h
, c om
p
a r ed
w
i
t
h
1 0
%
of
w h i
t
e a nd
7 7
%
of
A fr
i
c a n-A
m
e ri
c a n s.H
ow
e v e r ,t
h i
s s u r v ey w
a s c o nd
u ct
ed
vi
at
el
ep h
o n e,t
h
e r eb
y
e x cl
ud
i
ng
th
eL
at
i
n op
op
ul
at
i
o nw i
t
h
o ut t
el
ep h
o n e s e r vi
c e.T h
e r ep
o rt
of
t
h
eN
o rt h C
a r ol
i
n aL
at
i
n oH
e al
t
h T
a sk
F
o r c e(
2 0 0 3
)
p
r o vi d
e s a no v e r v
i
ew
o nt
h
eh
e al
t
h
of L
at
i
n o si
nN
o rth
C
a r ol
i
n a a nd
e xp l
ai
n sth
at
f
at
al i
sm m
ay p l
ay
am
aj
o r r ol
ei
nd
et
e r ri
ng L
at
i
n o sf
r om
g
et t
i
ng
m
ed i
c al
at t
e nt
i
o nS
om
eL
at
i
n o sm
ay
b
el i
e v et
h
at
i
nj
u ri
e s a nd
i l l
n e s s e s a r e c a u s ed b y
t
h
e e vi l d
o n et
o o n eb y
a n ot
h
e rT h
i
sr e
p
o rt
p
oi
nts o u
t t
h
at
L
at
i
n o sf
e el
th
at
a ni
nd
i
vi
d
u al
i
s of
te n
n ot
a c c o u nta
b l
ef
o rm
at t
e r so
f h
e al
t
h
a nd
w
el
l
b
ei
ng
,t
h
at t
h
e r ei
sl
i
t tl
et
h
at
c a nb
ed
o n eto
p
r e v e nt
h
a rm
A
d d i
t
i
o n al l y
,t
h
e r ep
ort
d i
sc
u s s e sh
ow
m
a ny
L
at
i
n o s a r e r el
u ct
a nt t
o s e ek
h
e al
t
h
c a r ei
no
f
em
b
a r r a s sm
e nt
ass oci
at
ed w i
t
h b
ei
ng
at t
e nd
ed b y
ap
r of
e s si
o n al
of
t
h
e op p
o si
t
eg
e nd
e ro r u n
d
e rg
oi
ng
m
ed i
c al
t
e st
st
h
at
c om
p
r om i
s ep
e r s o n al p
ri
v a cy
.T
h
eh
a z a rd
o u s n at
u r e of
ag
ri
c ul
t
u r eh
a sb
e e n e x am
i
n ed i
n n um
e r o u s st
ud i
e sr e v
i
ew
ed b
y
M
cC
u rd y
a nd C
a r r ol
l
(
2 0 0 0
)
T h
e s e a ut
h
o r sp
oi
nt
o ut t
h
at
m
o st
e
p
i
d
em i
ol
og
i
c al
st
ud
i
e s of
ag
ri
c ul t
u r al i
nj
u ri
e si
n v ol
v ef
am i l
y
f
a rm
e r s a nd
t
h
at
f
ew d
at
aa
d
d
r e s st
h
ei
m
p
a ct
of
r a c e o r et
h
ni
ci
t
y
o ni
nj
u ri
e s a nd i l
l
n e s s e s.M
cC
u rd
y
a nd C
a r r ol
l
a
l
s od i
s c u s st
h
e n e ed f
o r c o nt
i
n u ed
r e s e a r ch i
nt
h
e a r e a,i
n cl
ud
i
ng
t
h
ei
d
e nt
i
f
i c at
i
o n of
h
i
g h
-ri
sk g
r o up
s a nd
i
nj
u ry
ri
sk f
a ct
o r s.L
ew i
s et
al
.(
1 9 9 8
)
c o nd
u ct
ed
a st
ud
y
t
h
at
e x am i
n ed
ri
sk f
a ct
o r s a nd
ag
ri
c ul
t
u r al
i
nj
u ri
e si
nI
ow
af
am
i l y f
a rm
e r sT h
ei
r r e s e a r ch
f
o u nd
t
h
at
ay
o u ng
e r ag
e, aw
o rk
-l i m i
t
i
ng
h
e al
t
h
p
r ob
l
em
, e xp
o s u r et
o ch
em i
c al
s, a nd w
o rk
i
ng
o n s om
e o n e el
s e 's
f
a rm
w
e r e al l
s
i
g
ni
f
i c a nt
l
y
a s s o ci
at
ed
w
i
t
h i
nj
u ry
I
nt h
i
s st
ud
y
, s af
et
y
t
r ai
ni
ng h
ad
n o si
g
ni fi
c a nt
e
f f
e ct
o ni
nj
u ry
o ut
c om
e.H
ow
e v e r,t
h
e r e sp
o n s e r at
e of
t
h
e st
ud y w
a s o nl y 3 9 4
%
a nd
t
h
e st
ud
y w
a s s ub
j
e ct t
o r e c al l
b i
a s.A d
d
i
t
i
o n al
l y
, o nl y w h i
t
ef
a rm
e r s r e sp
o nd
ed
t
ot
h
es u r v e
y
L y
m
a n et
al
(
1 9 9 9
)
c o nd
u ct
ed
a st
ud y
t
od
et
e rm i
n ew h
at
f
a ct
o r s a r e a s s o ci
at
ed
w
i
t h
i
n c r e a s ed
ri
sk
of
ag
ri
c ul
t
u r al i
nj
u ry f
o rw
h
i
t
e ow
n e r/
op
erat
o r s,A
f
ri
c a n-
A m
e r
i
c a no
w
n e r/
op
e r at
o r s, a nd
A f
ri
c a n-A
m
e ri
c a nw
o rk
e r si
nA l
ab
am
a a nd
M
i
s si
s si
p p
i
T h i
sp
r o sp
e ct
i
v e st
ud
y
al
s op
r o vi d
ed i
nf
o rm
at
i
o n ab
o ut t
h
e r a ci
al d
i
st
ri b
ut
i
o n a nd
p
r e v al
e n c eo
f p
ri
o r ag
ri
c ul
t
u r al i
nj
u ri
e si
nt
h
e st
ud
y p
op
ul
at
i
o nD
at
aw
e r e c ol l
e ct
ed
u si
ng
q
u e st
i
o n n ai
r e s s e nt t
o1
,3 1 0 f
a rm
e r si
n r u r al
c o u nt
i
e sw
i
t
h
al
a rg
eA
f
ri
c a n-
A
m
e ri
c a nA l
ab
am
a a nd
M
i
s si
s si p p i A g
ri
c ul
t
u r al S
t
at
i
st
i
c sS
e r vi
c e s, a nd
ot
h
e r ow
n e r/
op
e r at
o r s a nd
w
o rk
e r sw
e r e r e c r ui
t
ed
t
h
r o ug h
c o u nt
y
ag
ri
c ul
t
u r al
ag
e nt
s a nd
f
a rm
a s s o ci
at
i
o n s.T h
eL y
m
a n et
al
.(
1 9 9 9
)
st
ud
y f
o u nd
s e v e r al
f
a ct
o r s, s u ch
a st
r a ct
o r u s e,h i g h l y
m
e ch
a ni
z ed
f
an n
i
ng
op
e r at
i
o n s, a nd
al
c oh
ol
c o n s um
p
t
io n
w
e r e a s s o ci
at
ed
w
i
t
h p
ri
o ri
nj
u ry i
nw h i
t
e ow
n e r/
op
e r at
o r sF
o rA
fr
i
c a n -A
m
e ri
c a n ow
n e r
/
op
e r at
o r s,b
e
i
ng
f
at
i
g
u ed
w h i
le
f
a rm in
g w
a s a s s o cia
t
ed
w
i
t
h
p
rio r
in
j
u ry
.F
o rA f
ric a n
-A
m
eri
c a nw
o rk
e r s,c a r e
f
ul
n e s s ab
o ut
s af
et
y
a nd
al
c oh
ol
c o n s um
p
t
i
o nw
e r e a s s o ci
at
ed w
i
t
h
p
ri
o ri
nj
u ry
,a
l
t
h
o ug
h
t
h
e a s s o cia
t
i
o nb
et w
e e n al
c oh
ol
c o n s um
p
t
io n
a nd p
ri
o ri
nj
u ry
d
i d
n ot
f
ol l
ow
al i
n e a rt
r e nd A
l
s o,A
f
ri
c a n-
A m
e ri
c a nw
o rk
e r sw
e r em
o r el
i k
e
l y
t
o r ep
o rt
i
nj
u ri
e sr e
q
ui ri
ng
m
ed
i
c al
at t
e nt
io n
o rh
o sp i
t
al i
z at
io n
.H
ow
e v e r, s
i
n c et
h
e st
ud y p
e ri
od w
a st
h
ef
a rm
e r s' a nd f
a rm
w
o rk
e r s 'e n
t
i
r e c a r e e r, n ot
j
u st
am
o r e r e c e nt p
eri
od
, a r e c al l
b
i
a sm
ay
b
ep
r e s e nt
i
nt h
i
s st
ud
y
M
cG w i
n et
al
(
2 0 0 0
)
r e-a n -a
l
y
z ed
t
h
ed
at
a c ol l
e ct
ed i
nt
h
eL y
m
a n et
al
(
1 9 9 9
)
s
t
ud
y
t
o e x am i
n eri
sk f
a ct
o r sf
o rA
f ri
c a n-A m
e ri
c a nf
a rm
w
o rk
e r sm
o r e cl
o s el
y
T h
ey
o
b
s e r v ed
t
h
at
in
j
u ry
r at
e sw
e r e2 9
t
i m
e s(
9 5
%
c o nf
id
e n c ei
nt
e r v al
(
C
l
)
=
2 0
-4 3
)
h
i
g h
e rf
o rA f ri
c a n -A
m
e ri
c a nf
a rm
w
o rk
e r s c om
p
a r ed
t
oA
f
ri
c a n-A m
e r
ic a n
ow
n e r s a nd
C
a u c a si
a n ow
n e r sA f
ri
c a n -A
m
eri
c a nf
a rm
w
o rk
e r sw
e r el
e s sw
el l
ed
u c at
ed
, s
i g
ni f
i c a nt
l y
y
o u ng
e r, a nd
l
e s sh k
el y
t
oh
a v e a ch
r o ni
cm
ed i
c al
c o nd i
t
io n
t
h
a nA
f
ri
c a n-A
m
e ri
c a n o rC
a u c a si
a n ow
n e r sA d
d i
t
i
o n al l y
,A
f
ric a n
-
A m
e ri
c a nw
o rk
e r sh
ad
a si
g
ni fi c a n
t
l
y h i g h
e ra
l
c oh
ol
c o n s um
p
t
i
o n r at
et
h
a nb
ot
h A f
ric a n
-A m
e ri
c a n a nd C
a u c a si
a n ow
n e r sR
e s ul
t
s of
t
h i
s st
ud
y
s up p
o rt
ed
t
h
efi
nd
in
g
of
t
h
e st
ud y
b
y L
ew
i
s et
al
.(
1 9 9
8
)
t
h
at t
h
o s ew h
ow
o rk
o n
f
a rm
s ow
n ed b
y
ot
h
e r s a r e at
in c r e a s e
d ri
sk f
o rin
j
u ry
H
ow
e v e r,t
h
eA fr
ic a n
-A m
e ric a n
f
a rm
w
o rk
e r sw h
op
a rt
i
ci
p
at
ed i
nt
h i
s st
ud
y w
e r e n ot
s el
e ct
ed i
n am
a n n e rs
i m
i l
a rto
f
a rm
ow
n e r s a nd
m
ay
n ot
b
e r ep
r e s e nt
at
i
v e of A fr
i
c a n-A
m
eri
c a nf
a rm
w
o rk
e r sin
A
l
ab
am
a a nd
M
i
s si
s si p p i
M
cC
u rd y
et
al
.(
2 0 0 3
)
st
ud
ie
d
ag
ri
c ul
t
u r al
in
j
u ry
in
H
i
sp
a nic
m i
g
r a nt
f
a rm
w
o rk
e r s,w h
ow
e r e r e sid i
ng
at
sta
t
e-a
dm i
ni
st
e r ed
M
i
g
r a nt
H
o u si
ng
C
e nt
e r si
nC
al
i fo r n
i
aA
ni
ni
ti
al q
u e sti
o n n ai
r e a nd
s ub
s eq
u e nt
f
ol l
ow
-u
p
s u r v ey
c ol l
e cte
d d
at
a o n o c c up
at
i
o n al
h
i
st
o ry
,h
e al
t
h h
ab i
t
s a nd
sta
t
u s, a nd d
em
og
r ap h
i
c ch
a r a ct
eri
sti
c sT h
ei
nj
u ry
ri
sk
f
o rw
o rk
e r si
nt
h
e stu
d y p
op
ul
at
i
o nw
a s c om
p
a r ab l
et
ot
h
eri
sk
f
o rw
o rk
e r si
n ot
h
e rl
a rg
e-s c a
l
e st
ud i
e s of f
a rm
w
o rk
e r sF
o rf
em
al
e s,b
ei
ng p
ai
d p i
e c e-r a
te
w
a s a s s o ci
ate
d
w
i
th
in c r e a s e
d i
n
j
u ry
ri
sk
T
h
efi
nd
i
ng
sin
th
eM
cC
u rd
y
et
al
(
2
0
0 0
)
st
ud y
sh
o ul d
b
e c o n si
d
e r ed
i
nl
i
g
h
t
of
th
ef
a ct
t
h
at
t
h
e stu
d
y p
op
ul
at
i
o n c o n si
st
ed
s ol
el y
of
w
o rk
e r s r e sid in
g
at
M
i
g
r a nt
H
o u si
ng
C
e nt
e r s,w
h
e r e r e si
d
e nt
s a r el
i m it
ed
t
of
a rm w
o rk
e r s a nd
t
h
ei
rf
am
i l
i
e sT h
e s ef
am i h
e sa r e u s u a
l l y
ab
l
et
ofi
nd
em
p l
oy
m
e nt
a nd h
ou si
ng i
n ad
v a n c e a nd
r em
ai
ni
nt
h
e s eC
e nte r s
f
o r a n e xt
e nd
ed
p
e ri
od
of
t
i m
eT
h
e r ef
o r e, si
ng
le
w
o rk
e r s a nd
w
o rk
e r sw
i
t
h m
o r eit
i
n e r a nt
h
ab
i
ts
,w h
om
ay
h
a v ed
i f f
e r e nt
i
nj
u ry
ri
sk
s,w
e r e e x cl
ud
ed f
r om
th
e st
ud y
p
op
ul
at
i
o n .I
n ad
d i
ti
o nto
th
e s el
a rg
e-s c al
e st
u
d
i
e s o nf
a rm
w
o rk
e r sd
e s c ri
b
ed
ab
o v e, ot
h
e rs
t
ud i
e sh
a v e e x am
i
n ed
sp
e ci
f
i cri
sk f
a ct
o r si
nt
h
ef
a rm
w
o rk
e rp
op
ul
ati
o nSt
al l
o n e s a nd
X
i
a ng
(
2 0 0 3
)
a s s e s s ed
t
h
e r ol
e of
al
c oh
ol
c o n s um
p t
i
o n o nth
e o c c u r r e n c e of
ag
ri
c ul
tu r a
l
i
nj
u ri
e s.T h
e st
ud y p
op
ul
at
i
o n c o n si
st
ed
of
a r a nd
om
s am
p l
e of
f
a rm
e r sw h
oh
a v e af
a rm
t
r u ck
r eg i
st
e r ed i
nt
h
e st
at
e a nd w h
o e a r nm
o r et
h
a nh
al f
of h i
s o rh
e rin c o
m
ef
r om
d
em
og
r ap
h i
c ch
a r a ct
e ri
st
i
c s,h
e al
t
h
st
at
u s, a nd
ri
sk f
a ct
o r s,i
n cl
ud
i
ng
al
c oh
ol
c o n s u
m
p
t
i
o n .D
at
af
o rt
h i
s st
ud
y w
e r e c ol l
e ct
ed
o v e r ap
e ri
od
of
t
h
r e ey
e a r s.S
t
al
l
o n e s a nd X
i
a ng
(
2 0 0 3
)
c o n cl
ud
ed
t
h
at
b
ot
h fr e
q
u e n cy
a nd
am
o u nt
of
al
c oh
ol
c o n s u
m
ed p
e r si
t t
i
ng w
e r e si
g
ni fi
c a nt
l y
a s s o ci
at
ed
w
i
t
h i
n c r e a s ed
ri
sk
of
ag
ri
c ul
t
u r al
i
nj
u ry
.F
a rm
r e si
d
e nt
sw h
od
r a nk
t
h
r e e o rm
o r ed
ri
nk
sp
e rd
ay h
ad
af
a rm
w
o rk i
nj
u ry
r a
t
e of
3
.6 2 p
e r1 0
,
0 0 0 p
e r s o n -d
ay
s(
9 5
%
C I
=
2 3 8
-4
.
8 5
)
, c o
m
p
a r ed
t
o a ni
nj
u ry
r at
e of
3
0
2 p
e r1 0
,0 0 0 p
e r s o n -d
ay
sf
o r r e si
d
e nt
sw h
od
r a nk
o n et
ot
w
od
ri
nk
sp
e rd
ay
(
9 5
% C
I
=
2
.4 4
-3
.
6 0
)
N
o n-
d
ri
nk
e r sh
ad
a ni
nj
u ry
r at
e of 1
.9 4 p
e r1 0
,0 0 0 p
e r s o n-d
ay
s(
9 5
%
C I
=
1 5 1
-2 3 7
)
I
nj
u ry
r at
e sw
e r eh
i
g h
e st
f
o rf
a rm
r e si
d
e nt
sw
h
ow
o rk
ed 5 0
t
o1 4 9
d
ay
sa n n u a
l
l y
of f
of
t
h
ef
a rm
,3 9 6 p
e r1 0
,0 0 0 p
e r s o n -d
ay
s(
9 5
% C
I
=
2
.6 1
-
5
.
3 1
)
A
l
s o ,y
o u ng
e rf
a rm
r e si
d
e nt
s,3 9 y
e a r s of
ag
e a nd f
ew
e r ,h
ad h i
g h
e ri
nj
u ry
r at
e s,3
.7 0 p
e r1
0
,0
0
0
p
e r s o n -d
ay
s(
9 5
% C
I
=
2
8
6
-4 5 3
)
H
ow
e v e r,m
o st
of
t
h
e st
ud
y p
op
ul
at
i
o nw
a sw h
i
t
e a nd
o nl y
i
n cl
ud
ed
s ub
j
e ct
si d
e nt
i
fi
ed
a sf
a rm
op
e r at
o r s a nd
n ot
f
a rm
w
o rk
e r sS i
n c et
h
e r em
ay b
ed i f f
e r e n c e si
np
at t
e r n s of
al
c oh
ol
c o n s um p
t
i
o nb
et w
e e nf
a rm
o
p
e r at
o r s a nd f
a rm
w
o rk
e r s,t
h
efi
nd i
ng
s of
t
h i
s st
ud
y
m
ay
n
ot
n e c e s s a ri
l y b
e ap p l i
c ab l
et
of
a rm
w
o rk
e r sT
h
e c o st
of
h
e al
t
h
c a r e ap p
e a r st
od
et
e rm
a ny i
nt
h
eH i
sp
a ni
cp
op
ul
at
i
o nf
r om
s e e
k i
ng
m
ed i
c al
at t
e nt
i
o n , e v e n s om
et
h
i
ng
a sf
u nd
am
e nt
al
a s r o ut
i
n eh
e al
t
h
s c r e e ni
ng
sSk
a e r et
al
(
1
9 9
6
)
c o nd
u ct
ed
a r a nd
om i
z ed i
nt
e r v e nt
i
o nt
ri
al i
nW
a sh i
ng t
o nS
t
at
et
od
et
e rm i
n eh
ow
t
h
e c o st
of
m
am m
og
r am
si
nfl
u e n c e sH
i
sp
a ni
cw
om
e n 's o