Agricultural Environment Migrant Clinicians Network
The Migrant Clinicians Network is an international non-profit organization of over 5000 health professionals who work to eliminate health problems among migrant and seasonal farm workers and other mobile underserved populations. A significant part of their work has been in occupational and environmental health efforts focused on children. As an example of their work, in Virginia, the Migrant Clinicians Network has provided educational materials and sessions to healthcare providers, head start workers, outreach workers, migrant farm workers, and the community about children’s environmental health issues and how to minimize potential hazardous exposures. Over a 2-year period, the group has worked with 600 migrant farm workers and their families. This has improved the knowledge of these individuals concerning environmental hazards and has helped minimize exposure.
Urban Environment Community-based Intervention Research Project—University of Michigan
This research project was used to try to reduce the amount of asthma in a given community and also to reduce the severity of the disease by carrying out asthma screening (by use of questionnaires, pulmonary function tests, and skin tests to determine specific allergies) and environmental testing for dust samples that were analyzed for cockroaches, which has high potential as an asthma trigger, dust mite, cat, dog, and mouse or rat allergens and provided for intervention by trained Community Environmental Specialists (CES). These individuals were all residents of Detroit, had a minimum of a high school education, and completed a 4-week training course before working with the community members. The project was composed of a group of children from 44 schools in areas in Detroit.
The study involved a group of caregivers of children, the local health department, community organizations, and a group of research scientists.
The household intervention consisted of the CES making a minimum of nine visits to each of the homes of the children involved in the project. The CES took annual dust samples, conducted annual surveys for the caregiver and the child, and on the other occasions provided educational materials and services to reduce the exposure to asthma triggers. The CES also made referrals for a group of other issues including medical care and tenants’ rights. Undermedicated children were found and this was corrected. Caregiver depression decreased because of the personal assistance given to them. Household-level intervention did work because the individuals reduced indoor exposures to environmental hazards by vacuuming and other cleaning techniques. Asthma-related health status improved. The neighborhood-level intervention project was not carried out because of a 10% reduction in the original grant funds.
The program involving CES in households to try to reduce asthma triggers is an excellent idea. By working with community groups, additional help is provided in education and support services for the child caregivers. The problem with the approach is that funds need to be provided by local entities with help from federal and state authorities to provide the necessary workers to carry out an actual program of this nature.