Although cervical cancer incidence and mortality rates have declined in the USA, African American women have a higher incidence rate of cervical cancer and a higher percentage of late-stage diagnosis than white women. Previous analyses by the authors showed that, even after adjusting for age, provider location, and availability, African American women were almost half as likely as white women to be diagnosed or enter Medicaid while at an early stage of their cervical cancer. To understand why these differences exist, we undertook a qualitative examination of the cervical cancer experiences of women enrolled in Georgia's Women's Health Medicaid Program (WHMP). Life history interviews were conducted with 24 WHMP enrollees to understand what factors shaped their cervical cancer experiences, from screening through enrollment in Medicaid. We also examined whether these factors differed by race in order to identify opportunities for increasing awareness of cervical cancer screening among underserved women. Results suggest that many women, especially African Americans, lacked understanding and recognition of early symptoms of cervical cancer, which prevented them from receiving a timely diagnosis. Additionally, participants responded positively to provider support and good communication but wished that their doctors explained their diagnosis more clearly. Finally, women were able to enroll in Medicaid without difficulty due largely to the assistance of clinical staff. These findings support the need to strengthen provider education and public health efforts to reach low-income and minority communities for screening and early detection of cervical cancer.
Purpose – The purpose of this paper is to provide a comprehensive narrative review of the literature on migrant farm worker child and adolescent health. It highlights current health issues and suggests methods to improve research and clinical practices with this underserved and vulnerable population. Design/methodology/approach – The methodology for this narrative review included a search of articles published between 2000 and 2012. From the primary search, 76 articles met the search criteria. A secondary search revealed three additional articles. Findings – The various methodologies used in the current literature have limited rigorous analysis of the health of pediatric migrant populations. The findings highlight the complex factors that influence migrant pediatric health. Despite the many challenges migrant farm worker children and their families face, they exhibit enormous resilience and strengths that may help counterbalance these challenges. Study categories that emerged from the analysis include health perspectives and behaviors, occupational health, access to care, utilization and satisfaction with health services, health outcomes and health disparities, and oral health. This review provides a strong foundation from which to work toward improving migrant pediatric health. Originality/value – This paper provides an original review of the unique health needs and the complex factors influencing the health of migrant farm worker children and adolescents. This will be of value to clinicians and researchers since migrant farm worker families are part of communities across the country. It offers public health professionals insight into services and programs that can improve the health and well-being of children, families, and communities.
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