Stigma, Health Disparities, and the 2009 H1N1 Influenza Pandemic: How to Protect Latino Farmworkers in Future Health Emergencies

Abstract

At the outset of the 2009 H1N1 influenza ("swine flu") pandemic, Mexican nationals and Mexican commodities were shunned globally, and, in the United States, some media personalities characterized Mexican immigrants as disease vectors who were a danger to the country. We investigated instances in the U.S. of stigmatization of Latino migrant and seasonal farmworkers (MSFWs) and developed guidance for officials in curtailing its effects. At the same time, we explored social factors that make farmworkers more vulnerable to influenza infection and its complications, including high rates of underlying medical conditions, limited access to health care, and certain circumstances that interfere with the ability to implement community mitigation measures. This article reviews study findings and concludes with advice to policymakers and practitioners on the need to mitigate stigmatization in future outbreaks, to create public health preparedness systems that better protect migrant and seasonal farmworkers, and to undertake larger reforms to reduce institutional conditions that render farmworkers at greater risk for morbidity and mortality during health emergencies.

What have we learned about communication inequalities during the H1N1 pandemic: a systematic review of the literature

“…The fact that the original H1N1 cases were first identified in Mexico likely caused this segment of the population to be aware of the risk of infection and have a different pandemic experience compared to other ethnic groups. Unfortunately this group also experienced social stigmatization because of the origin of the pandemic [68,69]. …”

Stress, adherence to preventive measures for reducing influenza transmission and influenza-like illness

“…Therefore, other pathways, including stress-related changes in biological susceptibility to ILI, may account for the associations observed here. Given recent reports of race/ethnic and socioeconomic differentials in 2009 H1N1 susceptibility,9 10 stress may represent a key mechanism by which risk in 2009 H1N1 has varied in the US population. Research should examine whether stress alone can explain differential severity in ILI symptoms and confirmed infection independently from other factors that may account for susceptibility or severity of illness.…”

“…Similarly, psychological risk factors for ILI, specifically among university aged students living in shared residential environments, have not to our knowledge been characterised. Given the recent H1N1 influenza pandemic and disparities in attack rates,9 10 stress may constitute a novel risk factor for explaining variability in susceptibility and disease severity in populations that experience a disproportionate burden of stress. Regarding pandemic strains, understanding novel risk factors like psychological stress among young adults would prove invaluable.…”

Predicting support for non‐pharmaceutical interventions during infectious outbreaks: a four region analysis

“…Recently (in 2009), US minorities were shown to have experienced worse outcomes than non-minorities during the H1N1 pandemic (Quinn et al, 2011), with disparities also extending to infection rates and intervention uptake. The reasons for this include social vulnerabilities (Cutter and Finch, 2008; Schoch-Spana et al, 2010; Quinn et al, 2011) and baseline-level co-morbidities (Hutchins et al, 2009). Minority and vulnerable populations also may belong to distinct social networks, and may utilise separate communication lines and sources of information, which are not always congruous with public health messaging (Plough et al, 2011).…”