美国农场工人的糖尿病患病率和护理障碍及其与移民工人身份的关系。

National Prevalence of Diabetes and Barriers to Care Among U.S. Farmworkers and Association With Migrant Worker Status.

机构信息

Department of Medicine, Brigham and Women's Hospital, Boston, MA.

Harvard T.H. Chan School of Public Health, Boston, MA.

出版信息

Diabetes Care. 2023 Dec 1;46(12):2188-2192. doi: 10.2337/dc23-0960.

DOI:10.2337/dc23-0960

PMID:37738553

Abstract

OBJECTIVE

To quantify the prevalence of diabetes and barriers to care among U.S. migrant farmworkers (i.e., those who travel from their permanent residence for seasonal farmwork).

RESEARCH DESIGN AND METHODS

Age-adjusted prevalence of self-reported diabetes and barriers to care were calculated among adult U.S. farmworkers from 2008 to 2017 National Agricultural Workers Surveys.

RESULTS

Among 16,913 farmworkers, 30.7% reported one or more barriers to care, most often due to cost. Age-adjusted self-reported prevalence of diabetes was 13.51% (95% CI 10.0-17.1) among migrant farmworkers and 10.8% (95% CI 9.0-12.6) among nonmigrant farmworkers with access to health care. Migrant farmworkers without recent health care had 83% lower odds of reporting known diabetes (adjusted odds ratio 0.17; 95% CI 0.06-0.54) compared with nonmigrant farmworkers, likely because of poor health care access and/or a healthy worker effect.

CONCLUSIONS

Many migrant farmworkers face barriers to care, which may lead to significant underdiagnosis of diabetes in this vulnerable population.

摘要

目的

量化美国流动农业工人（即那些为季节性农业工作而从常住地流动的人）中的糖尿病患病率和就医障碍。

研究设计和方法

根据 2008 年至 2017 年全国农业工人调查，对成年美国农业工人进行了年龄调整后的自我报告糖尿病患病率和就医障碍率的计算。

结果

在 16913 名农业工人中，有 30.7%报告存在一个或多个就医障碍，最常见的原因是费用。有医疗保险的流动农业工人中，年龄调整后的自我报告糖尿病患病率为 13.51%（95%CI 10.0-17.1），而无医疗保险的流动农业工人中这一比例为 10.8%（95%CI 9.0-12.6）。与有医疗保险的非流动农业工人相比，最近没有接受过医疗保健的流动农业工人报告已知糖尿病的几率低 83%（调整后的优势比 0.17；95%CI 0.06-0.54），这可能是由于医疗保健获取不足和/或健康工人效应。