Guillot-Wright Shannon, Wang Leonard Kuan-Pei, Figueira Bibiana Toro, Jones Mary Overcash, Maredia Ruhi, Kichili Nikhita
The University of Texas Health Science Center, Houston, USA.
The University of Texas Medical Branch, Galveston, USA.
Int J Equity Health. 2025 Jan 23;24(1):25. doi: 10.1186/s12939-024-02363-5.
Commercial fishing is a multibillion-dollar industry that supports job growth, small- to large- businesses, and port and city revenue. The commercial fishing industry continues to be one of the most dangerous in the US, with a fatality rate nearly 40 times higher than the national average. Dangers of the fishing industry are multi-faceted and include hazardous working conditions, strenuous labor, long work hours, and harsh weather. Moreover, a vast majority of fishermen suffer from economic insecurity, including safe and affordable housing and food insecurity.
We followed the recommendations and standards set by the Campbell and Cochrane Equity Methods Group and the Measurement and Evidence Knowledge Network. The review covered 1992-2022 to assess the state of research and to identify new barriers of and facilitators to injury prevention among commercial fishermen using a social determinants of health lens.
Of 292 articles identified, 27 studies met our inclusion criteria. Out of 27 articles reviewed, social determinants of health factors included the built environment, social & community factors, economic stability, health care access, and educational attainment. A major finding was the inability for fishermen to access primary care services, which was often rooted in being a low-wage, im/migrant, or transient worker, and can further escalate injuries. A secondary finding related to injury was a feedback loop where fishermen's unsafe environments led to a culture of accepting risk and downplaying injury, which further created unsafe environments.
Our review shows how injury is connected to social factors, such as a lack of health care access, as well as political-economic factors, such as a lack of sick leave benefits.
商业捕鱼是一个价值数十亿美元的产业，它支持就业增长，从小型企业到大型企业，以及港口和城市的收入。在美国，商业捕鱼业仍然是最危险的行业之一，其死亡率几乎是全国平均水平的40倍。捕鱼业的危险是多方面的，包括危险的工作条件、繁重的劳动、长时间的工作和恶劣的天气。此外，绝大多数渔民面临经济不安全问题，包括缺乏安全且负担得起的住房以及粮食不安全。
我们遵循了坎贝尔和考科蓝公平方法小组以及测量与证据知识网络制定的建议和标准。该综述涵盖了1992年至2022年的内容，以评估研究现状，并从健康的社会决定因素角度确定商业渔民预防伤害的新障碍和促进因素。
在识别出的292篇文章中，有27项研究符合我们的纳入标准。在审查的27篇文章中，健康的社会决定因素包括建筑环境、社会和社区因素、经济稳定性、医疗保健可及性和教育程度。一个主要发现是渔民无法获得初级保健服务，这通常源于他们是低薪、移民或临时工，这可能会使伤害进一步加剧。与伤害相关的第二个发现是一个反馈循环，即渔民的不安全环境导致了一种接受风险和淡化伤害的文化，这进一步造成了不安全的环境。
我们的综述表明了伤害是如何与社会因素（如缺乏医疗保健可及性）以及政治经济因素（如缺乏病假福利）相关联的。
