"If We Don't Produce, Bring Another:" Work Organization and Tomato Worker Health.

Objectives: Specific work processes and management structures that contribute to high rates of occupational illness and injury in agricultural industries are not well described in academic literature. This qualitative study of work organization in the U.S. fresh tomato industry investigates how work processes and management structures impact tomato workers' occupational health. Methods: After conducting literature review and key informant interviews, semi-structured interviews and focus groups were conducted with 36 individuals with experience working in the U.S. fresh tomato industry. Interviews and focus groups were audio-recorded, transcribed, coded, and analyzed using a modified grounded theory approach. Results: These data indicate that participants endured income insecurity and hazardous supervisory practices, including wage theft, retaliation, intimidation, and humiliation, that put them at risk of preventable illness and injury. Support from workers' organizations and health-conscious supervisory practices helped mitigate some of these occupational hazards. Conclusion: Participants' adverse work experiences may be considered sequelae of workers' lack of job control and positions of socioeconomic structural vulnerability. Other aspects of tomato work organization, including health-conscious supervisory practices and the involvement of workers' organizations, indicate that modifying work organization to better safeguard health is possible. Such modifications present compelling opportunities for employers, employees, organizations, community and government leaders, and health care professionals to help create healthier occupational environments for tomato workers

Thinking With and Against the Social Determinants of Health: The Latin American Social Medicine (Collective Health) Critique from Jaime Breilh

The concept of the social determinants of health has become increasingly accepted and mainstream in anglophone public health over the past three decades. Moreover, it has been widely adopted into diverse geographic, sociocultural, and linguistic contexts. By recognizing the role of social conditions in influencing health inequalities, the concept challenges narrow behavioral and reductive biological understandings of health. Despite this, scholars and activists have critiqued the concept of the social determinants of health for being incomplete and even misrepresenting the true nature of health inequities. Arguably, these critiques have been most thoroughly developed among those working in the Latin American social medicine and collective health traditions who formulated the “social determination of health” paradigm and the concept of interculturality decades prior to the advent of the social determinants of health. We draw on Jaime Breilh’s main works, with a focus on the recently published book, Critical Epidemiology and the People’s Health, to (1) provide a broad overview of the social determination of health paradigm and its approach to interculturality and (2) clarify how these ideas and the broader collective health movement challenge assumptions within the social determinants of health concept

How Do You Build a "Culture of Health"? A Critical Analysis of Challenges and Opportunities from Medical Anthropology.

The Robert Wood Johnson Foundation's Culture of Health Action Framework aims to "make health a shared value" and improve population health equity through widespread culture change. The authors draw upon their expertise as anthropologists to identify 3 challenges that they believe must be addressed in order to effectively achieve the health equity and population health improvement goals of the Culture of Health initiative: clarifying and demystifying the concept of "culture," contextualizing "community" within networks of power and inequality, and confronting the crises of trust and solidarity in the contemporary United States. The authors suggest that those who seek to build a "Culture of Health" refine their understanding of how "culture" is experienced, advocate for policies and practices that break down unhealthy consolidations of power, and innovate solutions to building consensus in a divided nation

a collaboration among refugee newcomers, migrants, activists and anthropologists in Berlin

In 2015, Germany entered what would later become known as the ‘refugee crisis’. The Willkommenskultur (welcoming culture) trope gained political prominence and met with signifi cant challenges. In this article, we focus on a series of encounters in Berlin, bringing together refugee newcomers, migrants, activists and anthropologists. As we thought and wrote together about shared experiences, we discovered the limitations of the normative assumptions of refugee work. One aim of this article is to destabilise terms such as refugee, refugee work, success and failure with our engagements in the aftermath of the ‘crisis’. Refugee work is not exclusively humanitarian aid directed towards the alleviation of suff ering but includes being and doing together. Through productive failures and emergent lessons, the collaboration enhanced our understandings of social categories and the role of anthropology

Misdiagnosis, Mistreatment, and Harm - When Medical Care Ignores Social Forces.

The Case Studies in Social Medicine demonstrate that when physicians use only biologic or individual behavioral interventions to treat diseases that stem from or are exacerbated by social factors, we risk harming the patients we seek to serve

La vulnerabilidad estructural y las nuevas perspectivas en medicina social sobre la salud de los migrantes: entrevista a James Quesada y Seth M. Holmes

A decade ago, a number of English-speaking authors focused mainly on the analysis and intervention of processes of social determination of health of migrants developed the concept of structural vulnerability as a way to combat individualism, biologism, the invisibilization of processes of structural determination and the blaming of victims. As part of the historical contributions of social medicine, the current developments of the structural vulnerability approach have been disconnected from the discussions of the collective health movement and Latin American social medicine in general, among other reasons due to linguistic barriers associated with the scarcity of publications in Spanish. The present interview, conducted with two of the primary representatives of the structural vulnerability approach, investigates its historical origins and seeks to explore the specific contributions that are being made today, as a way to bring them closer to Spanish-speaking readers and so enable dialogue with the proposals of Latin American social medicine.Desde hace una década, varios autores anglófonos, centrados principalmente en el análisis e intervención de los procesos de determinación social de la salud de los migrantes, forjaron el concepto de vulnerabilidad estructural, como una forma de combatir el individualismo, el biologismo, la invisibilización de los procesos de determinación estructural y la culpabilización de las víctimas. Siendo parte de las contribuciones históricas de la medicina social, los actuales desarrollos de la aproximación sobre la vulnerabilidad estructural han quedado desconectadas de las discusiones del movimiento de la salud colectiva y la medicina social latinoamericana en general, entre otras razones, por las barreras lingüísticas asociadas a la escasez de sus publicaciones en español. La presente entrevista, realizada a dos de sus principales representantes, indaga los orígenes históricos de dicha aproximación y busca explorar las contribuciones específicas que hoy está realizando, como una forma de acercarlas a los lectores de habla hispana, favoreciendo el diálogo con las propuestas de medicina social latinoamericanas

The first nationwide survey of MD-PhDs in the social sciences and humanities: training patterns and career choices

Abstract Background While several articles on MD-PhD trainees in the basic sciences have been published in the past several years, very little research exists on physician-investigators in the social sciences and humanities. However, the numbers of MD-PhDs training in these fields and the number of programs offering training in these fields are increasing, particularly within the US. In addition, accountability for the public funding for MD-PhD programs requires knowledge about this growing population of trainees and their career trajectories. The aim of this paper is to describe the first cohorts of MD-PhDs in the social sciences and humanities, to characterize their training and career paths, and to better understand their experiences of training and subsequent research and practice. Methods This paper utilizes a multi-pronged recruitment method and novel survey instrument to examine an understudied population of MD-PhD trainees in the social sciences and humanities, many of whom completed both degrees without formal programmatic support. The survey instrument was designed to collect demographic, training and career trajectory data, as well as experiences of and perspectives on training and career. It describes their routes to professional development, characterizes obstacles to and predictors of success, and explores career trends. Results The average length of time to complete both degrees was 9 years. The vast majority (90%) completed a clinical residency, almost all (98%) were engaged in research, the vast majority (88%) were employed in academic institutions, and several others (9%) held leadership positions in national and international health organizations. Very few (4%) went into private practice. The survey responses supply recommendations for supporting current trainees as well as areas for future research. Conclusions In general, MD-PhDs in the social sciences and humanities have careers that fit the goals of agencies providing public funding for training physician-investigators: they are involved in mutually-informative medical research, clinical practice, and teaching – working to improve our responses to the social, cultural, and political determinants of health and health care. These findings provide strong evidence for continued and improved funding and programmatic support for MD-PhD trainees in the social sciences and humanities.https://deepblue.lib.umich.edu/bitstream/2027.42/136187/1/12909_2017_Article_896.pd

Parasite Microbiome Project: Systematic Investigation of Microbiome Dynamics within and across Parasite-Host Interactions.

Understanding how microbiomes affect host resistance, parasite virulence, and parasite-associated diseases requires a collaborative effort between parasitologists, microbial ecologists, virologists, and immunologists. We hereby propose the Parasite Microbiome Project to bring together researchers with complementary expertise and to study the role of microbes in host-parasite interactions. Data from the Parasite Microbiome Project will help identify the mechanisms driving microbiome variation in parasites and infected hosts and how that variation is associated with the ecology and evolution of parasites and their disease outcomes. This is a call to arms to prevent fragmented research endeavors, encourage best practices in experimental approaches, and allow reliable comparative analyses across model systems. It is also an invitation to foundations and national funding agencies to propel the field of parasitology into the microbiome/metagenomic era

Health Is Still Social: Contemporary Examples in the Age of the Genome

Holtz and colleagues argue that social medicine, including an understanding of the social roots of disease, is as important now as it has ever been