Depression, social factors, and farmworker health care utilization.
OBJECTIVE
Farmworkers frequently live in rural areas and experience high rates of depressive symptoms. This study examines the association between elevated depressive symptoms and health care utilization among Latino farmworkers.


METHODS
Data were obtained from 2,905 Latino farmworkers interviewed for the National Agricultural Workers Survey. Elevated depressive symptoms were measured using the Center for Epidemiologic Studies Depression short-form. A dichotomous health care utilization variable was constructed from self-reported use of health care services in the United States. A categorical measure of provider type was constructed for those reporting use of health care.


RESULTS
Over 50% of farmworkers reported at least 1 health care visit in the United States during the past 2 years; most visits occurred in a private practice. The odds of reporting health care utilization in the United States were 45% higher among farmworkers with elevated depressive symptoms. Type of provider was not associated with depressive symptoms. Women were more likely to seek health care; education and family relationships were associated with health care utilization.


CONCLUSIONS
Latino farmworkers who live and work in rural areas seek care from private practices or migrant/Community Health Clinics. Farmworkers with elevated depressive symptoms are more likely to access health care. Rural health care providers need to be prepared to recognize, screen, and treat mental health problems among Latino farmworkers. Outreach focused on protecting farmworker mental health may be useful in reducing health care utilization while improving farmworker quality of life.
Aguirre Division, JBS International, Burlingame, CA 94010, USA. ageorges@jbsinternational. com.
A
A
Georges
T
T
Alterman
S
S
Gabbard
J G
JG
Grzywacz
R
R
Shen
J
J
Nakamoto
D J
DJ
Carroll
C
C
Muntaner
D000293:Adolescent; D000328:Adult; D000383:Agriculture / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology* / Q000208:ethnology; D054242:Emigrants and Immigrants; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D036301:Qualitative Research; D019035:Rural Health Services / Q000706:statistics & numerical data; D012737:Sex Factors; D012931:Social Environment; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Latino farmworkers; depression; health care utilization; immigrant; mental health