This research investigated the occurrence of injuries among children of migrant farm workers in Wisconsin in 1998, using four sets of methods: Focus groups. The information gleaned from these conversations with mothers was rich in details; broad in the range of discussion, and very helpful in understanding the situation of migrant families trying to raise children and yet depending upon migrant agricultural work as their major or only sources of income. We also profited from one mother's experiences reminding others about various incidents and experiences that they had. Thus, although the focus groups were not a scientific sampling of migrant farm worker mothers, the groups together produced a broad array of helpful information about child injuries and difficult situations in which they find themselves. Interviews with mothers. The scientific random sampling and the standardized interview schedule provided essential information that can be used to estimate the likelihood of various health and illness conditions occurring to children in these families. Thus, we did not obtain a lot of information about child injuries or pesticide exposure because these are fairly uncommon events. However, we did gather a great deal of information about the health and medical utilization patterns of the children, as well as of the mother and her history of pregnancies and births. This provides a context germane to understanding the environment in which the child lives. We know how many family members traveled with the child; whether he or she attended Head Start of Migrant Education classes; whether the child worked in agriculture or food processing; what the housing conditions was like, etc. Interviews with children. This effort was exploratory. We didn't know how the children would react to the questions, and what they might tell a nurse who was examining them at the time. It turned out almost all of the children responded to and answered the questions. They told of various illnesses and accidents they had had; about their work for pay and what they did; and they rated their own health status. It no doubt was advantageous that the interviews took place at the migrant education schools -- a neutral place to ask a child questions (rather than in crowded living quarters in the work camps). There was no one around who might influence or affect the answers. On the whole, these interviews enlarged our understanding of what migrant life was like for the children, including the role of work. Review of clinic records. This effort was blocked by the Director of the Migrant Health Clinic. Our initial intention was to interview the adult who accompanied the child to the clinic at the time of the intake. We prepared a specific "Clinic Intake Form" to make sure that information about circumstances surrounding the injury was given, including where the injury took place; who was with the child at the time; if there was supervision; the age of the supervisor; how many other children the supervisor was watching; what implements or machines or equipment were involved. When we learned that we could not impose on the time of the staff to fill in the form, and we had no money to hire someone to perform that task, we settled for a review of the records of all of the child injuries and illnesses that occurred. These records provided no circumstantial information surrounding the injury or illness and much less information about the supervision at the time it occurred. Therefore, our effort was thwarted. We recommend, in future research, that a specific individual paid by the research effort should be employed to perform the interviews with the accompanying adult when a child is brought in to an outpatient clinic. This could also include a visit to the site of the injury, if necessary. Data from these varied sources indicate that migrant children get fairly satisfactory preventive care relative to immunization, physical examinations, and dental visits. On the other hand, children experience a variety of injuries and minor illnesses. Some injuries are work related (e.g., trimming Christmas trees with a machete), others occur while helping in household (e.g., getting burned with hot oil while cooking), and some happen while playing (e.g., breaking an arm in a playground). Overall, injuries were of two types -- those that predictably occur during childhood years and others associated with work, including household duties, by immature and inexperienced children. We note that children emolled in well-supervised settings (Head Start, etc.) are less likely to sustain injuries than children not emolled. Because surveillance of injuries and pesticide exposures of the children of migrant farm workers is lacking, further research is sorely needed to answer basic questions: What injuries, illnesses, and exposures occur? What are the environing circumstances? What measures are taken following the incidents that occur?
Department of Rural Sociology, University of Wisconsin-Madison, 1450 Linden Drive, Madison, WI 53706