PEER DISCUSSIONS OF CANCER AMONG HISPANIC MIGRANT FARM-WORKERS

Hispanic migrant agricultural workers' exposure to pesticides and othe r agrichemicals places them at increased risk for a variety of acute a nd chronic conditions, including cancer. As a socioeconomically disadv antaged group, migrant workers also face many barriers to effective ca ncer control. In 1992, a series of focus groups was held with 55 Hispa nic migrant agricultural workers (22 women, 33 men) in central Wiscons in to gather information on their knowledge and attitudes regarding ca ncer etiology and treatment, their practices regarding cancer screenin g and early detection, and their concerns regarding occupational expos ure to pesticides. Beliefs that pesticides are toxic and can cause hea lth problems were common among participants. In addition, however, par ticipants reported that they are reluctant to demand occupational prot ections to which they are entitled because they are afraid of losing t heir jobs. Study results also suggest that barriers to effective prima ry and secondary prevention of cancer in this Hispanic migrant agricul tural worker population include knowledge and information barriers, cu ltural barriers, and socioeconomic barriers. A lack of knowledge and i nformation regarding the causes of cancer, its prevention, and its ear ly detection and treatment was evident among participants, which in tu rn was reflected in strong fatalistic attitudes toward the disease. Cu ltural barriers included attitudes of embarrassment and shame associat ed with physical examinations and women's strong discomfort with male clinicians. Socioeconomic barriers to secondary prevention included th e cost of obtaining health services, time constraints associated with the need to work and long working days, and a lack of transportation. Efforts to improve cancer screening as well as other preventive health services in the Hispanic migrant agricultural worker population must acknowledge these barriers and address as many of them as possible to be successful.