August 29, 2024 • 41 mins
The 2024 State of the Science Meeting from the Southeastern Coastal Center for Agricultural Health and Safety brought together several researchers and Extension professionals working at the intersection of agricultural health and safety research, policy, and outreach communication. In this episode, three speakers from the meeting reconvene to share a conversation highlighting the importance of culturally sensitive health interventions and innovative solutions to bridge healthcare gaps in rural areas. You’ll hear Dr. John Diaz. Dr. Lauri Baker, and Dr. David Buys discuss how factors like economic stability, education access, healthcare quality, neighborhood environment, and social context influence the health and well-being of farmworkers. Our guests also emphasize the vital role of Cooperative Extension in connecting land-grant universities with communities, particularly in the context of medicine and public health. Examples from Florida and Mississippi are highlighted, showing how the roles of Extension have evolved from primarily agricultural and home economics education to encompassing broader health initiatives.
Resources:
2024 SCCAHS State of the Science Meeting
On The Farm Film Series: https://www.onthefarm.life/
CAFE Latino: https://extadmin.ifas.ufl.edu/teams-and-programs/cafe-latino/
Transcripts available here: https://piecenter.com/media/podcast/#transcript
Are you an educator? The Science by the Slice podcast aims to inform diverse audiences about important issues in agriculture, natural resources, and public health. Check out our learning guides that were created as an educational tool to facilitate discussions related to the topics presented in podcast episodes. Download the learning guides here: https://piecenter.com/media/podcast/learn/
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ricky Telg (00:04):
This is Science by the Slice, a podcast from the
University of Florida'sInstitute of Food and
Agricultural Sciences Center forPublic Issues Education.
In this podcast, expertsdiscuss the science of issues
affecting our daily lives,reveal the motivations behind
the decisions people make, andultimately provide insight to
solutions for our lives.
Phillip Stokes (00:33):
My name is Philip Stokes, Education
Coordinator at the PIE Center.
I'm also joined by Dr.
Lisa Lundy, who is co-hostingthis podcast with me, and so I
want to take a minute to justintroduce the topic of this
episode and who we're joined by.
So this episode is also hostedin conjunction with the
Southeastern Coastal Center forAgricultural Health and Safety,
(00:55):
and earlier this year we had aState of the Science meeting and
the topic for that meeting wasrural agricultural health and
the health needs of theagricultural workforce, and so
during that meeting we hadreally good conversations with
some of our researchers andeducators that were a part of
that meeting, and we have someof them here with us today.
(01:17):
So we wanted to do a podcast tofollow up on some of those
topics and conversations, andthat's what we're doing here
today.
So, in addition to myself and Dr.
Lundy, I'm joined by Dr.
Lauri Baker, as well as Dr.
John Diaz and Dr.
David Buys, excuse me and so Iwant to give everyone just a
(01:39):
minute to introduce themselvesand just go around and say who
you are, a little bit about yourbackground and kind of your
research areas, just real casual.
Let us know who you are, and soeveryone who's listening has
your voice knows who you are.
And then also, we are videorecording this podcast as well,
so you'll be able to watch it onour YouTube channel as well.
(02:00):
So, Dr.
Lauri Baker, you want to startus out?
Lauri Baker (02:03):
Sure Happy to start .
I'm an Associate Professor inAgricultural Education and
Communication here at theUniversity of Florida and I have
a 65% research appointment and35% extension appointment.
Much of those appointments andthat work happens through the
PIE Center and so that's why I'maffiliated with this project.
As far as research interests,even before I came to the
(02:26):
University of Florida I waslooking at zoonotic disease and
communication issues surroundingthat and the opportunity to
come here.
Those issues have certainlyincreased and there's been a lot
of opportunity for digging indeep on that research and what
it means for rural communitiesand rural health, particularly
agricultural workers.
Phillip Stokes (02:47):
Great, thank you so much.
All right, Dr.
Diaz, how about you want to gonext?
John Diaz (02:53):
All right, so I'm Dr.
John Diaz.
I'm an Associate Professor andExtension Specialist in the
Department of AgriculturalEducation and Communication.
I also serve as a president ofa group called CAFE Latino,
which is the Coalition ofFlorida Extension Educators for
Latino Communities.
Really, my work focuses onincreasing the competency and
capacity of universities,extensions, nonprofit groups to
(03:16):
serve Latinos and Latinaimmigrant groups in the United
States but across the world, andso I've been obviously, because
of the demographics of farmworkers in the United States,
I've been working heavily inthat space, helping to better
understand how groups likeExtension can help to better
serve the agricultural workforcein our country.
Phillip Stokes (03:37):
Thank you and Dr .
David Buys.
David Buys (03:40):
Hi y'all, I'm David Buys.
I served for 10 years 10 yearsand one month actually as the
state health specialist for MSUExtension, Mississippi State
University Extension Service.
I am currently in an AssociateVice Provost for health sciences
role and interim head of campusat MSU Meridian.
So I still have a line back toExtension and will always
(04:05):
continue my work with extension.
My time with extension hasreally been peppered with a lot
of different issues.
I often explain to people thatwhat family practice is to
medicine I am a state healthspecialist to attention to
public health, to attention topublic health, and that is that,
like a family practice doc maysee a three-year-old with an ear
(04:28):
infection at 8 am, their 8:30appointment might be an
80-year-old with dementia andtheir next one might be a
40-year-old with hypertension.
Well, my public health practicehas been just that diverse
because we, as extensionprofessionals, take what issues
are present and walk in the door, if you will.
Among those issues has beenfarm stress and issues of mental
(04:52):
health, mental challenges thatour agricultural producers face.
So I've spent quite a bit oftime working on and around that
the last six, seven years andI'm delighted to be with you all
to talk more about this broadtopic.
Phillip Stokes (05:08):
Well, thank you, Dr.
Buys.
So those introductions wereactually really great to
introduce what we're going to betalking about today.
So, of course, last but notleast, Dr.
Lisa Lundy, if you can maybeintroduce yourself as well, tell
us your affiliation with theSoutheastern Coastal Center for
Ag Health and Safety and thenkick us off and we'll get the
conversation going.
Lisa Lundy (05:26):
All right, hi, I'm Lisa Lundy.
I'm a professor in theDepartment of Agricultural
Education and Communication andI'm also part of the Outreach
Core for the SoutheasternCoastal Center for Agricultural
Health and Safety and was abeneficiary of a conversation
along these lines among thisgroup earlier this year and very
(05:47):
excited to share thatconversation and a little bit of
that here with you today.
So we're going to actually kickoff with Dr.
Diaz and Dr.
Diaz, if you would tell us alittle bit from your perspective
.
Of course, we know that we justheard from Dr.
Buys how varied it is.
But describe the agriculturalworkforce too.
Who are our agriculturalworkers in terms of just
(06:10):
demographics and makeup, andthen what are some of their
unique healthcare needs?
John Diaz (06:16):
Yeah, so the makeup and demographics of the
agricultural workforce has beenchanging for some time.
If you look back at the 50s and60s, farms were predominantly
farmed by families, so there wasa lot of family operators and
family farm workers.
But as time has passed, we'reseeing a lot of those family
farms going by the wayside andmost of the workforce is
(06:38):
externally hired.
Nowadays, we're seeing most ofthose external hires being
either immigrants who are livingin the state that they reside
in or are temporary workersthrough an H-2A visa program.
Nowadays, even just the sheernumber of farmers and farm
workers is down.
So back in the 50s it wasaround 10 million and we're just
(06:59):
over 2 million now, with abouthalf, if not more, being hired
external workers.
And so those higher externalworkers, the H-2A program.
Back in 2022, which is the lastdata I had they were
contracting about 372,000 farmworkers, and that does not even
take into consideration thelarge segment of undocumented
(07:21):
workers that work in theagricultural industry.
So we couple that and thinkingabout healthcare.
There's a lot of healthcareneeds that are tied to the
realities of those workers, andso, because they're part of a
really arduous and rigorous worktype, they're exposed to a lot
of different risks, whether it'spesticide exposure, heat
(07:43):
exposure, the plethora of otherrisks that come with farm
working.
In addition to that, becausetheir life is somewhat turbulent
, whether they're a temporaryworker, an immigrant or just a
domestic worker working sevendays a week, as Dr.
Buys said, there's a lot ofissues related to mental health,
and so it's really thescenarios and the needs within
(08:04):
agricultural workers is verycomplicated, which makes serving
them and understanding how toserve them complicated onto
itself.
Lisa Lundy (08:13):
Yeah.
Thank you so much.
That gives us such a greatoverview and I know you've
painted such a picture of theworkforce and I know you've been
involved specifically in someoutreach health clinics for
agricultural workers.
In your experience, what aresome of the things that prompt
(08:33):
someone to come in, or maybewhat are some of the things that
present in those settings asfar as health care issues?
John Diaz (08:41):
Yeah, so one of the biggest health care issues that
we see on a regular basis isissues of chronic disease.
Because these farm workers areof low socioeconomic status,
they cannot afford to eat freshfruits and vegetables and so
they're really relegated toeating a lot of processed foods,
and eating a lot of processedfoods within a very tight
(09:02):
schedule, so if it's somethingthey've prepared themselves or
going through a drive-throughwhen they have five minutes to
spare.
So, for example, with a lot ofthe farm workers that we're
seeing, their A1C levels are atastronomical levels, so A1C
levels of 10, 11, 12, 13, 14,and 15, where prediabetes and
(09:23):
diabetes are in the 5, 6, and 7range.
And so just trying to wrap ourheads around what that looks
like and why they're havingthese issues and again it comes
back to kind of the realities oftheir life and their
inabilities to access not onlyhealth care but those fresh
fruits and vegetables andhealthy foods that they would
need to prevent them fromgetting issues like diabetes.
Phillip Stokes (09:44):
Yeah, you know, Dr.
Diaz, you talked about.
You brought up access right andthe realities of their life,
and I think a lot of times whenwe discuss healthcare, we think
about being informed of theappropriate choices to make.
We try to get these thingstaught to us in school as we're
(10:05):
growing up.
But, as you mentioned, theseworkers and this agricultural
workforce they're coming fromall over the place and so
thinking about just access toinformation or access to health
care, or access to healthy food,um, you know, knowing it, there
are barriers that come inbetween that so what are some,
Dr.
Baker, I want to ask you whatare some of the factors that
influence the choices thatpeople make when going about
(10:25):
their health care?
Lauri Baker (10:42):
Yeah, absolutely.
One of the models that we liketo use a lot at the PIE Center
in this kind of work is calledthe health belief model, and
essentially in that model reallythere's an element of how much
you believe you are at risk, orthat you believe you're at
danger, and so, thinking aboutsome of the things that Dr Diaz
says, you know, if you havegrown up in a family that has
(11:03):
always worked outside, hasalways been in potentially
transient migrant communitieswhere you were working seven
days a week, you may believethat that's very normal and you
may believe that you aren't atrisk because those are practices
that are happening all the timearound you, and so people's
willingness to take action onpreventative health care is much
(11:28):
lower if they don't believethat they're at risk, and so
that's one of the things thatwe've really tried to look at in
the PIE Center.
We did five different surveysthroughout COVID, and during
that time one of the things thatreally kind of kept coming out
in this data was that there wasa real difference between rural
and urban communities and theirtrust in science, and we found
(11:52):
in many of our models that thatwas predictive of whether they
would be willing to seek care,whether they would be willing to
get a vaccine, so apreventative type of issue.
They were also very, veryinfluenced by the people around
them and so, as we kind of heardDr Diaz reference, many of
these communities are Spanishspeaking.
(12:13):
They may have just differenttrusted information sources.
They may not be listening toprogramming in English, and if
that's the only way that we'redelivering those messages, that
could be a challenge.
One of the other things thatwe've really seen, as I
mentioned, kind of zoonoticdisease being something that
we've worked at a lot isrecently we've seen, with
(12:37):
climate change and other issuessurrounding that, an increase in
vector-borne diseases, and sojust this past year, Hardy
County in Florida had over 20cases of dengue that were
locally acquired, and so we justreceived a grant this week,
(12:57):
actually hot off the presses,from the CDC and the State
Department of Health to reallydig deep into that issue and see
.
Prior to that, a lot of thedengue cases that we've been
seeing in Florida were notlocally acquired, meaning that
while they were reported withinthe state of Florida, they
actually, you know, were bittenby a vector overseas and then
(13:19):
they came here and werediagnosed.
So the locally acquired casesare a much bigger concern, right
, and so, as we're starting tohave some of those conversations
, we met with Hardy CountyDepartment of Health and they
said, you know, as they're goingand having conversations with
farm workers, there's a lot ofcultural differences there and
so they may be leaving doorsopen, they may be allowing
(13:43):
livestock, chickens inparticular in and out of the
house, there may be standingwater, things that we all know
could be preventative actions.
So, kind of tying back to thathealth belief model, we're going
to go into those communitiesand have some conversations
about their trusted informationsources you know who are they
listening to.
What would make a difference inthem taking some of those
(14:06):
preventative actions, in thiscase toward preventing dengue
cases?
Lisa Lundy (14:12):
Yeah, Dr.
Buys, I'm wondering if youcould follow up on that a little
bit.
We've talked Dr Baker reallygot us off to such a good start
thinking about the health beliefmodel and the things that you
know, whether it's our ownperception of the risk or even
our own perception that we havethe self-efficacy to do
something about it.
But in terms of things that areoutside of agricultural
(14:33):
workers' control, things thatare in their environment that
are impacting their health, canyou talk a little bit about
those things and some of thework you've done in that area?
David Buys (14:44):
Yeah, and I love that this question got pitched
to me.
I don't know that y'all knowthis and the listeners certainly
most likely wouldn't.
My doctorate was in medicalsociology and I tell people, as
you can distill that four yearsof education into this, this
very simple statement, which iskind of like thank you, Captain
Obvious, but that people canonly choose from the choices
(15:04):
available to them.
And, and I think as we thinkabout these, yes, absolutely we
need to be understanding whatmotivates people to act.
Why are people engaged in thebehaviors internally?
What drives those decisionsthey make?
But we've also got to work, asDr Diaz has just said, upstream.
We like to use that phrase aswell a lot in the public health
(15:25):
space.
It's upstream of the problem.
What's the environment wherepeople are?
What are they living in andworking in?
Um, there's a.
You know, the construct of thenotion of the social
determinants of health is notreally new anymore, but it's so,
you know, all things consideredkind of in the grand scheme of
public health history, it's arelatively new, new concept and
(15:48):
that's really just the notionthat these are the conditions
and the environments wherepeople are born, live, learn,
work, play, worship and age thataffect a wide range of things
that can affect people's health.
So again I'll say where they'reborn, where they live, where
they learn, where they work,where they play, where they
worship and where they age.
(16:09):
So a wide range of things.
We kind of group those into afewer number of domains.
Those are economic stability,education access and quality,
healthcare access and quality.
They were in built environmentand in the social and community
context.
So you know as we think aboutthose Dr.
(16:31):
Diaz, and all of us havereferenced the kind of pressure,
the family pressure that manyof these farm workers may face
to continue to generate anincome for their family, come
(16:53):
from backgrounds that they don'thave the education and didn't
have the access to education youknow previously or currently,
to understand why thesebehaviors that are so important
are important for them.
And then, once they are, are illable to get to a health care
provider that health care accessand quality piece and if they
are, it may just be a one-offurgent care kinds of kind of
situation which better than butstill may not be enough to help
(17:15):
them fully recover and get backto the operation as quickly as
possible.
The neighborhood and builtenvironment we know that housing
for a lot of foreign workers isreally compromised, and just
that living standard can affecttheir ability.
If we're talking about housingwhere spaces aren't fully sealed
, there may be environmentalrisks that they face just due to
(17:38):
their housing environment.
And then their social andcommunity context.
Are they living in a communitywhere the social norms are such
that they would be compelled?
Are these normalized behaviors?
So the social determinants ofhealth are absolutely a helpful
way for us to think upstream ofthese behaviors that we want to
(18:00):
promote, that we know arehealth-promoting.
They're health-promotingbehaviors, but they don't have
the environment.
Those choices are not availableto them.
Lisa Lundy (18:13):
yeah, and as I was this, listening to what you're
saying and thinking about, youknow you can only choose from
the choices available to you,and then, thinking about some of
our agricultural workers, thatthose choices are not constant.
They may be following um,moving to different locations,
for, you know, different growingseasons.
How does that furthercomplicate and this is really
(18:33):
for any of you your situationwhen those choices are always
kind of in flux?
David Buys (18:40):
Well, I'll just jump in, you know, initially, and
just say, just learning a newenvironment.
And even if you go to a similarenvironment, the same
environment, year after year,but you're only there for two
months, three months, whateverthe stint is, it's going to be
challenging to really embedyourself and understand where to
go to the clinic, where to gofor that PPE that you might need
(19:01):
, that's not provided by youremployer.
Just learning the environmentis difficult and if your number
one goal is to generate incomefor your current, your present
living situation and to sendback home, then you know those.
These other things are reallysecondary.
John Diaz (19:21):
Absolutely, and I think what's what complicates
that is just the, the financiallandscape that's that's coupled
with healthcare, and so you knowa lot of these rural areas, the
the only available healthcareoptions are either a so you know
a lot of these rural areas theonly available healthcare
options are either a hospitalwhich we see a lot of rural
hospitals are closing orfederally qualified health
clinics.
Federally qualified healthclinics are a great initial
(19:42):
option for a lot of these farmworkers, but if they were to see
a primary care physician andneeded some follow-up care from
a specialist, that's where wesee a lot of the healthcare
options stop.
And so you couple the changingenvironment.
You're migrating all over theplace, and then it changes
insurance based on state andlegal status.
(20:02):
It just makes it again thedecision-making process.
A lack of familiarity andawareness just makes it really
complicated for them to know.
And so at the end of the day,they know they need to work,
they need to be there for theirfamily and that's an easy
decision that they know how tomanage.
And so that's what ends uphappening, is they make
decisions for their familybefore themselves.
Lisa Lundy (20:20):
Yeah Well, I mean we've we definitely have
identified and I'm sure there'smany more that we haven't
identified some significantchallenges in this From you
all's perspective, whether it becommunication, extension,
health care delivery.
What are some solutions thatyou've seen that you think are
(20:40):
really working or have a lot ofpotential?
Dr Baker, do you want to startus off from a communication
standpoint?
Lauri Baker (20:46):
Sure, I'd be happy to do that.
I think it's definitely one ofthose places where communication
and education align prettyclosely and it's hard to
distinguish between those as awhole.
But I also think one of thethings we've talked a lot about
the self-efficacy of ag workersin particular.
But the other piece that we'vealso looked at is those
(21:07):
surrounding them and those whomay have more power or ability
to affect the livelihood ofagricultural workers.
So you know, thinking ofproperty owners and farm owners
and working with them to alsounderstand how they can provide
better spaces, how they cantreat areas large scale, how
(21:29):
they can help those people findhealth care opportunities and
educate them, provide things inmultiple languages and that type
of thing.
We're also working as a part ofthe Southeastern Center for
Vector-Borne Disease.
There are 17 different statesand we're about to dig into
North Carolina specifically,where we've seen an issue where
(21:51):
the ticks in North Carolina arebeing testing positive for a lot
of diseases but we're notseeing in rural health care the
report of those diseaseshappening, and so we're going to
go in and do some qualitativework to understand is this a
diagnosis issue?
Are those rural communitiesprepared to make diagnoses?
(22:13):
Are they prepared to have thoseconversations and so perhaps
it's an educational gap there.
Again, we haven't gone in justyet.
We'll go in this fall andhopefully learn more.
But I think all of us havereally talked about this
holistic approach.
It's not just one thing oranother, and so I think, the
more that we can look at thepeople surrounding these issues,
(22:36):
the situation surrounding theseissues and places where we can
identify gaps in education andgaps in communication, and
empower those that can make adifference to do that, whether
that's through policy or whetherthat's through individual
action, working through churches, working through schools In
many cases children are kind ofthe gateway toward the education
(22:58):
and communication outputs inthose areas.
David Buys (23:02):
So I'll go the other direction from what I answered
in my last question, which, youknow, the last question I really
dove in on the notion of goingupstream and working at that
contextual kind of level.
But I'll go really even beyondthe, just the individual level
behavior.
And that is really how do wechange the hearts of the people
(23:26):
and the things like grabpeople's heart, then you can
grab their minds.
And so one of the things thatyou all on this call know, but
that our listeners may not, isthat I worked last several years
on a film project and I wish Icould take credit for actually
production of the film.
I don't know how to turn acamera on, so I have to give
credit to our, to my colleaguesat the MSU TV Center for the
(23:49):
actual work of the filmdevelopment itself.
But we developed a piece calledOn the Farm and we have a first
season that tells the story offour farmers and their families
and the stressors they face.
And then we've got a secondseries now that's just out that
premiered on our broadcastingaffiliate here in July and what
(24:11):
we found is that that film thatreally captures the stories, the
individual level stories thatare in a very raw and authentic
kind of way is we show thataround the state and around the
region is having a tremendousimpact on increasing or
(24:34):
improving the understanding thatthose that have the ability to
make decisions that would impact, possibly impact our farm
workers their eyes are beingopened in a significant way.
Um, and an interesting storyabout that is when we started
the project, before we had ourfirst film, even in the bag, um,
we had a significant buy-insince a buy-in from some of our
(24:59):
farm organizations here in thestate farm bureau, uh, being
among them, and that, yes, greatwork on getting this out to our
work with y'all, to get thisout to our county association
meetings.
Um, and and once the film wascomplete the first season of the
film was complete what we?
We started going down that roadand trying to get them to make
(25:20):
good on their commitment.
What we found is that thoselocal farmers who would watch
this and those that were like,say, the president, the
president of their county boardfor Farm Bureau, would take a
look at this and they'd say youknow, that's really well done,
it's impressive, but we livethis every day.
We don't want to watch filmabout it.
(25:40):
So we pivoted and our primaryaudience for that film has been
healthcare workers, thosephysician, nurses, and this has
even been embedded in courses inschool nursing school, health
professions not at MississippiState but at other places, and
the evaluation data that we'regetting back indicates that
(26:02):
folks have no idea what ourfarmers face, be it the farm
owners or the farm workers.
They are absolutely cluelessand in Mississippi, agriculture
is our number one industry andyet we're preparing people for
professions that would interactwith farmers and until now we
haven't really had anintentional way of reaching
those who have such an impact onthat population.
(26:25):
Those will have such an impacton on that population.
So I, as you know as proud aswe are of that work and that
film and I would offer it toanybody because it's available
on the farm dot life, I wouldjust say the broader lesson here
is is to find a way gotta finda way to grab the hearts of
those that have the ability toto make a change and and impact
(26:46):
farmers and farm workers for thebetter.
John Diaz (27:09):
yeah, and I agree with what both Dr.
Baker and Dr.
Buys have said, and I think, inaddition to that, we, you know,
we've got to have clearcommunication, you got to be
aware of what's going on, and wealso have to play to the and
minds of those that areinfluential in this, in this
paradigm.
But I'll take it even kind of,bring it all full circles.
Once we've been able to createthis synergy, I think it's
(27:29):
important for groups likeExtension to really go and meet
folks where they're at, and sothat's what we're trying to do
specifically in the state ofFlorida.
So, for example, we're going outto the farms to provide health
screening, vaccination andeducation.
We're going to the churchesthat they're going to on their
one day off and providing healthscreening, vaccinations,
connection to local clinics andall those different things.
(27:53):
And in addition to that, theyalso have to take part of worker
protection standard training tomaintain, for example, their
pesticide applicationcertification.
So we're going to trainingslike that, so we're finding
places where they're alreadygoing to be to help to provide
the education and the servicesthat they need amidst the
(28:14):
craziness that is their life.
So I think that if we're ableto bring those three things
together, I think it'll help tomake some real change and
hopefully transform the healthaccess and quality of care
paradigm that the farm workersare dealing with currently.
Phillip Stokes (28:49):
So Dr.
Diaz you brought up CooperativeExtension and I think that's
where we were going to go nextbecause I did want to ask, and
Dr.
Buys I want to hear yourperspective from the state of
Mississippi as well.
But what is briefly CooperativeExentions and what is this role
in healthcare because I feellike it's a relatively new shift
that we've seen, that we'reasking extension agents to
address certain healthcare needsthat you know.
Maybe in the past it was morescientific or technical or
agricultural focused.
So, Dr Baez, do you have any,or actually both?
I'm going to open it up to bothof you if you want to comment
on that.
John Diaz (29:10):
Yeah.
So first, cooperative extensionis a really the connection of
land grant universities to thecommunities in the state that
they serve.
So in the state of Florida, wehave Florida A&M University and
the University of Florida, whohave a connection to the 67
counties and tribal reservationsthat exist in the University of
Florida, who have a connectionto the 67 counties and tribal
reservations that exist in thestate of Florida, and their goal
is to build relationships withcommunities and connect them
(29:33):
with information and sciencethat's happening at the
universities that they represent.
So what is the role in medicineand public health?
So I think COVID was an amazingcase study to show how
extension can work not only intocommunities to provide services
(30:07):
but also to provide education.
And so we're really trying tobuild out that model and take
advantage of the amazing workand the amazing relationships
and connections that our localextension agents have made to
bring health professionals tothese communities and provide
these services and educationopportunities that they didn't
(30:28):
have in the past.
And so we're having really,really great luck in
capitalizing on these greatextension agents that are doing
work with these communities.
They're doing work in the spaceof public health and now we've
developed a coalition ofpartners that are focused on
agricultural health and safetyand specifically increasing
access to quality services whichwere not there before.
(30:51):
So represents a new opportunity.
I think we may not have it allhumming and buzzing the way that
we would want to, but we'relearning along the way, and my
vision is to have medicalprofessionals more fully
integrated into the extensionmodel.
So it's not just colleges of agand life sciences, we also have
colleges of medicine, collegesof business, colleges of
(31:11):
engineering, helping totransform.
David Buys (31:14):
You know what we're working within today and I would
just go, you know, a little bitfurther back in history and
just for folks that don't know,Mississippi, it's certainly the
same.
We and Alcorn State Universityboth have agents and uh
extension service and and acrossboth universities we have
(31:36):
agents in every county.
The fact we're the onlystatewide it has still has an
eight to five presence every dayof the week in every county.
State State Department ofHealth doesn't.
The Human Services, childProtective Services none of
those have fully operational 8-5, five days a week services in
(31:57):
every county.
But attention has remainedcommitted to our mission to be
fully present all the time inevery county of the state.
Historically I would just saythat the land-grant universities
building out from the early1860s to 1914, there was this
(32:19):
evolution from being strictly ateaching-focused operation to a
commitment to take that teachingto the people, take that
education to the people,primarily and initially around
agriculture, but also includingwhole economic, what we used to
call whole economics now familyand consumer sciences.
A lot of states are moving tothe concept of family and
(32:40):
consumer sciences, transitioningto family and community health,
and I think that may be abetter way of framing where we
are now is that we really aredoing family and community
health work In most states.
I would say that we are reallynever intending to move to a
provision of clinical services.
That's not really who we are,but we are connected.
(33:01):
We are one of the strongestassets and straight to the
attention and the attentionbreaks the table is a connection
, and initially that connectionfrom the university around
agriculture, home, economics, tothe community.
But also now, as ouruniversities have become more
and more sophisticated andoffered more and more services,
we're able to kind of serve as ahub and bring in expertise from
(33:25):
, as a few said, medicine,engineering and the list goes on
to those communities as well.
Through this vehicle, throughthis mechanism and it's an
extraordinarily powerfulmechanism healthcare reform back
(33:49):
in the early part of the Obamaera President Obama era that the
notion of health extension waswritten into the bill.
Our model is one that othersenvy and would love to be able
to replicate.
It's not been fully rolled out.
This notion of health extension, separate from cooperative
extension, has not been fullysuccessful, and so I think the
fact that the healthcareindustry envies what we do and
(34:10):
we continue to be successful isall the more evidence that we
need to be working together andpushing a greater focus on
health through extension,through this powerful
infrastructure that we have.
Phillip Stokes (34:25):
Yeah, Dr Baker, did you want to add anything
about your work in Extension orsome of the communication
efforts or really anything else?
Sure I think I certainly agreewith everything Dr.
Buys and Dr.
Diaz said and I think Extensionis uniquely positioned to
deliver some of thatcommunication.
In a lot of our models lookingat vaccinations of children and
looking at vaccination for COVIDin general, community-based
social marketing was one of thethings that really impacted
(34:55):
people's attitude toward gettingvaccinated, as well as their
intention to get vaccinated.
Can you share what that is realquick?
Lauri Baker (35:01):
Yes, absolutely I was going to say.
Essentially, what extension isis built on that model.
People are already embeddedwithin these communities.
They're members of thecommunity, they're going to
school, they're going to church,their children are interacting
with people in these communities.
So they already are kind ofboots on the ground.
(35:21):
They're trusted informationsources, while they're also
plugged into science and trustin science is another thing that
we've seen in our models thathave been really impactful in
people's decision making, and soExtension has that opportunity
to be in those communities toinfluence all the things we've
talked about today, to influencethe social norms around health
(35:44):
issues, people's self-efficacyto make decisions around health
issues, particularly in ruralcommunities.
The other aspect is when we askabout trusted information
sources and compare ruralcommunities to urban communities
, trust and extension is muchhigher in our rural communities.
So, as we're thinking aboutrural health care, in many cases
(36:08):
they may not have a localclinic, but if they have a local
agent, that person cancertainly be a liaison, someone
to help them get the rightanswers, get the right
information and continue to havereminders and information about
how they can connect morebroadly.
So I can't really think of abetter vehicle than Extension to
(36:30):
deliver some of thosecommunication messages around
health.
John Diaz (36:51):
They don't have.
Extension is viewed as more ofa trusted messenger than our
medical professionalcounterparts, and so they see it
as a great partnership to helpto influence those
decision-making paradigms on theground and hopefully get folks
to get vaccinated, you know,start to engage more in
preventative health,no-transcript.
(37:24):
So again it's been a great,great connection, a great
vehicle to get some of themedical science implemented on
the ground.
David Buys (37:32):
I would layer in that we've not talked about
really research at all.
We've talked a lot aboutevaluation or sort of needs
Describe, generally work.
That Extension is careful tostay out of the formal research
world.
We're pretty much aboutpractice and applied effort and
at the same time we are a greatpartner for researchers.
(37:52):
We're not here to be theirresearch assistants or to simply
be their data gatherers orsolely their access to
participate for their studies,but there are often synergies
where folks with research grantscan work with us and we can
(38:12):
plus up things for communitiesthrough research grants and then
the researchers also get theaccess they need for data
collection.
It's a really, reallyremarkable partnership on that
side as well, and lots ofscience has been developed to
inform implications frompartnerships that Extension
(38:34):
brings to the table.
I am very careful toreemphasize what I said, that we
are not sitting aroundtwiddling our thumbs waiting for
researchers to come, get us togive out their instruments or
convene a focus group for them,but where there are synergies,
we are ready and willingpartners.
Phillip Stokes (38:57):
Dr.
Lundy, do you have any otherquestions or thoughts to kind of
wrap up today's conversation?
Lisa Lundy (39:03):
No, I just thank you all three of you.
I think that the three of yourepresent a lot of like.
We've discussed solutions andpotential for collaboration, and
so I really enjoyed hearingfrom all three of you today and
very thankful that you took thetime to participate.
Phillip Stokes (39:40):
Yeah, of course we started out talking about the
challenges and some of thosebarriers, but it really is
encouraging to hear all of thework that is being done and some
of the positive changes thathave happened over time.
You know not always easily doneso right, but it's great to
hear about the work you're alldoing in those areas as well.
I just want to thank you allfor joining today sure thanks
for having us yep thanks forhaving us great well, uh, once
again.
(40:01):
um, this is being video recorded.
If you want to check us out onthe southeastern coastal center
for agricultural health andsafety YouTube channel, you can
see it there.
We'll also stream it whereveryou get your podcasts and until
next time, be on the lookout forother episodes from Science by
the Slice.
Thanks so much for listening.
Ricky Telg (40:24):
Science by the Slice is produced by the UF-IFAS
Center for Public IssuesEducation in Agriculture and
Natural Resources.
Thanks for listening to today'sepisode.
Subscribe to Science by theSlice on your favorite podcast
app and give us a rating orreview as well.
Have a question or comment?
Send us an email to piecenter @ifas.
ufl.
edu.
(40:45):
That's piecenter.
All one word @ ifas.
ufl.
edu.
We'd love to hear from you.
If you enjoyed today's episode,consider sharing with a friend
or colleague.
Until next time, thanks forlistening to Science by the
Slice.
This is Science by the Slice, a podcast from the
University of Florida'sInstitute of Food and
Agricultural Sciences Center forPublic Issues Education.
In this podcast, expertsdiscuss the science of issues
affecting our daily lives,reveal the motivations behind
the decisions people make, andultimately provide insight to
solutions for our lives.
Phillip Stokes (00:33):
My name is Philip Stokes, Education
Coordinator at the PIE Center.
I'm also joined by Dr.
Lisa Lundy, who is co-hostingthis podcast with me, and so I
want to take a minute to justintroduce the topic of this
episode and who we're joined by.
So this episode is also hostedin conjunction with the
Southeastern Coastal Center forAgricultural Health and Safety,
(00:55):
and earlier this year we had aState of the Science meeting and
the topic for that meeting wasrural agricultural health and
the health needs of theagricultural workforce, and so
during that meeting we hadreally good conversations with
some of our researchers andeducators that were a part of
that meeting, and we have someof them here with us today.
(01:17):
So we wanted to do a podcast tofollow up on some of those
topics and conversations, andthat's what we're doing here
today.
So, in addition to myself and Dr.
Lundy, I'm joined by Dr.
Lauri Baker, as well as Dr.
John Diaz and Dr.
David Buys, excuse me and so Iwant to give everyone just a
(01:39):
minute to introduce themselvesand just go around and say who
you are, a little bit about yourbackground and kind of your
research areas, just real casual.
Let us know who you are, and soeveryone who's listening has
your voice knows who you are.
And then also, we are videorecording this podcast as well,
so you'll be able to watch it onour YouTube channel as well.
(02:00):
So, Dr.
Lauri Baker, you want to startus out?
Lauri Baker (02:03):
Sure Happy to start .
I'm an Associate Professor inAgricultural Education and
Communication here at theUniversity of Florida and I have
a 65% research appointment and35% extension appointment.
Much of those appointments andthat work happens through the
PIE Center and so that's why I'maffiliated with this project.
As far as research interests,even before I came to the
(02:26):
University of Florida I waslooking at zoonotic disease and
communication issues surroundingthat and the opportunity to
come here.
Those issues have certainlyincreased and there's been a lot
of opportunity for digging indeep on that research and what
it means for rural communitiesand rural health, particularly
agricultural workers.
Phillip Stokes (02:47):
Great, thank you so much.
All right, Dr.
Diaz, how about you want to gonext?
John Diaz (02:53):
All right, so I'm Dr.
John Diaz.
I'm an Associate Professor andExtension Specialist in the
Department of AgriculturalEducation and Communication.
I also serve as a president ofa group called CAFE Latino,
which is the Coalition ofFlorida Extension Educators for
Latino Communities.
Really, my work focuses onincreasing the competency and
capacity of universities,extensions, nonprofit groups to
(03:16):
serve Latinos and Latinaimmigrant groups in the United
States but across the world, andso I've been obviously, because
of the demographics of farmworkers in the United States,
I've been working heavily inthat space, helping to better
understand how groups likeExtension can help to better
serve the agricultural workforcein our country.
Phillip Stokes (03:37):
Thank you and Dr .
David Buys.
David Buys (03:40):
Hi y'all, I'm David Buys.
I served for 10 years 10 yearsand one month actually as the
state health specialist for MSUExtension, Mississippi State
University Extension Service.
I am currently in an AssociateVice Provost for health sciences
role and interim head of campusat MSU Meridian.
So I still have a line back toExtension and will always
(04:05):
continue my work with extension.
My time with extension hasreally been peppered with a lot
of different issues.
I often explain to people thatwhat family practice is to
medicine I am a state healthspecialist to attention to
public health, to attention topublic health, and that is that,
like a family practice doc maysee a three-year-old with an ear
(04:28):
infection at 8 am, their 8:30appointment might be an
80-year-old with dementia andtheir next one might be a
40-year-old with hypertension.
Well, my public health practicehas been just that diverse
because we, as extensionprofessionals, take what issues
are present and walk in the door, if you will.
Among those issues has beenfarm stress and issues of mental
(04:52):
health, mental challenges thatour agricultural producers face.
So I've spent quite a bit oftime working on and around that
the last six, seven years andI'm delighted to be with you all
to talk more about this broadtopic.
Phillip Stokes (05:08):
Well, thank you, Dr.
Buys.
So those introductions wereactually really great to
introduce what we're going to betalking about today.
So, of course, last but notleast, Dr.
Lisa Lundy, if you can maybeintroduce yourself as well, tell
us your affiliation with theSoutheastern Coastal Center for
Ag Health and Safety and thenkick us off and we'll get the
conversation going.
Lisa Lundy (05:26):
All right, hi, I'm Lisa Lundy.
I'm a professor in theDepartment of Agricultural
Education and Communication andI'm also part of the Outreach
Core for the SoutheasternCoastal Center for Agricultural
Health and Safety and was abeneficiary of a conversation
along these lines among thisgroup earlier this year and very
(05:47):
excited to share thatconversation and a little bit of
that here with you today.
So we're going to actually kickoff with Dr.
Diaz and Dr.
Diaz, if you would tell us alittle bit from your perspective
.
Of course, we know that we justheard from Dr.
Buys how varied it is.
But describe the agriculturalworkforce too.
Who are our agriculturalworkers in terms of just
(06:10):
demographics and makeup, andthen what are some of their
unique healthcare needs?
John Diaz (06:16):
Yeah, so the makeup and demographics of the
agricultural workforce has beenchanging for some time.
If you look back at the 50s and60s, farms were predominantly
farmed by families, so there wasa lot of family operators and
family farm workers.
But as time has passed, we'reseeing a lot of those family
farms going by the wayside andmost of the workforce is
(06:38):
externally hired.
Nowadays, we're seeing most ofthose external hires being
either immigrants who are livingin the state that they reside
in or are temporary workersthrough an H-2A visa program.
Nowadays, even just the sheernumber of farmers and farm
workers is down.
So back in the 50s it wasaround 10 million and we're just
(06:59):
over 2 million now, with abouthalf, if not more, being hired
external workers.
And so those higher externalworkers, the H-2A program.
Back in 2022, which is the lastdata I had they were
contracting about 372,000 farmworkers, and that does not even
take into consideration thelarge segment of undocumented
(07:21):
workers that work in theagricultural industry.
So we couple that and thinkingabout healthcare.
There's a lot of healthcareneeds that are tied to the
realities of those workers, andso, because they're part of a
really arduous and rigorous worktype, they're exposed to a lot
of different risks, whether it'spesticide exposure, heat
(07:43):
exposure, the plethora of otherrisks that come with farm
working.
In addition to that, becausetheir life is somewhat turbulent
, whether they're a temporaryworker, an immigrant or just a
domestic worker working sevendays a week, as Dr.
Buys said, there's a lot ofissues related to mental health,
and so it's really thescenarios and the needs within
(08:04):
agricultural workers is verycomplicated, which makes serving
them and understanding how toserve them complicated onto
itself.
Lisa Lundy (08:13):
Yeah.
Thank you so much.
That gives us such a greatoverview and I know you've
painted such a picture of theworkforce and I know you've been
involved specifically in someoutreach health clinics for
agricultural workers.
In your experience, what aresome of the things that prompt
(08:33):
someone to come in, or maybewhat are some of the things that
present in those settings asfar as health care issues?
John Diaz (08:41):
Yeah, so one of the biggest health care issues that
we see on a regular basis isissues of chronic disease.
Because these farm workers areof low socioeconomic status,
they cannot afford to eat freshfruits and vegetables and so
they're really relegated toeating a lot of processed foods,
and eating a lot of processedfoods within a very tight
(09:02):
schedule, so if it's somethingthey've prepared themselves or
going through a drive-throughwhen they have five minutes to
spare.
So, for example, with a lot ofthe farm workers that we're
seeing, their A1C levels are atastronomical levels, so A1C
levels of 10, 11, 12, 13, 14,and 15, where prediabetes and
(09:23):
diabetes are in the 5, 6, and 7range.
And so just trying to wrap ourheads around what that looks
like and why they're havingthese issues and again it comes
back to kind of the realities oftheir life and their
inabilities to access not onlyhealth care but those fresh
fruits and vegetables andhealthy foods that they would
need to prevent them fromgetting issues like diabetes.
Phillip Stokes (09:44):
Yeah, you know, Dr.
Diaz, you talked about.
You brought up access right andthe realities of their life,
and I think a lot of times whenwe discuss healthcare, we think
about being informed of theappropriate choices to make.
We try to get these thingstaught to us in school as we're
(10:05):
growing up.
But, as you mentioned, theseworkers and this agricultural
workforce they're coming fromall over the place and so
thinking about just access toinformation or access to health
care, or access to healthy food,um, you know, knowing it, there
are barriers that come inbetween that so what are some,
Dr.
Baker, I want to ask you whatare some of the factors that
influence the choices thatpeople make when going about
(10:25):
their health care?
Lauri Baker (10:42):
Yeah, absolutely.
One of the models that we liketo use a lot at the PIE Center
in this kind of work is calledthe health belief model, and
essentially in that model reallythere's an element of how much
you believe you are at risk, orthat you believe you're at
danger, and so, thinking aboutsome of the things that Dr Diaz
says, you know, if you havegrown up in a family that has
(11:03):
always worked outside, hasalways been in potentially
transient migrant communitieswhere you were working seven
days a week, you may believethat that's very normal and you
may believe that you aren't atrisk because those are practices
that are happening all the timearound you, and so people's
willingness to take action onpreventative health care is much
(11:28):
lower if they don't believethat they're at risk, and so
that's one of the things thatwe've really tried to look at in
the PIE Center.
We did five different surveysthroughout COVID, and during
that time one of the things thatreally kind of kept coming out
in this data was that there wasa real difference between rural
and urban communities and theirtrust in science, and we found
(11:52):
in many of our models that thatwas predictive of whether they
would be willing to seek care,whether they would be willing to
get a vaccine, so apreventative type of issue.
They were also very, veryinfluenced by the people around
them and so, as we kind of heardDr Diaz reference, many of
these communities are Spanishspeaking.
(12:13):
They may have just differenttrusted information sources.
They may not be listening toprogramming in English, and if
that's the only way that we'redelivering those messages, that
could be a challenge.
One of the other things thatwe've really seen, as I
mentioned, kind of zoonoticdisease being something that
we've worked at a lot isrecently we've seen, with
(12:37):
climate change and other issuessurrounding that, an increase in
vector-borne diseases, and sojust this past year, Hardy
County in Florida had over 20cases of dengue that were
locally acquired, and so we justreceived a grant this week,
(12:57):
actually hot off the presses,from the CDC and the State
Department of Health to reallydig deep into that issue and see
.
Prior to that, a lot of thedengue cases that we've been
seeing in Florida were notlocally acquired, meaning that
while they were reported withinthe state of Florida, they
actually, you know, were bittenby a vector overseas and then
(13:19):
they came here and werediagnosed.
So the locally acquired casesare a much bigger concern, right
, and so, as we're starting tohave some of those conversations
, we met with Hardy CountyDepartment of Health and they
said, you know, as they're goingand having conversations with
farm workers, there's a lot ofcultural differences there and
so they may be leaving doorsopen, they may be allowing
(13:43):
livestock, chickens inparticular in and out of the
house, there may be standingwater, things that we all know
could be preventative actions.
So, kind of tying back to thathealth belief model, we're going
to go into those communitiesand have some conversations
about their trusted informationsources you know who are they
listening to.
What would make a difference inthem taking some of those
(14:06):
preventative actions, in thiscase toward preventing dengue
cases?
Lisa Lundy (14:12):
Yeah, Dr.
Buys, I'm wondering if youcould follow up on that a little
bit.
We've talked Dr Baker reallygot us off to such a good start
thinking about the health beliefmodel and the things that you
know, whether it's our ownperception of the risk or even
our own perception that we havethe self-efficacy to do
something about it.
But in terms of things that areoutside of agricultural
(14:33):
workers' control, things thatare in their environment that
are impacting their health, canyou talk a little bit about
those things and some of thework you've done in that area?
David Buys (14:44):
Yeah, and I love that this question got pitched
to me.
I don't know that y'all knowthis and the listeners certainly
most likely wouldn't.
My doctorate was in medicalsociology and I tell people, as
you can distill that four yearsof education into this, this
very simple statement, which iskind of like thank you, Captain
Obvious, but that people canonly choose from the choices
(15:04):
available to them.
And, and I think as we thinkabout these, yes, absolutely we
need to be understanding whatmotivates people to act.
Why are people engaged in thebehaviors internally?
What drives those decisionsthey make?
But we've also got to work, asDr Diaz has just said, upstream.
We like to use that phrase aswell a lot in the public health
(15:25):
space.
It's upstream of the problem.
What's the environment wherepeople are?
What are they living in andworking in?
Um, there's a.
You know, the construct of thenotion of the social
determinants of health is notreally new anymore, but it's so,
you know, all things consideredkind of in the grand scheme of
public health history, it's arelatively new, new concept and
(15:48):
that's really just the notionthat these are the conditions
and the environments wherepeople are born, live, learn,
work, play, worship and age thataffect a wide range of things
that can affect people's health.
So again I'll say where they'reborn, where they live, where
they learn, where they work,where they play, where they
worship and where they age.
(16:09):
So a wide range of things.
We kind of group those into afewer number of domains.
Those are economic stability,education access and quality,
healthcare access and quality.
They were in built environmentand in the social and community
context.
So you know as we think aboutthose Dr.
(16:31):
Diaz, and all of us havereferenced the kind of pressure,
the family pressure that manyof these farm workers may face
to continue to generate anincome for their family, come
(16:53):
from backgrounds that they don'thave the education and didn't
have the access to education youknow previously or currently,
to understand why thesebehaviors that are so important
are important for them.
And then, once they are, are illable to get to a health care
provider that health care accessand quality piece and if they
are, it may just be a one-offurgent care kinds of kind of
situation which better than butstill may not be enough to help
(17:15):
them fully recover and get backto the operation as quickly as
possible.
The neighborhood and builtenvironment we know that housing
for a lot of foreign workers isreally compromised, and just
that living standard can affecttheir ability.
If we're talking about housingwhere spaces aren't fully sealed
, there may be environmentalrisks that they face just due to
(17:38):
their housing environment.
And then their social andcommunity context.
Are they living in a communitywhere the social norms are such
that they would be compelled?
Are these normalized behaviors?
So the social determinants ofhealth are absolutely a helpful
way for us to think upstream ofthese behaviors that we want to
(18:00):
promote, that we know arehealth-promoting.
They're health-promotingbehaviors, but they don't have
the environment.
Those choices are not availableto them.
Lisa Lundy (18:13):
yeah, and as I was this, listening to what you're
saying and thinking about, youknow you can only choose from
the choices available to you,and then, thinking about some of
our agricultural workers, thatthose choices are not constant.
They may be following um,moving to different locations,
for, you know, different growingseasons.
How does that furthercomplicate and this is really
(18:33):
for any of you your situationwhen those choices are always
kind of in flux?
David Buys (18:40):
Well, I'll just jump in, you know, initially, and
just say, just learning a newenvironment.
And even if you go to a similarenvironment, the same
environment, year after year,but you're only there for two
months, three months, whateverthe stint is, it's going to be
challenging to really embedyourself and understand where to
go to the clinic, where to gofor that PPE that you might need
(19:01):
, that's not provided by youremployer.
Just learning the environmentis difficult and if your number
one goal is to generate incomefor your current, your present
living situation and to sendback home, then you know those.
These other things are reallysecondary.
John Diaz (19:21):
Absolutely, and I think what's what complicates
that is just the, the financiallandscape that's that's coupled
with healthcare, and so you knowa lot of these rural areas, the
the only available healthcareoptions are either a so you know
a lot of these rural areas theonly available healthcare
options are either a hospitalwhich we see a lot of rural
hospitals are closing orfederally qualified health
clinics.
Federally qualified healthclinics are a great initial
(19:42):
option for a lot of these farmworkers, but if they were to see
a primary care physician andneeded some follow-up care from
a specialist, that's where wesee a lot of the healthcare
options stop.
And so you couple the changingenvironment.
You're migrating all over theplace, and then it changes
insurance based on state andlegal status.
(20:02):
It just makes it again thedecision-making process.
A lack of familiarity andawareness just makes it really
complicated for them to know.
And so at the end of the day,they know they need to work,
they need to be there for theirfamily and that's an easy
decision that they know how tomanage.
And so that's what ends uphappening, is they make
decisions for their familybefore themselves.
Lisa Lundy (20:20):
Yeah Well, I mean we've we definitely have
identified and I'm sure there'smany more that we haven't
identified some significantchallenges in this From you
all's perspective, whether it becommunication, extension,
health care delivery.
What are some solutions thatyou've seen that you think are
(20:40):
really working or have a lot ofpotential?
Dr Baker, do you want to startus off from a communication
standpoint?
Lauri Baker (20:46):
Sure, I'd be happy to do that.
I think it's definitely one ofthose places where communication
and education align prettyclosely and it's hard to
distinguish between those as awhole.
But I also think one of thethings we've talked a lot about
the self-efficacy of ag workersin particular.
But the other piece that we'vealso looked at is those
(21:07):
surrounding them and those whomay have more power or ability
to affect the livelihood ofagricultural workers.
So you know, thinking ofproperty owners and farm owners
and working with them to alsounderstand how they can provide
better spaces, how they cantreat areas large scale, how
(21:29):
they can help those people findhealth care opportunities and
educate them, provide things inmultiple languages and that type
of thing.
We're also working as a part ofthe Southeastern Center for
Vector-Borne Disease.
There are 17 different statesand we're about to dig into
North Carolina specifically,where we've seen an issue where
(21:51):
the ticks in North Carolina arebeing testing positive for a lot
of diseases but we're notseeing in rural health care the
report of those diseaseshappening, and so we're going to
go in and do some qualitativework to understand is this a
diagnosis issue?
Are those rural communitiesprepared to make diagnoses?
(22:13):
Are they prepared to have thoseconversations and so perhaps
it's an educational gap there.
Again, we haven't gone in justyet.
We'll go in this fall andhopefully learn more.
But I think all of us havereally talked about this
holistic approach.
It's not just one thing oranother, and so I think, the
more that we can look at thepeople surrounding these issues,
(22:36):
the situation surrounding theseissues and places where we can
identify gaps in education andgaps in communication, and
empower those that can make adifference to do that, whether
that's through policy or whetherthat's through individual
action, working through churches, working through schools In
many cases children are kind ofthe gateway toward the education
(22:58):
and communication outputs inthose areas.
David Buys (23:02):
So I'll go the other direction from what I answered
in my last question, which, youknow, the last question I really
dove in on the notion of goingupstream and working at that
contextual kind of level.
But I'll go really even beyondthe, just the individual level
behavior.
And that is really how do wechange the hearts of the people
(23:26):
and the things like grabpeople's heart, then you can
grab their minds.
And so one of the things thatyou all on this call know, but
that our listeners may not, isthat I worked last several years
on a film project and I wish Icould take credit for actually
production of the film.
I don't know how to turn acamera on, so I have to give
credit to our, to my colleaguesat the MSU TV Center for the
(23:49):
actual work of the filmdevelopment itself.
But we developed a piece calledOn the Farm and we have a first
season that tells the story offour farmers and their families
and the stressors they face.
And then we've got a secondseries now that's just out that
premiered on our broadcastingaffiliate here in July and what
(24:11):
we found is that that film thatreally captures the stories, the
individual level stories thatare in a very raw and authentic
kind of way is we show thataround the state and around the
region is having a tremendousimpact on increasing or
(24:34):
improving the understanding thatthose that have the ability to
make decisions that would impact, possibly impact our farm
workers their eyes are beingopened in a significant way.
Um, and an interesting storyabout that is when we started
the project, before we had ourfirst film, even in the bag, um,
we had a significant buy-insince a buy-in from some of our
(24:59):
farm organizations here in thestate farm bureau, uh, being
among them, and that, yes, greatwork on getting this out to our
work with y'all, to get thisout to our county association
meetings.
Um, and and once the film wascomplete the first season of the
film was complete what we?
We started going down that roadand trying to get them to make
(25:20):
good on their commitment.
What we found is that thoselocal farmers who would watch
this and those that were like,say, the president, the
president of their county boardfor Farm Bureau, would take a
look at this and they'd say youknow, that's really well done,
it's impressive, but we livethis every day.
We don't want to watch filmabout it.
(25:40):
So we pivoted and our primaryaudience for that film has been
healthcare workers, thosephysician, nurses, and this has
even been embedded in courses inschool nursing school, health
professions not at MississippiState but at other places, and
the evaluation data that we'regetting back indicates that
(26:02):
folks have no idea what ourfarmers face, be it the farm
owners or the farm workers.
They are absolutely cluelessand in Mississippi, agriculture
is our number one industry andyet we're preparing people for
professions that would interactwith farmers and until now we
haven't really had anintentional way of reaching
those who have such an impact onthat population.
(26:25):
Those will have such an impacton on that population.
So I, as you know as proud aswe are of that work and that
film and I would offer it toanybody because it's available
on the farm dot life, I wouldjust say the broader lesson here
is is to find a way gotta finda way to grab the hearts of
those that have the ability toto make a change and and impact
(26:46):
farmers and farm workers for thebetter.
John Diaz (27:09):
yeah, and I agree with what both Dr.
Baker and Dr.
Buys have said, and I think, inaddition to that, we, you know,
we've got to have clearcommunication, you got to be
aware of what's going on, and wealso have to play to the and
minds of those that areinfluential in this, in this
paradigm.
But I'll take it even kind of,bring it all full circles.
Once we've been able to createthis synergy, I think it's
(27:29):
important for groups likeExtension to really go and meet
folks where they're at, and sothat's what we're trying to do
specifically in the state ofFlorida.
So, for example, we're going outto the farms to provide health
screening, vaccination andeducation.
We're going to the churchesthat they're going to on their
one day off and providing healthscreening, vaccinations,
connection to local clinics andall those different things.
(27:53):
And in addition to that, theyalso have to take part of worker
protection standard training tomaintain, for example, their
pesticide applicationcertification.
So we're going to trainingslike that, so we're finding
places where they're alreadygoing to be to help to provide
the education and the servicesthat they need amidst the
(28:14):
craziness that is their life.
So I think that if we're ableto bring those three things
together, I think it'll help tomake some real change and
hopefully transform the healthaccess and quality of care
paradigm that the farm workersare dealing with currently.
Phillip Stokes (28:49):
So Dr.
Diaz you brought up CooperativeExtension and I think that's
where we were going to go nextbecause I did want to ask, and
Dr.
Buys I want to hear yourperspective from the state of
Mississippi as well.
But what is briefly CooperativeExentions and what is this role
in healthcare because I feellike it's a relatively new shift
that we've seen, that we'reasking extension agents to
address certain healthcare needsthat you know.
Maybe in the past it was morescientific or technical or
agricultural focused.
So, Dr Baez, do you have any,or actually both?
I'm going to open it up to bothof you if you want to comment
on that.
John Diaz (29:10):
Yeah.
So first, cooperative extensionis a really the connection of
land grant universities to thecommunities in the state that
they serve.
So in the state of Florida, wehave Florida A&M University and
the University of Florida, whohave a connection to the 67
counties and tribal reservationsthat exist in the University of
Florida, who have a connectionto the 67 counties and tribal
reservations that exist in thestate of Florida, and their goal
is to build relationships withcommunities and connect them
(29:33):
with information and sciencethat's happening at the
universities that they represent.
So what is the role in medicineand public health?
So I think COVID was an amazingcase study to show how
extension can work not only intocommunities to provide services
(30:07):
but also to provide education.
And so we're really trying tobuild out that model and take
advantage of the amazing workand the amazing relationships
and connections that our localextension agents have made to
bring health professionals tothese communities and provide
these services and educationopportunities that they didn't
(30:28):
have in the past.
And so we're having really,really great luck in
capitalizing on these greatextension agents that are doing
work with these communities.
They're doing work in the spaceof public health and now we've
developed a coalition ofpartners that are focused on
agricultural health and safetyand specifically increasing
access to quality services whichwere not there before.
(30:51):
So represents a new opportunity.
I think we may not have it allhumming and buzzing the way that
we would want to, but we'relearning along the way, and my
vision is to have medicalprofessionals more fully
integrated into the extensionmodel.
So it's not just colleges of agand life sciences, we also have
colleges of medicine, collegesof business, colleges of
(31:11):
engineering, helping totransform.
David Buys (31:14):
You know what we're working within today and I would
just go, you know, a little bitfurther back in history and
just for folks that don't know,Mississippi, it's certainly the
same.
We and Alcorn State Universityboth have agents and uh
extension service and and acrossboth universities we have
(31:36):
agents in every county.
The fact we're the onlystatewide it has still has an
eight to five presence every dayof the week in every county.
State State Department ofHealth doesn't.
The Human Services, childProtective Services none of
those have fully operational 8-5, five days a week services in
(31:57):
every county.
But attention has remainedcommitted to our mission to be
fully present all the time inevery county of the state.
Historically I would just saythat the land-grant universities
building out from the early1860s to 1914, there was this
(32:19):
evolution from being strictly ateaching-focused operation to a
commitment to take that teachingto the people, take that
education to the people,primarily and initially around
agriculture, but also includingwhole economic, what we used to
call whole economics now familyand consumer sciences.
A lot of states are moving tothe concept of family and
(32:40):
consumer sciences, transitioningto family and community health,
and I think that may be abetter way of framing where we
are now is that we really aredoing family and community
health work In most states.
I would say that we are reallynever intending to move to a
provision of clinical services.
That's not really who we are,but we are connected.
(33:01):
We are one of the strongestassets and straight to the
attention and the attentionbreaks the table is a connection
, and initially that connectionfrom the university around
agriculture, home, economics, tothe community.
But also now, as ouruniversities have become more
and more sophisticated andoffered more and more services,
we're able to kind of serve as ahub and bring in expertise from
(33:25):
, as a few said, medicine,engineering and the list goes on
to those communities as well.
Through this vehicle, throughthis mechanism and it's an
extraordinarily powerfulmechanism healthcare reform back
(33:49):
in the early part of the Obamaera President Obama era that the
notion of health extension waswritten into the bill.
Our model is one that othersenvy and would love to be able
to replicate.
It's not been fully rolled out.
This notion of health extension, separate from cooperative
extension, has not been fullysuccessful, and so I think the
fact that the healthcareindustry envies what we do and
(34:10):
we continue to be successful isall the more evidence that we
need to be working together andpushing a greater focus on
health through extension,through this powerful
infrastructure that we have.
Phillip Stokes (34:25):
Yeah, Dr Baker, did you want to add anything
about your work in Extension orsome of the communication
efforts or really anything else?
Sure I think I certainly agreewith everything Dr.
Buys and Dr.
Diaz said and I think Extensionis uniquely positioned to
deliver some of thatcommunication.
In a lot of our models lookingat vaccinations of children and
looking at vaccination for COVIDin general, community-based
social marketing was one of thethings that really impacted
(34:55):
people's attitude toward gettingvaccinated, as well as their
intention to get vaccinated.
Can you share what that is realquick?
Lauri Baker (35:01):
Yes, absolutely I was going to say.
Essentially, what extension isis built on that model.
People are already embeddedwithin these communities.
They're members of thecommunity, they're going to
school, they're going to church,their children are interacting
with people in these communities.
So they already are kind ofboots on the ground.
(35:21):
They're trusted informationsources, while they're also
plugged into science and trustin science is another thing that
we've seen in our models thathave been really impactful in
people's decision making, and soExtension has that opportunity
to be in those communities toinfluence all the things we've
talked about today, to influencethe social norms around health
(35:44):
issues, people's self-efficacyto make decisions around health
issues, particularly in ruralcommunities.
The other aspect is when we askabout trusted information
sources and compare ruralcommunities to urban communities
, trust and extension is muchhigher in our rural communities.
So, as we're thinking aboutrural health care, in many cases
(36:08):
they may not have a localclinic, but if they have a local
agent, that person cancertainly be a liaison, someone
to help them get the rightanswers, get the right
information and continue to havereminders and information about
how they can connect morebroadly.
So I can't really think of abetter vehicle than Extension to
(36:30):
deliver some of thosecommunication messages around
health.
John Diaz (36:51):
They don't have.
Extension is viewed as more ofa trusted messenger than our
medical professionalcounterparts, and so they see it
as a great partnership to helpto influence those
decision-making paradigms on theground and hopefully get folks
to get vaccinated, you know,start to engage more in
preventative health,no-transcript.
(37:24):
So again it's been a great,great connection, a great
vehicle to get some of themedical science implemented on
the ground.
David Buys (37:32):
I would layer in that we've not talked about
really research at all.
We've talked a lot aboutevaluation or sort of needs
Describe, generally work.
That Extension is careful tostay out of the formal research
world.
We're pretty much aboutpractice and applied effort and
at the same time we are a greatpartner for researchers.
(37:52):
We're not here to be theirresearch assistants or to simply
be their data gatherers orsolely their access to
participate for their studies,but there are often synergies
where folks with research grantscan work with us and we can
(38:12):
plus up things for communitiesthrough research grants and then
the researchers also get theaccess they need for data
collection.
It's a really, reallyremarkable partnership on that
side as well, and lots ofscience has been developed to
inform implications frompartnerships that Extension
(38:34):
brings to the table.
I am very careful toreemphasize what I said, that we
are not sitting aroundtwiddling our thumbs waiting for
researchers to come, get us togive out their instruments or
convene a focus group for them,but where there are synergies,
we are ready and willingpartners.
Phillip Stokes (38:57):
Dr.
Lundy, do you have any otherquestions or thoughts to kind of
wrap up today's conversation?
Lisa Lundy (39:03):
No, I just thank you all three of you.
I think that the three of yourepresent a lot of like.
We've discussed solutions andpotential for collaboration, and
so I really enjoyed hearingfrom all three of you today and
very thankful that you took thetime to participate.
Phillip Stokes (39:40):
Yeah, of course we started out talking about the
challenges and some of thosebarriers, but it really is
encouraging to hear all of thework that is being done and some
of the positive changes thathave happened over time.
You know not always easily doneso right, but it's great to
hear about the work you're alldoing in those areas as well.
I just want to thank you allfor joining today sure thanks
for having us yep thanks forhaving us great well, uh, once
again.
(40:01):
um, this is being video recorded.
If you want to check us out onthe southeastern coastal center
for agricultural health andsafety YouTube channel, you can
see it there.
We'll also stream it whereveryou get your podcasts and until
next time, be on the lookout forother episodes from Science by
the Slice.
Thanks so much for listening.
Ricky Telg (40:24):
Science by the Slice is produced by the UF-IFAS
Center for Public IssuesEducation in Agriculture and
Natural Resources.
Thanks for listening to today'sepisode.
Subscribe to Science by theSlice on your favorite podcast
app and give us a rating orreview as well.
Have a question or comment?
Send us an email to piecenter @ifas.
ufl.
edu.
(40:45):
That's piecenter.
All one word @ ifas.
ufl.
edu.
We'd love to hear from you.
If you enjoyed today's episode,consider sharing with a friend
or colleague.
Until next time, thanks forlistening to Science by the
Slice.
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