Folk and Clinical Medical Utilization Patterns Among Mejicano Migrant Farmworkers

Abstract

Each year, migrant workers from south Texas and Mexico travel north more than 2,000 miles for seasonal work in agriculture. They carry with them knowledge of both basic folk medicine and clinical medicine. This paper investigates migrants' utilization of folk healing and clinical medicine in both the sending and receiving states. Two methods of collecting data were employed: (a) a structured interview with a 10% stratified random sample of the workers when in Wisconsin and (b) an intensive ethnographic study of health behavior of 12 families when residing both in Wisconsin and Texas. Findings suggest that specific patterns of utilization depend mainly on structural conditions such as geographic location and availability of folk or clinical medical services and on the nature of the illness to be cured, and depend secondarily on sex, age, income, and educational level. For the migrants, there is little incompatibility between medical systems; people move easily between one and the other, often supplementing one with the other.

This study has examined the medical behavior of a group of Hispanic migrant workers who travel each year more than 2,000 miles from the border region of Texas, a primarily Mejicano-oriented culture, to Wisconsin, a primarily Anglo-oriented cultural system. The Mejicano migrants carry with them a viable folk medicine tradition, and within this population are found healers who address specific illness patterns. Because of the general low income level, low educational attainment, difficulty with English, and occasional discrimination on the part of both local governmental units and medical institutions, migrants are affiliated only marginally with the Anglo clinical medicine domain.

From our interviews with migrants, we have noted that they utilize aspects of both folk and clinical medical traditions, often choosing among various therapies on the basis of the availability of specific providers and the geographical location of the services provided as well as cultural conceptions of illness, healers, and therapies.

Although it was discovered that there are a small number of migrants who outrightly prefer folk medical therapies over clinical therapies and that there are others who exclusively prefer clinical medicine, we conclude that the great majority believe in both folk and clinical medicinal traditions, and they selectively utilize the knowledge and services from both domains. In short, there generally appears to be few problems of incompatibility between the two systems.

In Wisconsin, the federally funded farmworker clinic, La Clinica de los Campesinos, is undoubtedly incorporating greater numbers of Mejicano migrants into the domain of modern clinical medicine. However, the concentration of the Mejicano population in Texas at the border and geographic proximity to Mexico strongly influence the continued use and practice of folk medicine by Mejicano migrants. But through the long migratory process and the extension of greater medical coverage to this population through federal programs, new patterns of medical utilization are being created. Although it is possible to document increased utilization of clinical medical services among the Mejicano migrants, it is not possible at this time to determine if folk medicine is being practiced less extensively.

Todos los años trabajadores migratorios del sur de Texas y de México viajan hacia el norte más de 3,200 kilómetros para participar en las labores agrícolas de temporada. Llevan consigo conocimientos, tanto de remedios caseros básicos, como de medicina clínica. Este trabajo investiga la utilización que hacen los trabajadores migratorios de los remedios caseros y de la medicina clínica, tanto en el estado de origen, como en el de destino. Se emplearon dos métodos para la recolección de datos: una entrevista estructurada con una muestra aleatoria estratificada del 10% de los trabajadores cuando se encontraban en Wisconsin, y un estudio etnográfico intensivo del comportamiento de 12 familias respecto a la salud mientras residían tanto en Wisconsin como en Texas. Los hallazgos sugieren que los patrones específicos de utilización dependen básicamente de condiciones estructurales, como la localización geográfica, la disponibilidad de los servicios médicos caseros o clínicos y la naturaleza de la enfermedad; y secundariamente del sexo, la edad, el ingreso y el nivel de educación. Para los trabajadores migratorios existe poca incompatibilidad entre los sistemas médicos; la gente pasa con facilidad de uno a otro, suplementando con frecuencia uno con el otro.