Perceptions of Risk and Safety in a Day Laborer Community in Los Angeles, California

: 2.027_NCD Perceptions of Risk and Safety in a Day Laborer Community in Los Angeles, California B. Silverberg; Kaiser Permanente Los Angeles Medical Center, Los

Background: By definition, day laborers receive a piece-meal income from temporary work. Sometimes they find themselves in potentially dangerous situations, but due to fear of reprisal, may not protest. One study in Los Angeles found that 38% of male day laborers had been solicited for sex by another man while looking for work. Similarly, 26% had had sexual contact with a female prostitute over the preceding year. Alcohol and/or drugs were frequently involved in both types of encounters and safer sex practices were not always followed.
Methods: In this pilot study, 12 semi-structured interviews were conducted with adult day laborers to explore their attitudes towards and perceptions of health risks in the community of Westlake/Mac-Arthur Park. Interviews were performed in immediate proximity to a parking lot in which day-laborers were known to look for work. Subjects were recruited via convenience sampling and received a nominal monetary incentive for participation. Inclusion criteria included being over age 18, self-identifying as a day laborer, and speaking English or Spanish. Transcripts were analyzed using a grounded theory approach.
Findings: Two-thirds of respondents had previously agreed to potentially unsafe work, mainly in construction. Slightly more than half of respondents stated they did not have a clinic or medical provider that they considered to be their own. Many had delayed seeking care at some point due to cost, insurance, or legal status. Half were aware of prostitution in the community, and a small proportion had been involved in it, either as a purveyor or client. Most endorsed engaging in safer sex practices. When faced, hypothetically, with a friend involved in higher-risk sexual activity, onethird of respondents would not intervene; between one-sixth and one-third would counsel on the risk of sexually-transmitted infections and encourage use of condoms. Nearly two-thirds of respondents cited health and access to care as their primary daily concern.
Interpretation: For most day laborers, their body is their source of income. As such, maintaining their health is important. Nonetheless, they may not feel able to demand safer work environments. Medical providers and other advocates for day laborers' rights must be cognizant of the risks day laborers face in order to better serve their needs.

Socioeconomic, Psychosocial, and Healthcare-Access Contributors to Poisoning and Suicide in Sri Lanka: An Ecological Survey
A.E. Sumner 1 , J. Whittall 2 , A. Rodrigo 3 , T. da Silva 4 , A.V. Ravindran 4 ; 1 University of Toronto, Toronto, ON, Canada, 2 University of Toronto, Toronto, Ontario, Canada, 3 University of Kelaniya, Ragama, Sri Lanka, 4 University of Toronto, Toronto, Canada Background: Sri Lanka has recently undergone a series of turbulent changes, including a prolonged civil war, tsunami, and considerable government instability, which have contributed to a substantial degree of poverty and resultant health disparities across the country. Despite recent political stability and economic growth, Sri Lanka reports the fourth highest suicide rate in the world, with rates of deliberate self-harm estimated to be many times higher. Most suicides in Sri Lanka occur among young adults, and suicide is the leading cause of death in the 16-24 age group. Though pesticide ingestion remains the most common method of suicide, the use of pharmaceuticals has recently increased in prevalence. Given the urgency of this situation, the aim of this study is to evaluate contributing factors for suicide and self-poisoning in Sri Lanka.
Methods: Demographic and socioeconomic factors, psychiatric comorbidity, and healthcare access data were collected from national census reports (2012), including the Household Income and Expenditure Survey, Annual Health Bulletin, and the Census of Population and Housing. Suicide and poisoning rates were collected from police records and published hospital data, respectively, for each of the 25 governmental districts. Descriptive statistics and linear regression analyses were performed to evaluate the predictive power of contributing factors on suicide and poisoning risk. NCDs and Social Determinants of Health J a n u a r y eF e b r u a r y 2 0 1 7 : 1 7 0 -1 8 6