Finding a deeper understanding of intertwined health-related challenges in the Downeast shellfishery through mixed-methods, community-engaged research
Topics:
Keywords: fisheries, qualitative, health, public health, opioid, injury, shellfish, social determinants of health, social vulnerability, Maine, community engagement
Abstract Type: Paper Abstract
Authors:
Tora Johnson, University of Maine at Machias
Joseph Spiller, University of Southern Maine
Gray Jones, University of Maine
Katherine Darling, University of Maine at Augusta
Lois-Ann Kuntz, University of Maine at Machias
Tara Casimir, University of Southern Maine
Debra Kantor, University of Maine
Lauren Sachs, Healthy Acadia
Amy Dowley, University of Maine
Rory Morgan,
Abstract
In 2019, the softshell clam (Mya arenaria) harvest provided more than $10 million to Downeast Maine’s 1,483 harvesters. Public health depends on harvesters handling their catch safely and knowing where it is legal to harvest. Harvesters’ well-being and ability to understand regulations are influenced by an array of social factors that may prevent participation in management, interfere with their ability to adhere to public health closures, and increase risk of injury, chronic pain and substance use disorder. In a series of community-engaged studies, we have employed mixed-methods (surveys, interviews and stakeholder engagement) to understand intertwined health-related challenges in the Downeast shellfishery. We identified problems with state maps and notices informing harvesters about shellfish closures; over half of harvesters reported difficulty determining where harvesting was legal. Housing insecurity and lack of internet limited access to information about fisheries closures and healthcare. Harvesters reported injuries from multiple causes with many anecdotes of self-medication, addiction and overdose stemming from injury, further complicating their ability to adhere to fisheries closures. Combined with norms about self-sufficiency, barriers to healthcare, housing and literacy played a significant role in adverse health outcomes, even as social networks provide workarounds for challenges in management and health. Our work led to an overhaul of Maine’s maps and notices for informing clammers where it is safe and legal to dig. Future work will pilot interventions, including education of healthcare providers and regulators about practices for supporting harvesters, innovative healthcare arrangements, fisheries policy to improve access to flats, and improving closure communication.
Finding a deeper understanding of intertwined health-related challenges in the Downeast shellfishery through mixed-methods, community-engaged research
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Paper Abstract
