A Harvest of Shame Revisited: Substance Use and Abuse Within the Delmarva Migrant Stream

After realizing some 15 years ago that we had not "turned the corner" on drug abuse, the substance abuse treatment community became more deliberate in waging this war by developing culturally, ethnically, age-, and gender-specific intervention modalities to ensure a more equitable continuum of care. Additionally, research efforts began to reflect the disparities of health and longevity between ethnic minority and nonethnic minority populations which culminated in the U.S. Department of Health and Human Services Task Force on Black and Minority Health Report of 1986. This comprehensive and much acclaimed report contributed significantly to a knowledge base and provided a frame of reference for health planning and service delivery. But the information contained therein was overwhelmingly focused on urban areas.

A literature review reveals a paucity of information on access to care in rural communities, especially those with populations consisting of seasonal and migrant farmworkers. This population has received little visibility since "Harvest of Shame" was aired on national television 30 years ago. An analysis of substance use and abuse among this population in the Delmarva (Delaware, Maryland, Virginia) peninsula as well as an assessment of services available to them is the intent of this report. Information for this report was developed from secondary analysis of program reports, needs assessments, policy analyses, and interviews with service providers. A preliminary analysis suggests that there appears to be increased substance abuse and drug trafficking among this population. There also tends to be a greater understanding of Hispanic American use and abuse than that of black Americans and other ethnic groups (e.g., Mexicans, Guatemalans, Haitians) in the migrant stream. Finally, substance abuse is encouraged and access to care is hampered by sociocultural factors and stresses such as school-related problems, lack of vertical mobility, language problems, and poor integration and coordination of the service delivery systems.