“Voicing” the Social Determinants of Health on the Backside of a Horse Racetrack

Workers in the horse racing industry often live and work on the backside of the track, traveling from track to track as the racing season dictates. There has been little research on the social determinants of health and living conditions of the workers. We conducted a two-phase project: 1) a cross-sectional survey of backside workers; and 2) a community-based participatory research project with four workers who worked and lived at a local racetrack using Photovoice. Substance abuse, safety concerns, limited access to health care, a high rate of work-related injuries and social isolation were common problems reported by the workers. Six themes were identified: 1) safety and health; 2) coping; 3) life philosophy: fatalism vs. hope; 4) love of horses; 5) working conditions; 6) living conditions; and 7) backside culture. Results are discussed in relation to the social determinants of health.