The impact of economic deregulation for health disparities among Gulf of Mexico commercial fishermen

Commercial fishing is one of the most dangerous occupations in the US and includes some of the most vulnerable populations, including low-wage, older, and (im)migrant workers. We conducted a secondary data analysis of the National Oceanic and Atmospheric Administration's (NOAA) Voices Oral History Archives to better understand how structural and social determinants of health (SDoH) are related to individual injury and illness among fishermen. Interviews from Gulf of Mexico (GOM) English- and non-English speaking commercial fishermen, family members of fishermen, and policymakers were analyzed following an interpretive analytical approach. Our results show that key policy changes associated with deregulation have led to a decline in economic opportunities for fishermen in the GOM region and have long-term implications for their health and well-being. Specifically, we demonstrate how the deregulation of waterfront development, offshore oil development and pricing, and seafood imports has shaped precarious employment for fishermen, such as lower wages, job insecurity, loss of benefits, and decreased social protections. The economic precarity of fishermen is directly and indirectly related to injury, including not having the finances to maintain their boats, machines, or safety equipment as well as an inability to afford healthcare services. The linkage between poverty and structural conditions shows how neoliberalism has produced health disparities and inequities among fishing communities. We argue that governance theory can help build future research-to-policy and research-to-practice projects that are community-based, participatory, and built on long-term trust and communication.