Image of a cargo ship at sea

New Research Examines Health Care Rights and Access Among Migrant Seafarers

A new study finds that seafarers – the men and women who keep cargo ships, oil tankers and cruise ships sailing from port to port – will not report dangerous work and health conditions because they fear losing future work. The policies put in place and the way contracts are structured make seafarers less likely to access care and report dangerous conditions, according to University of Texas Medical Branch assistant professor Dr. Shannon Guillot-Wright’s new research published in Humanities and Social Sciences Communications.

Utilizing photo-ethnography, which involved traditional methods such as observations and informal conversations along with photovoice that allowed the participants to take photos that were representative of their lives, the study was conducted between December 2016 and October 2017 in a U.S. Gulf of Mexico port with a crew of all-male, English-speaking Filipino migrant seafarers.

“I’ve studied immigration policy for over a decade, but in 2015 I learned more about migrant seafarers and fishermen,” Guillot-Wright said. “I quickly realized they were an under-researched population, especially within public and global health studies. I wanted to understand how or if seafarers sought health care because of their dual positions as migrants and workers at sea, which was accomplished.”

Through the information collected, several key themes emerged including that seafarers routinely underreport adverse work and health conditions for fear of losing future work contracts. These adverse conditions range from working aboard dangerous vessels and routes to concealing severe and moderate injury and illness.

“I expected seafarers to not have as much access to health services as land-based workers, but I was surprised to learn that their precariousness was the driver to not accessing services, not a lack of insurance,” Guillot-Wright said. “The precariousness was driven by larger, macro policies that have allowed for more contractual employment, which increases employee risk and decreases employer risk.”

The study explained how seafarers are often subject to short-term contracts, which are typically nine months and must be renewed after each voyage. While these contracts guarantee certain protections and rights such as access to health care providers and facilities, they do not guarantee continued employment if the seafarers are seen as unhealthy.

Guillot-Wright argues throughout the study that structural violence, such as labor policies, exploit seafarers and result in practices that negatively influence their health and wellbeing. This structural violence was demonstrated through the chronic pain, self-medication and emotional anguish captured through the photo-ethnography.

“Often in global and public health studies, there is a large emphasis on changing people’s health behaviors, but less emphasis on understanding how structures shape behaviors,” Guillot-Wright said. “By turning our gaze away from individual, risky choices and instead on how power works and operates in the lives of people, we can understand health disparities as systematic instead of individualistic.”

The full research paper can be found at