Future policy & public health solutions need an SDOH lens to disrupt the self-reinforcing cycle of commercial fishing environments facilitating a culture of risk acceptance and injury downplay.

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We also found that occupational injury often occurred within a feedback loop.

Fishermen’s unsafe environments ➡️ culture of accepting risk and downplaying injuries 🔁 further unsafe environments and occupational injuries

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High rates of fatal and non-fatal injury among commercial fishermen were connected to:

👥 social factors (isolation, language & cultural barriers, physical location, & food insecurity)
📄 political-economic factors (decreased income, health care costs, 🚫 sick leave benefits, & work environment)

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Many fishermen were unable to access 🏥 services, whether for primary care or to treat occupational injuries, which was often rooted in being a low-wage, im/migrant, or transient worker.

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Of 292 unique studies, 27 met inclusion criteria. Healthy People 2030 SDoH factors included:

🏡Built environment (n = 19)
👥Social & community factors (n = 14)
📊Economic stability (n = 10)
🩺Health care access (n = 7)
🎓Educational attainment (n = 7)

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