Unless she needs to be stitched up, Deer Isle lobsterman Julie Eaton probably isn’t going to the hospital.
She’d have to dock her boat in Stonington and drive up to the hospital in Blue Hill, nearly a 45-minute ride away. Not only will she lose out on a fishing day, but when she does get there, it’ll probably cost an arm and a leg, because Eaton, like many lobstermen, doesn’t have insurance.
“Health care is a challenge,” she said. “I don’t have insurance. I don’t go unless I’m bleeding.”
It’s a common refrain in the industry and one backed up by the results of a recent survey of more than 100 Down East lobstermen and shellfish harvesters.
The survey, conducted by University of Maine at Machias professor Tora Johnson and presented at the Northern Light Research Expo last month, polled 106 lobstermen and shellfish harvesters in Hancock and Washington counties and found that barriers to medical care in the injury-prone industry are likely significant contributors to addiction and overdose.
Johnson said the burden of traveling from remote fishing villages to health care providers while trying to sell the day’s catch, scheduling doctor visits around the tides and a prevalence of either little to no health insurance in the industry were some of the major hurdles to care.
The survey, which also queried 28 health care providers and included in-depth interviews with 13 harvesters, is one of the first to critically look at what factors prevent fishermen from being able to get medical care Down East — a region that relies heavily on the coastal economy.
“What we are hearing is a very large, probably vast, majority of harvesters have trouble finding access to the health care that they need,” she said.
Fishing is a dangerous line of work, but lobstermen, clammers and other harvesters often defer treatment for their aches and pains due to the barriers to treatment they face. Survey takers told Johnson that there is a persistent culture of minimizing injury or illness, partially due to the stressful nature of the job.
Harvesters may also be reluctant to seek treatment because every day that they aren’t on the flats or the water is a day without pay, said Bridie McGreavy, a UMaine professor that works extensively with clammers and other shellfish harvesters in the region. She was a partner in the research.
“They don’t get sick days and there can be real consequences if they miss a tide,” she said.
Back pain is a common injury that harvesters work through and often treat with pain medication, which, when left unchecked, can lead to addiction.
But substance abuse falls all over the spectrum, from alcohol, marijuana and heroin to caffeine and kratom, a herbal substance with a stimulant-like effect that Johnson had never even heard of before her research.
Lubec shellfish warden and Trescott clammer Sheldon Lyons said that overuse injuries are common, whether it’s on the flats or on a boat. He wears a back brace and has been able to avoid serious injuries over the years.
Lyons himself only ever takes ibuprofen but said addiction from self-medication is not uncommon in the region, though it seems to have trailed off in recent years.
“It was at its peak four to five years ago,” he said. “It has calmed down a lot in this town.”
While the study doesn’t give any hard numbers on how common addiction is among harvesters in the eastern reaches of Maine, it does give a peek into what could be preventing treatment and then exacerbating the issue.
“This was not a way to determine how prevalent these problems are,” said Johnson of her pilot study. “We don’t need to count them to know this is a significant problem, and it needs a solution.”
Johnson embarked on her research to get a fuller picture of the things that can affect fishermen’s health. She wants to use the survey as a springboard to find better ways to make health care more accessible.
“We hope to find ways to intervene and help harvesters find better health outcomes,” she said. “It’s literally a life or death question.”