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Selenium intake, age, gender, and smoking in relation to indices of selenium status of adults residing in a seleniferous area

While the answer is complex, with a number of contributing factors including the ad campaigns discussed earlier, the CDC highlights an important influence: institutionalized learning

Two child workers said that an elected official from their district had visited the farm where they worked.[180] Three workers said that representatives of the National Employment Council (NEC) had visited their workplaces.[181] A few workers told Human Rights Watch that health officials came to inspect the housing compounds where they lived.[182] But overwhelmingly, workers interviewed for this report said union organizers were the only people to inspect conditions at their workplaces and speak with them about grievances

I think things are getting better, but like quitting, its a journey.