Farmworkers in the U.S.

Friday, 11 April 2014

For the first time in decades, the current generation isn’t as healthy as the one that came before.” The theme for day five of National Public Health Week is “Be the Healthiest Nation in One Generation” and is dedicated to turning around the declining trend in health faced by Americans today. To address this trend, it’s important that we understand the barriers to good health faced by all people in the United States. At Farmworker Justice, we spend a lot of time contemplating migration as a social determinant of health. Specifically, we discuss the roadblocks that affect good health and quality of life and we think about ways to lift those roadblocks, either through advocating for policy change or through health promotion and education projects.

In terms of farmworkers, migration from their home to the U.S. has a lot to do with their health. Just a few factors related to migration that affect farmworkers include poverty, language, discrimination, and national policies.

Most farmworkers live at or below the poverty line. Health outcomes of people who live near the poverty line are worse than for those who enjoy higher incomes.
Eighty-one percent of farmworkers speak Spanish but immediately after arriving in the U.S. they need to navigate everything from grocery stores, public schools, housing, and health clinics almost entirely in English.
• Discrimination, both overt acts of discrimination and microagressions (every day, more subtle forms of discrimination), is associated with increased anxiety, anger, depression, and stress levels.
• Policy can be discriminatory when it is does not provide protections to workers equitably across professions. For example, many states do not require agricultural employers to provide workers’ compensation insurance coverage for farmworkers, even though agriculture is ranked among the most dangerous occupations by the U.S. Department of Labor.
• Policies that don’t seem to be about health, like immigration policy, can actually have a great impact on the health and wellbeing of our community members. For example, children who hear about deportations may constantly fear the separation of their families and people who cannot obtain driver’s licenses may avoid driving to a clinic.

Not only do poverty, language barriers, discrimination, and policy serve as enormous sources of stress, but they also stand in the way of accessing and receiving appropriate medical and mental health services. In addition, sixty-four percent of farmworkers are uninsured, so even when they do seek care, paying for it presents another barrier.

To reverse the decline in the nation’s health outcomes, it is important to address the barriers, social inequalities, and injustices that contribute to the decline. We must also recognize that the health of each individual is affected by the overall health of our communities so working toward better health outcomes for the entire community will create better health for each individual.
 

by Chelly Richards
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Thursday, 10 April 2014

The CDC estimates that each year roughly 1 in 6 Americans gets sick, 128,000 are hospitalized, and 3,000 die of foodborne illnesses. We’ve all seen the frightening consequences from fruits and vegetables contaminated with salmonella or listeria. Eating safe, healthy food, today's theme of National Public Health Week, is a basic building block of public health. While most conversations about this topic revolve around responding to outbreaks or creating more rigorous standards and surveillance by government agencies, few consider the important role of farmworkers in preventing foodborne illnesses.

Food safety advocates have long recognized that the working conditions and training of farmworkers can significantly affect food safety: overworked and underpaid farmworkers in the field are typically not encouraged to look out for safety concerns. If employers don't provide sanitary facilities, or fail to provide the necessary training or economic incentives to stop production when unsafe conditions exist, important opportunities to improve food safety are lost. 

Farmworker Justice is a co-founder of a unique collaboration between farmworker, environmental and consumer advocates, retailers, and farmers that aims to promote food safety and improve working conditions in the produce industry. The Equitable Food Initiative (EFI) has developed a set of food safety, labor, and pesticide standards and a training program to help farmworkers and farm owners and their managers work together to implement the standards. 

EFI's food safety standards recognize that farmworkers are often the first line of defense against contaminated food. Under the EFI system, workers receive training to recognize food safety risks and are encouraged to report unsafe conditions, improper practices or procedures in the field to their supervisor. It’s a common sense approach to food safety that benefits workers, growers, retailers and consumers: fresh fruits and vegetables grown and harvested in ways that respect workers can help reduce the potential for transmission of foodborne illness.
 

by Jessica Felix-Romero
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Wednesday, 09 April 2014

Day three of National Public Health Week is entitled “Get Out Ahead!” and is dedicated to prevention as a national priority. Community and migrant health centers across the United States serve the preventative and primary health care needs of many of the farmworkers who plant, tend, and harvest the nation’s crops. Farmworkers and their families encounter numerous barriers to accessing health care such as cost, transportation, language, and lack of sick leave, to name a few. Outreach is a critical component of health care delivery to farmworker communities. I spent several years as a farmworker health outreach worker in rural North Carolina. This personal experience working in farmworker health in a small community provides insight to health problems faced by farmworkers and the barriers they regularly face when seeking health care.

Let’s first start with some quick farmworker health facts. Agricultural work is low paying, physically demanding work. The Bureau of Labor Statistics ranked agriculture as the third most dangerous job in 2012. Many farmworker families live at or below the poverty level and approximately 64% are uninsured. Cancer, heart disease, stroke, and diabetes are among the top five causes of death for Latinos in the U.S. For farmworkers, specifically, many of whom are Latino, a recent study showed an elevated prevalence of anemia and obesity and stunting in children of farmworker families. The burden of these conditions can be lessened or prevented under the regular care of a physician. Lack of insurance limits the options that farmworkers have when they seek health care and it is sometimes a barrier to receiving care at all. Many turn to community and migrant health centers to receive preventative care where they are able to pay for health care on a sliding-fee scale based on their income. Outreach workers are a valuable part of the health care team at these health centers.

As an outreach worker, the farmworkers I served worked in the Christmas tree fields nine months of the year. Many traveled from Mexico year after year to do this work, leaving behind their homes and families to live with other farmworkers in old houses, trailers, or barracks that were provided by the growers that hired them.

My work entailed visiting farmworkers in their homes in the evenings after work, collecting their personal and contact information, asking questions about their health, and screening for diabetes, high blood pressure, and HIV. They would usually be cleaning up from work and taking turns in the kitchen so many of these conversations happened while they cooked dinner and made lunch for work the next day. I let them know their options for accessing health care in their community and explained the process for making and paying for appointments. During the day, I coordinated these appointments, making calls to farmworkers, clinics, and specialists. I drove farmworkers to appointments and provided Spanish-English interpretation. I learned about their home towns. I heard border crossing stories. I knew when their kids in Mexico were getting in trouble at school. Working in this capacity allowed me to spend the time necessary to gain the trust of farmworkers within our community. I used this insight to help doctors, nurses, dentists, and clinic administrators better understand the conditions that affect farmworkers’ health and adjust treatment plans to best fit the realities they face.

The outreach workers at community and migrant health centers connect farmworkers to important preventative health care services through education, case management, and building trust within the community. The work, while challenging, is extremely fulfilling. We recognize that regardless of where you live, everyone has a right to be healthy. Our nation’s farmworkers, who harvest the fruits and vegetables essential to our health, deserve access to quality health care.

by Chelly Richards
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