Key Words farm worker, migrant labor, occupational health and safety, Hispanic health, minority health s Abstract Despite a recent surge in knowledge about U.S. hired farm workers, little is known about the health of this population. No national data are available on the size of the population, mortality or morbidity data, or on chronic health indicators. Demographic data show that these workers are mostly Mexican immigrant or migrant males, and nearly two thirds live in poverty. At least half of all current hired farm workers are undocumented. Fewer than one in five have health insurance, either through their employer or through government programs. However, programs targeting women farm workers, such as WIC or, in California, emergency MediCal, are more effective in helping them obtain needed services. The federal Migrant Health Program serves about 13% of the total of workers plus dependent family members. This paper reviews what is known in the following topical areas: (a) mortality and morbidity; (b) access to health care services; (c) control of infectious diseases; (d ) maternal and child care; (e) occupational health; ( f ) violence; and (g) chronic health indicators. It is suggested that future research incorporate a minimal physical examination of all patients or subjects in order to establish baseline information for the population. Such information will be helpful in targeting interventions and measuring their effectiveness.
The survey finds elevated prevalence of indicators of chronic disease but lack of health care access. Participants without employment authorization reported a greater prevalence of high-risk behaviors, such as binge drinking, and were less knowledgeable about workplace protections.
We studied historical materials to examine the conditions that gave rise to California's rural slums, the consequences of their emergence, and how interpretations of housing, health, and welfare policies by government officials, and public health officials in particular, produced health inequities for residents of these communities. For more than a century, successive groups of immigrants and domestic migrant laborers have worked on California's farms and faced numerous challenges, among them a lack of safe and affordable housing, poor working conditions, and denial of public services. Although these experiences are not new, nor are they unique to agricultural workers, they illustrate a longer history in which inequities and injustices have been rooted in the exploitation and disposability of labor. Ameliorating or even redressing inequities will require understanding the social determinants of health through ecological approaches that can overcome the historical, social, and political causes of inequity.
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