No abstract

Farmworkers contribute significantly to North Carolina's communities and economy; however, they incur significant occupational risks with limited workplace protections. Many barriers complicate their access to health care services. Recommendations include increased number of outreach workers, extended clinic hours, strengthening workplace protections, and inclusion of farmworkers in community needs assessments. N orth Carolina is among the most diversified agricultural states in the nation with approximately 50,200 farmers growing over 80 different commodities [1]. It is the nation's largest producer of tobacco and sweet potatoes, the second largest producer of Christmas trees, and ranks eighth nationally for the total value of agricultural products sold [2]. Farmworkers are an integral part of North Carolina's economy, helping to respond to the demand for seasonal labor to plant, cultivate, harvest, and pack the state's varied agricultural products. However, farmworkers remain an often invisible, underserved population. The North Carolina Department of Commerce estimates that there were approximately 80,000 migrant and seasonal farmworkers (MSFW) in our state in 2017 (North Carolina Department of Commerce, unpublished data, 2017). Although farmworkers reside in all of North Carolina's 100 counties, 60% of the MSFW population lives in just 16 counties (see Figure 1). Farmworkers are classified as seasonal (living in North Carolina year round but working in agriculture on a seasonal basis) or migrant (moving to North Carolina on a temporary basis to work in agriculture). Migrant workers come to North Carolina with family or friends or are recruited through the federal H2A visa program. The H2A program provides temporary visas for agricultural workers after recruiters demonstrate that there are no US citizens willing to be hired. This program supplies 27% of all of North Carolina farmworkers, with the majority of H2A workers recruited from Mexico. Although estimates indicate that the overall farmworker population in North Carolina has decreased by 5% between 2014 and 2017 (North Carolina Department of Commerce,