Migrant and seasonal farmworkers in the United States face serious health inequalities. Most of these workers either migrate to jobsites or leave their families for seasonal work and have little or no access to healthcare. Many are at greater risk for occupational injury due to chemical exposure and physical exertion and fear seeking care due to concerns about discrimination.

The vast majority of migrant farmworkers are young male Latinos (84%). Most families earn less than $10,000 per year, and 62% are food insecure.1 Barriers to healthcare include language, lack of documentation and long working hours.

Farmwork is grueling and physically demanding. Each crop presents its own set of difficulties. Strawberries are dubbed la fruta del Diablo (the Devil’s fruit), since workers must bend over all day to gather the tiny berries. Rain can quickly turn fields into pools of mud. Pickers are exposed to harsh climates, insects and unsanitary living conditions. Mistreatment and abuse from employers, most of which goes unreported due to fear of deportation, is common.2

Despite harsh working conditions, difficult labor and discrimination most migrant workers report that life in America still exceeds the poverty and desolation of their home countries. When asked if they would come to America again, many report they would for the future of their children.2    

Traditionally, federally funded health services have provided care to migrant and seasonal farmworkers. There are currently 159 such centers in the United States. You can find information about locations nearest to you at the National Center for Farmworker Health website (www.ncfh.org). Unfortunately, these centers are not accessible to all who need services. For instance, there is only one such center in the entire state of Louisiana. 

Utilizing mobile healthcare clinics that focus specifically on migrant worker health is one potential solution to poor access to healthcare among this group. Ensuring mobile health clinics travel to farmworker camps in evening hours is important. Staff should include Spanish speakers and those who are familiar with the cultural preferences of the population. A multidisciplinary approach, involving medicine, nursing, dentistry, physical therapy, and social services would likely have the best outcomes. Mobile clinics also provide good student learning opportunities, for both medical and cultural purposes.

Another potential solution to manage chronic health conditions in migrant workers is using text messages to send health reminders. This strategy has been shown to improve patient compliance with recommended therapies in other at-risk populations. Approximately 81% of Hispanic male farmworkers have cell phones and would be interested in participating in such a program.3

Improving the health of this vulnerable population will require innovative solutions, and nurse practitioners should be involved in spearheading these strategies.

Jessica Swanson, FNP, MSN, is in the DNP program at the University of Central Florida College of Nursing in Orlando, where Julee Waldrop, DNP, FNP, PNP, is the director of the MSN-DNP program and an associate professor.

References

  1. Luque J, Castañeda H. “Delivery of Mobile Clinic Services to Migrant and Seasonal Farmworkers: A Review of Practice Models for Community-Academic Partnerships.” Journal Of Community Health. 2013;38(2): 397-407.
  2. “Fields of Tears. They came to America illegally, for the best of reasons” The Economist.18 Dec 2010; 87-89. Available at www.economist.com/node/17722932.
  3. Price M et al. “Hispanic migrant farm workers’ attitudes toward mobile phone-based telehealth for management of chronic health conditions.” Journal of Medical Internet Research. 2013;15(4):e76. Available at www.jmir.org/2013/4/e76/.