Farmworkers Feed Nation, But Few Have Health Care

San Francisco – Around 75 percent of farmworkers hired in the United States lack health insurance, the highest proportion of any major occupational category.

More than 90 percent of them are foreign born (most from Mexico), young, married and Spanish-speaking. They toil in the fields so they can send money back home to support their families.

Sadly, they are five times more likely to have an occupational fatality than workers in “all industries combined,” says a new report by the Kresge Foundation on health-related inequities among farmworkers and the resurgence of labor-intensive agriculture.

Nation’s Most Vulnerable Employees

Don Villarejo, a senior researcher and advocate on farmworker health in California, developed the report. The state leads the nation in the number of employed farmworkers. The highest concentrations of them are found in the counties of Fresno, Monterey, Tulare and Kern.

The report calls the estimated 1.8 million hired farm laborers among the nation’s “most vulnerable employees.” They suffer from health disparities because they lack access to health care and health insurance.

The study emphasizes that now, more than ever, American agriculture depends on hired farmworkers because “of increases in U.S. production of labor-intensive crops, such as vegetables, fruits and ornamentals, and a decline in the number of family farms.”

Farmworkers rarely have health care coverage through their employers. Also, few are eligible for public programs, in part because of their immigration status, according to the report.

The National Agricultural Work Survey (NAWS) conducted between 2007 and 2009, shows that nearly all newcomers, many from villages in Southern Mexico and Central America, were undocumented.

The Kresge study notes that many hired farm workers are poorly informed about the rights and responsibilities of employees. For instance, only 40 percent of undocumented male hired farm workers were aware of the state’s worker compensation insurance program, although coverage is universal for all employees in California.

“Not enough outreach is being done and not enough information is put out,” lamented Jeff Ponting, director of the California Rural Legal Assistance (CLRA) program’s indigenous farmworker project in San Francisco.

Their Rights Denied

“A lot of employers do not recognize the rights of farmworkers,” said Michael Marsh, directing attorney at CLRA’s Salinas, Calif., office.

Because many employers don’t offer them paid sick leave, hired farmworkers continue to labor even when they are sick, fearing they might lose their job if they take time off.

Transportation problems, language and cultural differences, as well as limited clinic hours also create barriers, according to NAWS.

“We see a lot of sick people – people with colds, cough and flu – picking fruit and vegetables,” Marsh said. He added that frequently the produce is packed unwashed and sent to the market.

When their illness becomes so acute as to interfere with their work, they go to the emergency room, he said.

Farmworkers’ advocates assert that California will not be able to maintain a robust agricultural industry unless it offers laborers affordable health care.

The report says that a few large farms have responded to hired farm workers’ health disparities by providing company-funded medical clinics for their employees. The Western Growers Assurance Trust opened the Cedar Health and Wellness Center in Salinas, Calif., two years ago. It serves up to 80 patients a day, charging patients $5 per visit for bilingual, confidential health care.

Some other clinics charge modest fees on a sliding scale. But “some farmworkers cannot afford even this,” Marsh stated.

Rely on Safety Net, Traditional Healers

Joel Diringer, a San Luis Obispo, Calif.-based health-policy expert, said that for the most part, California farmworkers have relied on a network of safety-net clinics, such as the one in Salinas, as well as hospital emergency rooms and curanderos (traditional healers).

Diringer, who has also written studies on farmworker health, warned that if California wants to protect its $36 billion agricultural industry, it must take steps to ensure that its farm laborers have access to health care services that emphasize early and preventive care.

Although Obamacare (the 2010 Affordable Care Act) includes preventive care, it denies coverage to the undocumented.

Diringer said he hopes President Obama’s proposed immigration reform policies address health care access for farmworkers.

The Kresge Foundation’s health-program director David Fukuzawa commented, “You can’t have healthy food without a healthy food system, and that includes people who produce it.”