Hired and Contract Agricultural Workforce – Sustainable Solutions

On August 7, 2019, a thematic session on hired and contract agricultural workers was held as part of the Western Agricultural Safety and Health Conference in Seattle, WA. This session had three goals: (1) to enhance collaborations between people working on common research and outreach challenges to improving health and safety among hired and contract agricultural workers; (2) to share knowledge of unique approaches appropriate for improving the health of hired and contract workers; and (3) to learn about effective approaches to addressing sensitive health issues such as sexual harassment and mental health among vulnerable workers.

Dr. Marc Schenker of the Western Center for Agricultural Health and Safety and the Migration and Health Research Center at the University of California at Davis chaired the session. Dr. Schenker began by highlighting that Latino immigrants comprise a substantial majority of the agricultural workforce in the United States. These farmworkers are a vulnerable and underserved worker population. They are at increased risk of occupational injury and poor health outcomes from working in dirty, dangerous, and demeaning (3-D) jobs. Limited English proficiency, low levels of formal education, discrimination, different perceptions of job-related risks, and limited job-related training are just a few of the factors that place these workers in a precarious position.¹ Further, many lack legal authorization to work in the United States, leaving few alternatives for employment.² Because there have been many transitions in agriculture such as fluctuations in the numbers of undocumented farmworkers, an increased percentage of indigenous immigrant farmworkers, decreased total farmworker immigration, and a rise in anti-immigrant policies and deportations, new frameworks are needed to monitor and study migrant health. Improving farmworker health requires both reducing and eliminating workplace hazards and addressing the social determinants of health, which are defined as the “conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.”³ Social and health systems need to be restructured to be more sensitive to the needs of these vulnerable workers. Programs and policies that focus on the social determinants of health and attend to areas of need are critical.

A panel discussion moderated by Dr. Xochitl Castañeda, Director of Health Initiative of the Americas at the School of Public Health at the University of California Berkeley, sought to explore unique and effective approaches to improving the health of immigrant, Latinx farmworkers. Each of the four panelists represented unique regions of the country and different approaches to improving health and safety.

Mary Jo Ybarra-Vega, Outreach/Behavioral Health Coordinator for Moses Lake/Quincy Community Health Center in eastern Washington, described the history of the use of promotores de salud (community health workers) both in Mexico and throughout Latino communities in the United States. She also discussed the importance of using promotores de salud in agricultural health and safety initiatives as they are a valuable link between workers and social and health service providers, in part due to their strong trusting relationships with workers and their families; cultural and linguistic capacities; and intimate knowledge of the community.

Dr. Athena Ramos from the University of Nebraska Medical Center and Central States Center for Agricultural Safety and Health discussed effective approaches to promoting farmworker well-being. First, she framed farmworker health as a human rights issue.⁴ Then, she discussed specific approaches to promoting well-being including improving the availability, accessibility, acceptability, and quality of healthcare services for farmworkers; creating, implementing, and enforcing policies to protect and value farmworkers; and developing culturally, linguistically, and logistically relevant programs and interventions that address multiple levels of the socioecological model. She emphasized the importance of integrating farmworkers’ perspectives as end-users and highlighted examples of effective models for improving farmworker health including in-person and hands-on approaches, audio-based education, radionovelas (radio dramas), and technology-based models such as telehealth, customized apps, and text messaging.

Dr. Anita Alves Pena from Colorado State University shared recent findings based on an analysis from the National Agricultural Workers Survey. She noted that men, those with limited English proficiency or formal education, and those from Mexico were less likely to have access to field sanitation and that regulatory standards may not equitably protect all workers.⁵ She also discussed the impact of wage differentials and how they are used to compensate workers for dangerous working conditions. She highlighted the power of economic principles to change individual risk behavior.

Dr. Vanessa Casanova from the University of Texas Health Science Center and the Southwest Ag Center discussed the use of the H-2B visa program in forestry and how guest workers are the preferred workforce for large forest contractors in the United States. In her research, pesticide, fungicide, and herbicide exposure have been identified as an actionable threat to health. Therefore, she proposed partnering with industry as an effective approach, particularly vendors, nurseries, and small-scale contractors.

This session addressed many of the issues that are faced by Latinx immigrant workers in the agriculture, forestry, and fishing sector. It also highlighted some effective potential solutions to improving health and safety, ranging from health education programs and partnerships, to economic incentives, to policy development and enforcement initiatives.

Future directions

It is clear that we must move beyond solely diagnosing problems that agricultural workers face. Instead, we must translate these diagnoses into relevant interventions to prevent, reduce, and eliminate health and social disparities. Integrating sustainable solutions to improve farmworker health is paramount. All of the NIOSH Ag Centers have considerable research and outreach activities that aim to reduce adverse outcomes among vulnerable workers. These activities must be sensitive to the social determinants of health among immigrant farmworker populations, and utilize a variety of approaches and collaborators to achieve the goal of a safe and healthy working environment for all.