Ineligible? Take Your Pick

Could you imagine only being paid $54 over an eight hour day harvesting 5,760pounds of oranges? That’s $0.02 per orange picked. Job security? Think again! Farmworker unemployment rates are double those of all wage and salary workers according to the 2008 National Agriculture Worker Survey (NAWS). Oh, and don’t forget about pesticide exposure and the frequent use of dangerous machinery! And, as if these conditions aren’t enough, farmworkers frequently face heat-related illnesses such as nausea, dizziness, heat exhaustion, heat stroke, dehydration, and even death – not surprising seeing how many are not allowed water or shade breaks during the day.

Providing health care services to farmworkers and their family members is a significant challenge, as they experience multiple barriers to accessible health care. Furthermore, due to the nature of their work, farmworkers are disproportionately affected by environmental and occupational hazards (unintentional injury, pesticide exposure, respiratory problems, and heat-related illness or death… just to name a few). Moreover, farmworkers are more likely to suffer from chronic conditions such as diabetes and mental health conditions.

The extensive list of health problems farmworkers endure is exacerbated by their frequent inability to obtain health insurance. According to the 2001 National Agricultural Workers Survey (NAWS), only 25% of farmworkers reported having some type of health insurance, as employer-sponsored health insurance is rare for migrant farmworkers. Farmworkers’ income levels would normally qualify them for most state Medicaid programs, but because of the migratory nature of their employment, minimum state residency requirements, varying state Medicaid eligibility requirements, and the lack of Medicaid portability from state to state, they are generally precluded from obtaining Medicaid and/or other state insurance programs. State methodologies for calculating annualized income and asset determination are also a barrier to obtaining Medicaid coverage. In many instances farmworkers exceed a state’s income eligibility levels because projected annual income level is calculated using the most recent pay stub rather than using actual yearly income. Additionally, most farmworkers do not have paid sick leave and cannot afford to take time off to see a health professional. For insured, underinsured and uninsured farmworkers, many health problems go unchecked and untreated until the farmworker requires the services of a more costly emergency department.

Just who are we talking about here?

Every year, the United States employs nearly two million seasonal farm laborers, approximately half of whom are migrants. The 2012 USDA Agriculture Census informs us that almost three-quarters of hired crop farmworkers are not migrants, but are considered settled, meaning they work at a single location within 75 miles of their home. This number is up from 42 percent in 1996-98. Among migrant workers, the largest group are “shuttlers,” who work at a single farm location more than 75 miles from home, and may cross an international border to get there. They made up about 12 percent of hired crop farmworkers in 2007-09, down from about 24 percent in 1996-98.

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Photo source:

More common in the past, the “follow the crop” migrant farm worker, who moves from state to state working on different crops as the seasons advance, is now a relative rarity. These workers make up just five percent of those surveyed by the NAWS in 2007-09, down from a high of 14 percent in 1992-94.

Pesticide Exposure – Green Tobacco Sickness

In addition to exposure to the hot sun, sometimes even the crops are against them. For instance, tobacco harvesters, many in North Carolina, face a unique type of illness called Green Tobacco Sickness (GTS). Caused by absorbing a high level of dissolved nicotine through the skin, which happens when workers touch wet tobacco leaves, this illness is characterized by nausea, vomiting, weakness, dizziness, and sometimes an increase in blood pressure and heart rate. The report by Oxfam and FLOC about human rights abuses in NC cites that “moisture on tobacco leaves from dew or rain may contain as much as 9 mg of dissolved nicotine per 100 ml of dew, roughly equivalent to the nicotine content of six average cigarettes. On a humid day, especially after a recent rain, the average fieldworker may be exposed to as much as 600 ml of dew.” Exposure to high levels of nicotine increases body temperature, making farmworkers even more vulnerable to heat related illness and heat stroke. An unendingly vicious cycle.

The Migrant Health Center Program

Despite all the negative forces at play, a number of federally funded organizations throughout the United States provide services for migrant and seasonal farmworkers through coordination, community organizing, information sharing, partnerships and training among migrant health centers and allied organizations.

The Migrant Health Act was enacted in 1962 and called for the development of health clinics (MHC) dedicated to serving farmworkers and their families. Today, MHCs are funded as part of the Consolidated Health Centers program, yet retain their uniqueness as providers of care for the farmworker population. Since 2000, the MHC program has grown substantially. Funding for MHCs has more than doubled over an eight year period, increasing from $79 million to $171 million. Currently, 140 MHCs with approximately 1,150 delivery sites around the nation and Puerto Rico – delivering care to 807,000 migrant and seasonal farmworkers and their families each year. These patients make up about one-quarter of the entire U.S. farmworker population.

Patients of MHCs are similar to patients in all health centers. However, comparatively, MHC patients have higher rates of un-insurance and poverty. Over half of all farmworkers are uninsured and 82% of farmworkers are at or below the federal poverty line. Not surprisingly, MHC patients are slightly less likely to have Medicaid when compared to all health center patients. To aid this problem, some MHCs deliver care through voucher programs.

Providing Cost Effective Care

Given the critical role of farmworkers in the U.S. economy, the Migrant Health Center (MHC) program is an important and vital investment. MHCs remove barriers to care for farmworkers through their ability to provide preventive and comprehensive health care in the patients’ own language, provide treatment regardless of the patients’ ability to pay, locate in areas near migrant and seasonal farmworkers, and customize their services and hours of operation to meet their patients needs. MHCs are able to keep their patients’ costs down by treating their illnesses and injuries early so they avoid debilitating disease and do not have to seek expensive emergency room care.


Migrant Farm Workers Receive Free Health Care xIK9I71OhdnlPhoto: A migrant farm worker picks spinach near a mobile clinic on September 16, 2009 on a farm near Wellington, Colorado. The Salud Family Health Centers sends the mobile clinic to farms throughout northeastern Colorado to serve the migrant population, most of whom are immigrants with little other access to basic health care. While funding of health care for undocumented workers has become a controversial topic in the health care reform debate, the federal government already funds basic care for such workers through grants to non-profit clinics, which serve one of America’s most vulnerable uninsured populations.

(September 15, 2009 – Source: John Moore/Getty Images North America)

An Issue of Justice

Farm workers work hard in the fields to support themselves and their families – all while putting food on our plates and supporting our billion-dollar agricultural industry. They deserve access to medical services that address the multitude of work-related health concerns they face. Additionally, farm workers deserve stronger workplace protections, such as water and shade breaks and protection from pesticides. You can support the efforts of farmworker organizations by becoming a supporting member: familiarize yourself with their case, offer your time, or provide what financial support you can. We can each do something to advocate for those who are the unacknowledged backbone of our country. They deserve nothing less.

Great organizations to check out include:

Coalition of Immokalee Workers

CIW is a worker-based human rights organization internationally recognized for its achievements in the fields of social responsibility, human trafficking, and gender-based violence at work. Built on a foundation of farmworker community organizing starting in 1993, and reinforced with the creation of a national consumer network since 2000, CIW’s work has steadily grown over more than twenty years to encompass three broad and overlapping spheres: Fair Food Program, Anti-Slavery Campaign, Campaign for Fair Food.

Pesticide Action Network

Pesticide Action Network North America (PAN North America, or PANNA) works to replace the use of hazardous pesticides with ecologically sound and socially just alternatives. As one of five PAN Regional Centers worldwide, they link local and international consumer, labor, health, environment and agriculture groups into an international citizens’ action network. This network challenges the global proliferation of pesticides, defends basic rights to health and environmental quality, and works to ensure the transition to a just and viable society.

United Farm Workers of America

The United Farm Workers of America has over 25,000 workers under contract in California, Washington, Florida and Texas. With the passage in the fall of 2002 of historic legislation that strengthened the California Agricultural Relations Act, the UFW is beginning its biggest farm worker organizing drive in twenty years throughout California.

Northwest Treeplanters and Farm Workers United

Pineros y Campesinos Unidos del Noroeste was founded in 1985 as Oregon’s union of farm workers, nursery, and reforestation workers. In 1992, in response to grower retaliation against striking workers, PCUN launched a successful nationwide boycott against grower-owned NORPAC, Oregon’s largest food processor. In another campaign, PCUN recently won the first farm worker contract in Oregon’s history.

Centro Campesino

The mission of Centro Campesino is to improve the lives of members of the Latino and migrant community in southern Minnesota through community organizing, education and advocacy. Centro Campesino is membership-based organization that was born and exists to create and demand positive social change. They are guided by their values of faith, hope, unity and justice.

Farm Labor Organizing Committee

FLOC began in 1967 when farmworker turned organizer Baldemar Velasquez convinced a small grounp of migrant farm workers in northwest Ohio to come together for their common good. Initial successes generated strong reactions in the agricultural industry as FLOC members exposed labor exploitation. Since then, FLOC has built a membership of thousands of migrant farm workers by empowering them to demand better wages, working, and living conditions.

Farmworker Association of Florida

The Farmworker Association of Florida is a membership organization of 6,500 farm worker families. The Association addresses wages, benefits, and working conditions, as well as pesticides, field sanitation, disaster response, immigration, and other community-based issues.



About the Author: Devin Foote

Devin Foote

Devin is a native of mid-Michigan where he grew up with vegetable, dairy, and commodity farming. He completed his undergraduate from Michigan State’s Lyman Briggs School in 2007 studying Environmental Science and Human Biology. Since graduating he has spent time managing Community Supported Agriculture (CSA) and market farms on New York’s Long Island and Hudson Valley. An active advocate for agricultural reform, he has worked with local, state, regional, and national institutions to strengthen US agricultural policy. Before returning to his native Michigan, Devin worked in Washington DC with U.S. Senator Debbie Stabenow on Agriculture, Health, and Trade policy. Since 2010 he has worked as an educator, farm manager, site developer and aggregator of all things Grown in Detroit, working with residents to develop a more robust local and regional food system in Detroit, MI. He has experience with brownfield development, curriculum development, small-scale farm operations, social enterprises, and business start-ups. 

Currently he is a graduate student at MSU in the Department of Community Sustainability focusing on regional food systems. His thesis work through the Center for Regional Food Systems (CRFS) will be looking at small farm viability with urban, peri-urban, and rural producers through collaboration with the Hoophouses for Health program and growers in Detroit’s Grown in Detroit cooperative. His research interests include: small farm viability, supply chains, food hubs, farm-to-institution, agriculture-nutrition linkages, public health, social entrepreneurship, community food systems, social networks and climate resilience.


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