California’s ‘most disadvantaged’ workers have widespread chronic health issues, study finds

Despite widespread chronic illness among the people that grow food in California – many struggle to access reliable healthcare.

A new study from UC Merced Community and Labor Center sheds light on the chronic health issues, healthcare access, and workplace conditions that impact the wellbeing of California farmworkers.

Researchers say in a news release that it’s the largest-ever academic study on the “nation’s most disadvantaged workforce.”

“Agriculture is one of California’s most vital and productive industries, yet many of its workers experience profound challenges in maintaining their health and wellbeing,” Edward Flores of UC Merced Community and Labor Center, said in a statement.

One sobering finding of the study is that 49% forty-nine percent​ of California farmworkers reported being without health insurance.

The UC Merced Community and Labor Center surveyed more than 1,240 California farmworkers in six different languages – English, Spanish, and the Indigenous languages Mixteco, Triqui, Zapotec and Ilocano – between August 2021 and January 2022.

A majority of the farmworkers surveyed were located in the Central Valley, a region that grows a quarter of the nation’s food.

Researchers also formed a community advisory board of 26 farmworker-serving organizations, which informed the research. Ten of these organizations and two health clinics conducted data collection, including the United Farm Workers, Californians for Pesticide Reform, Central California Environmental Justice Network (CCEJN), Central Coast Alliance United for a Sustainable Economy (CAUSE), Centro Binacional para el Desarrollo Indígena Oaxaqueño (CBDIO), Lideres Campesinas, and others.

Flores, of UC Merced, said the data from the report “should inform policy development” related to the health and well-being of agricultural workers.

Lack of insurance, chronic conditions and mental health

Several generalizations about farmworkers’ health and wellbeing have held true over years, yet UC Merced’s researchers’ findings provide a clearer – and more alarming – picture than the estimated ones in the past.

Among multiple health findings, UC Merced researchers report:

• Nearly half of those surveyed said they didn’t have health insurance at some point in the last 12 months.
• Between one-third and a half of farmworkers reported having at least one chronic condition; 20% said they have diabetes and 19% have hypertension.
• Women reported 14% of them had preterm births, and 15% had a baby with low birth weight.

Unchecked stress can contribute to many health problems like high blood pressure, heart disease, obesity, and diabetes, according to the Mayo Clinic. It can further intensify the risks of these health conditions because it triggers hormonal imbalances, and increases heart rate and sugar levels. Neither is beneficial for someone with diabetes, hypertension, or both.

“Agriculture is a demanding job, requiring working long hours under difficult working conditions,” Paul Brown, UC Merced Professor of Health Economics, said in a news release. “Our study provides a snapshot into the health of these workers, as well as highlights the challenges that workers in California face in getting access to good, high quality, and affordable healthcare.”

Adding to farmworkers’ strained physical health, mental health struggles further hinder workers’ wellbeing, according to researchers.

Out of the farmworkers polled, close to 20% feel nervous, anxious or on edge. About 10% are diagnosed with anxiety and another 7% are diagnosed with depression.

These findings estimate that almost a quarter of farmworkers are dealing with mental health troubles. Yet less than 7% are seeking mental health services, according to the report.

“These findings highlight high levels of underdiagnosis,” researchers said in the report, “and underutilization of mental health resources.”

Farmworker Health in California

Working conditions on California farms

The study also highlights both the health risks and labor violations that farmworkers face on the job.

Nearly half, about 43%, of farmworkers surveyed said their employer had “never” provided a heat illness prevention plan as mandated under law at a time that California has experienced its driest three years on record.

Workers that apply pesticides – which are linked to a number of adverse health outcomes – had unique challenges. Among those who applied pesticides, 75% said they received training on the safe use of pesticides, yet 21% also said they did not understand the training.

Researchers noted that under state law, pesticide safety training “must be delivered in a language that is understandable to farmworkers” and as the report indicates, many farmworkers speak Indigenous languages, rather than Spanish or English, as their primary language.

Aside from the on-the-job health risks, farmworkers reported high rates of wage theft and fear of retaliation.

Almost one-fifth, or 19%, of farmworkers surveyed said they had not been paid earned wages by an employer at one point or another.

A majority of farmworkers, or 68%, reported that they’re employed by farm labor contractors rather than by growers or farmers directly. Nationwide, farm labor contractors were found to be the biggest violators of federal wage and hour laws, according to a separate 2020 study conducted by the left-leaning Economic Policy Institute.

Despite these challenges, 36% of California farmworkers said they would be unwilling to file a report against an employer. Nearly two-thirds said they wouldn’t file a report due to fear of retaliation or job loss.

Where can policymakers step in?

The UC Merced study highlights a number of areas where policy makers could take a closer look at existing laws and practices in both the agricultural workplace and other areas.

Some of the recommendations include:

• Expanding farmworker access to the economic and social safety net. Last year, a coalition of Democratic legislators and community groups threw their support behind a bill that would have created a pilot program to provide undocumented workers with access to unemployment benefits. Gov. Gavin Newsom vetoed the bill citing the program’s cost in his veto message.
• Expanding farmworkers’ healthcare access. California will be the first state to make all undocumented adults, regardless of age, eligible for Medi-Cal health insurance by Jan. 1, 2024
• Investing public resources in protecting workers’ rights. The California Department of Industrial Relations has a multilingual caravan that visits the fields to educate farmworkers on their labor rights
• Invest public resources in agricultural development that raises industry work standards, particularly as it relates to technological development. A Central Valley coalition was awarded $65 million in federal funding to create an ag-tech hub, but some are concerned that such developments could hurt farmworkers without a strong worker and labor voice at the table.