From suffering in silence to raising our voice: Addressing the health and housing needs of agricultural workers

In 1999, the California Agricultural Workers Health Survey (CAWHS) documented the health status of agricultural workers and identified the most significant health-related needs experienced by this population. The survey resulted in the report, “Suffering in Silence,” and a commitment of $50 million by The California Endowment to agricultural worker health over five years. The first phase of this initiative occurred in 1999 with the funding of the $30 million Agricultural Worker Health and Housing Program. The second phase occurred in 2002, with the award of $10.5 million to 30 organizations to meet the immediate health needs of California's agricultural workers. Lastly, the third phase of this initiative is supporting a community empowerment program called Poder Popular. This paper will describe strategies and best practices to provide health services and health promotion interventions in housing, primary health care, increasing access to care, oral health, and mental health. In addition, it will describe community empowerment strategies to achieve sustainable social change. There were common challenges discussed among grantees including finding culturally competent health professionals, communicating with Mexican indigenous populations who do not speak Spanish or English, and forming meaningful community collaborations and relationships. The California Endowment's vision for this initiative is to encourage and promote agricultural worker involvement and to develop leadership and community empowerment. The dissemination of effective strategies and best practices to serve and to empower this population will promote the development of important policies to address sustainable social change.