Farmworkers feed the nation while enduring health inequities at work and at home

Domestic production and U.S. exports of labor-intensive agricultural products – fruits, vegetables and ornamental crops – have expanded rapidly during the past several decades. The most successful of these crops require hand labor to grow and harvest. Migrant and seasonal farmworkers (hereafter farmworkers) are the workforce supporting this growth. However, farmworkers are a socially vulnerable population: low-income, ethnic minority, mostly recent immigrants who often lack authorization for employment, low educational attainment, limited English proficiency, ineligible for nearly all needs-based government programs, and without any social support. Maternal and child health concerns are usually ignored under farmworkers' employment-based benefits, even if farmworkers have any such benefits. In the revolving door of this workforce, the newest entrants represent greater challenges: indigenous migrants from Central American villages and southern Mexico, speaking traditional indigenous languages, and limited Spanish; and farmworkers working under life threatening human trafficking debt-bondage. Review of national agricultural public data analyzed the effects of the increased labor-intensive agricultural crop production on the health of farmworker population and their families. Factors included demographics of the current farmworker population, living conditions, health care access, workplace risks, and longstanding disparities in Federal and state employment standards. Despite Affordable Care Act legislation, the denial of access to medical care continues for farmworkers, characterizing this major occupational group with the highest proportion of uninsured families. A plan of priority action steps is proposed to respond to the widespread prevalence of disproportionately adverse health outcomes for farmworkers and their families.