Finding Health in Unexpected Places: Health in Migrant and Non-Migrant Coffee Farm Workers in Rural Nicaragua

Background: Numerous studies demonstrate poor health outcomes in migrant workers when compared to non-migrant workers.

Methods: The study was conducted at two neighboring coffee farms in north central Nicaragua. Free health fairs were held at both coffee farms during one week in January, 2014. All migrant and non-migrant workers were invited to participate. Demographic characteristics, focused health history, and access to health services were measured using selected items from the Central American Diabetes Initiative (CAMDI) Survey. All participants responded to the self-rating of health question “Compared to others your age, how would you rate your health?” and reported the number of work days missed due to illness and number of days worked when sick in the previous month.

Results: A total of 233 workers aged 18-75 were eligible to participate and were included in this sample. Of those 142 were migrant workers. Age and number of days worked when sick were significantly associated with self-ratings of health (p<0.05), while sex, migrant status, and number of days missed work due to illness were not.

Discussion: The lack of association between migrant status and self-rating of health, while encouraging, may simply reflect the healthy worker effect. Migrant and non-migrant workers who report going to work even when they feel sick both self-report poorer health. To effectively promote health in this population, nurses need to expand their focus beyond the obvious workers who miss work due to illness and regularly seek to identify those who report to work despite feeling sick.