Developing a Network of Community Health Workers: Improving the Lives of Migrant Farmworkers

Abstract

One of the main strengths of today's global food system is the labor force. Within emergent countries, farmworkers are an important element of competitiveness. However, food production that frequently stands in developed countries family tables rests upon the usually precarious living and health conditions of farmworkers, especially those that should migrate from regions that are far from the agribusiness where they work and live most of the year. Furthermore, healthcare becomes a challenging task because of cultural, socioeconomic and ethnic barriers. The aim of this study was to develop and evaluate a Community Health Worker (CHW) training model among agricultural Mexican migrant farmworkers, focusing on strengthening a health prevention environment conducive to improve health. This was a qualitative action-driven research carried out in southern Mexico communities as well as at northwest Mexico agribusiness. The project was implemented in four stages: needs assessment, curriculum design, training and implementation and process evaluation. The socioecological model guided our methodological and analytical process; we followed a Community Based Participatory Approach (CBPA) to interview and train a network of 40 CHW. Results showed that CHW's main health priorities were dehydration and heat stroke, respiratory infections, gastrointestinal infections, work accidents, hygiene, nutrition, as well as mental health including substance abuse and depression. Training evaluation 1) improved communication between middle management and migrant farmworkers, as well as between middle management and farm administrators, 2) increased middle management consciousness about farmworkers health needs and responsibility, and 3) increased awareness about how improving the environment could help prevent diseases.

Supports for migrant farmworkers: tensions in (in)access and (in)action

“…However, some MAWs do connect with various informal actors, such as church groups, local business owners, volunteers, and community members (Preibisch, 2004), some of whom may help workers’ understand/defend their rights. Given the various gaps in formal services and access to such services, community lay workers, informal volunteers and community workers can make an impact on this population’s ability to better understand health and safety information (Ortega-Vélez et al , 2016), and access to medical care (Sexsmith, 2017) and basic information about their rights and entitlements (Rodgers and Drolet, 2018).…”

Health conditions among farmworkers in the Southwest: An analysis of the National Agricultural Workers Survey

“…Often, employers provide little support and harsh working conditions leading to reduced worker safety, greater musculoskeletal and respiratory health issues, and, in some cases, abusive supervisors ( 1 – 3 ). Potential adverse health exposures and outcomes include pesticide, heat, and sun exposure; injuries due to dangerous tools and machinery; infectious disease complications; musculoskeletal injuries; respiratory illness; mixed increased risk for chronic disease; chronic respiratory problems; cancer; depression; tuberculosis; neurological deficits; and higher rates of infertility and miscarriages ( 4 , 5 ).…”

“…Some health outcomes are preventable or manageable with increased availability and affordability of health care services; improved continuity of care; and the use of culturally competent health strategies that consider linguistical differences and low health literacy ( 4 ). Along with these solutions, it must also be considered that most migrant and seasonal farmworkers (MSFWs) live in isolated rural areas that further complicate transportation to much needed resources and services ( 4 ). Farms are typically located in medically underserved areas that suffer from provider shortages and low-retention rates ( 4 ).…”

Harvesting Health Knowledge: Breast Cancer Perceptions in the South Florida Latinx Farmworker Community

“…Latinx farmworkers have little-to-no contact with formal health systems, experience widespread discrimination in health care settings, occupy a historically marginalized status, and are often unable to seek health services due to low wages, high and often dangerous work demands, and constant migration and transience (Arcury & Quandt, 2007; Castañeda et al, 2010; Findling et al, 2019; Quesada et al, 2011). Furthermore, these issues can present challenges for the collection of health statistics and information on immigrant Latinx farmworker’s health beliefs, including those related to disease prevalence, cancer screening rates, and general health outcomes (Chavez, 2012; Montealegre et al, 2013; Ortega-Vélez et al, 2016).…”

“…Providing health information, social support for prevention and treatment, as well as a means of social capital to increase access and service utilization of health and cancer screenings, are all associated with CHW-led interventions (Angier et al, 2013; Dean et al, 2014; Fernández et al, 2009; Schwingel et al, 2017; Shelton et al, 2016; Tucker et al, 2018). CHWs are vital to reaching underserved immigrant groups and addressing language and other serious barriers to health care (Oluwole et al, 2003) and have been essential to the delivery of health education and interventions in communities like the Latinx farmworkers (Ortega-Vélez et al, 2016; Palmer-Wackerly et al, 2019).…”