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KU researchers determining health care access barriers facing migrant farmworkers across country

Wed, 07/19/2017


LAWRENCE — Millions of migrant and seasonal farmworkers are critical to getting food from farms to our tables, yet they often struggle to meet their own basic needs. They face health risks, barriers to care and poor health outcomes. Because they make vital labor contributions, it is important for both economic and humanitarian reasons to understand the health care obstacles and challenges that farmworkers face.

Researchers at the University of Kansas are partnering with the Migrant Farmworkers Assistance Fund and others in multiple states to shape a research agenda that can guide researchers, funders, providers and policymakers. The agenda will be developed by hearing directly from migrant and seasonal farmworkers about what their health goals and challenges are and learning more from those who work with them.

KU researchers received funding from the Patient-Centered Outcomes Research Institute Engagement Awards program to better understand an underserved and under-researched population that works in nearly every U.S. state. The funding will enable researchers to interact directly with workers in different Midwestern states, conducting engagement sessions and surveys in Spanish and English so that the workers' voices and perspectives guide the researchers toward the most pressing concerns.

“We’ll discover the kind of future research needed to understand the barriers to health care that migrant and seasonal farmworkers face, as well as which health care outcomes are important to them,” said Cheryl Holmes, research associate in the School of Social Welfare and KU project lead. “We also want to know what might lead them to reach out for care.”

The research team will focus on crop- and orchard-based migrant and seasonal farmworkers in the Midwest. They hope to build a knowledge base for future research about barriers to health care, including:

  • Lack of understanding of the medical system
  • Lack of insurance
  • Health care costs
  • Lack of time off to see health professionals.

Researchers also hope to learn from the workers which health care outcomes are most important to them, such as staying healthy enough to work, providing for their families or treatment of work-related health problems.

“We want to understand the barriers, facilitators and motivators that migrant and seasonal farmworkers have to seek health care and follow through with treatment. Family-centeredness, personal relationships (personalismo), respect and a strong work ethic are examples of cultural values that seem to be contributing to migrant and seasonal farmworkers’ health care behaviors,” said Susana Mariscal, senior research assistant in the social welfare school. “Migrant and seasonal farmworkers have histories of endurance, resilience and a variety of strengths from which we would like to learn.”

Farmworkers have a wide range of health issues, some of which also depend upon their type of work. Whether they work in orchards, harvest corn or wheat, pick field crops or perform other labor, farmworkers often work for low wages under challenging conditions. Many endure heat and cold, pesticide exposure, substandard housing, inadequate sanitation and food insecurity. 

Researcher and project co-lead Michelle Levy said, “Ultimately, this work is about learning from and with migrant and seasonal farmworkers and using what is learned to improve the health and lives of these underserved families.”

Finding and engaging migrant and seasonal farmworkers to participate in research can be difficult. But with more than 30 years of serving this population, Migrant Farmworkers Assistance Fund has built up trust and is well-positioned to make these connections.

“Migrant Farmworkers Assistance Fund is interested to participate in this project to better understand and serve the health care needs of the workers and families. They are often hidden and on the move; always in rural and underserved areas where services are limited. They face many barriers to accessing health care. The workers and families we accompany and serve are proud and vital to wholesome, local food,” said Suzanne Gladney, immigration attorney and MFAF director.

The research team will also collaborate with an advisers’ partner group made up of health care workers, researchers and policymakers.

The majority of these workers are foreign-born, and the labor they perform is so strenuous that even in times of economic hardship, Americans typically will not take the jobs they do. America does, however, benefit greatly from farmworker sacrifices. Researchers have estimated that a complete loss of immigrant agricultural labor could cut U.S. economic output by tens of billions of dollars and cause the price of food to skyrocket.

With information from workers, service providers and other key stakeholders, the researchers will craft a research agenda that will help guide inquiry in the area of migrant and seasonal farmworker health care. The goal is that with insight from all parties, targeted and needed research can be conducted, and that this will translate into better health care access for the workers, more efficient and effective services for providers, and guidance for both research funding organizations and local, state and federal policymakers.

“We’re interested in better understanding where the research gaps are and the most pressing areas to pursue,” Holmes said. “There is a pronounced lack of health care information coming directly from the farmworkers, and they are the ones who understand their struggles and hopes the best. We want to partner with the farmworkers as well as learn from providers, funders and policymakers what is needed to make informed decisions.”

PCORI is an independent, nonprofit organization authorized by Congress in 2010 to fund comparative effectiveness research that will provide patients, their caregivers and clinicians with the evidence needed to make better-informed health and health care decisions. PCORI is committed to seeking input from a broad range of stakeholders to guide its work.

Photo from the Migrant Farmworkers Assistance Fund.



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