Precious little is known about migrant workers, but nothing is known about the state of migrant’s mental health. That is, until now.
Athena Ramos, program coordinator in the Center for Reducing Health Disparities (CRHD), UNMC College of Public Health, and her team spent last summer surveying 200 migrant workers in five counties in Nebraska. The 18-month project was a $12,000 pilot project funded by the Central States Center for Agricultural Safety and Health in the College of Public Health.
Her goal was to develop baseline data on the health of migrant farmworkers and to understand their migratory patterns. She’s just begun to scratch the surface.
“No one really knows how many migrant workers there are in Nebraska,” said Ramos, who also is an instructor of health promotions. In 1993, the National Center for Farmworker Health estimated there were 12,697 migrant workers in the state.
Today, that many people in one place would constitute Nebraska’s 15th largest city – yet migrants are the most economically disadvantaged working group in the United States. Their access to food and health care is extremely limited, they are isolated from family and friends and work long hours in difficult weather conditions.
An average migrant farmworker is male, 33 years old and, if lucky, has a seventh grade education. He earns less than $12,500 for six months of backbreaking seasonal work and two months of nonagricultural work to support a family in his home country. He spends two months on the road and is unemployed for 10 weeks. An average family income is less than $17,500 – far below the United States poverty level of $23,550 for a family of four.
An estimated three to five million migrant and seasonal farmworkers are employed in this country each year. Their labor supports a $28 billion fruit and vegetable industry in the U.S., Ramos said. Latinos make up 83 percent of the migrant labor force. “They are not stealing any jobs,” she said.
“Mobility and long days often threaten their health and pose a significant barrier to accessing health care,” Ramos said. Follow-up care and continuity of care for chronic conditions are serious problems.
“Health care is usually not provided. If a worker gets hurt, he has to keep going for fear of losing paid work time,” Ramos said. “No transportation is provided to get medical care. If they are close, they may be able to get to one of the three migrant health care clinics in the state – Bridgeport, Gering and Alliance. Otherwise, a small community clinic may not have an interpreter or specific skills in behavioral health needed to serve this population.”
Depression and stress are related to isolation, economic hardship, substandard and overcrowded living conditions, lack of recreation, physical, emotional and/or sexual abuse and weather conditions. Some workers have cell phones, but they get no postal mail.
“Migrant workers are vulnerable and because of the challenging life conditions, low levels of education, and lack of access to culturally and linguistically appropriate health care services, they may be more at risk for injury and occupational exposures, substance abuse, and sexually transmitted diseases.
“What’s worse is there is a lack of general knowledge of preventive health care measures,” she said.
With the help of the Nebraska Migrant Education Program, Ramos and her team hosted dinners and held community meetings in migrant camps (mostly low-end motels) in eight cities – Hastings, Grand Island, O’Neill, Wood River, South Sioux City, Dakota, Kearney and Clay Center. They also distributed a bilingual resource guide on alcohol, tobacco, mental health and stress, with referrals to community health centers and relevant hotlines.
Ramos found two basic groups of workers – those who have an H2A visa come directly from Mexico, work for one employer for six to 10 weeks and then return to Mexico, and the migrants who follow the crops through the Midwest. The major sources of stress were: legal and logistics, social isolation, work conditions, family, and substance abuse by others.