Access to Healthcare for Migrant and Seasonal Farmworkers (MSFW) and their families in Oregon

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Access to Healthcare for Migrant and Seasonal
Farmworkers (MSFW) and their families in Oregon
Washington

• Shannon Paris Oscar Ramos
• HE 407 Migrant Health
• Instructor Daniel Lopez-Cevallos, PhD, MPH
• Western Oregon University

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Introduction

• MSFWs are an indispensable aspect to the U.S 200
  billion agricultural industry.
• OR - 60 billion
• WA XX billion

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Role of Farmworkers

• Thousands of workers harvest the bountiful
  produce, assuring the country have at their table
  accessibility to delicious, healthy, affordable
  foods

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What they do

• Working in the heat, cold and rain
• Bent over and crouched most of the time
• Tilling soil
• Planting seeds
• Transplanting seedlings

• Removing weeds
• Applying pesticides
• Staking and pruning plants
• Harvesting crops
• Packing crops
• Preparing for the market

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What we owe to them

• It would be prudent for our society to ensure
  that this vulnerable, economically disadvantaged,
  hard-working group of people and their families,
  have in return, accessible health care.

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State of Oregon

• Oregon has an estimated 174,484 MSFWs and their
  families (State of OR Migrant Health)
• Largest concentration found in the fertile
  Willamette Hood River Valleys.
• Most MSFWs do not have health coverage.

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State of Washington

• Washington has an estimated 186,976 MSFWs and
  their families (Farmworker Enumeration Study)
• Largest concentration are found in the middle of
  the state and as just like in Oregon, most do not
  have health coverage.

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MSFWs Health Problems

• MSFWs experience a higher incidence of health
  problems due to the following factors
• Lack of health insurance (cannot get it)
• Economic factors (low pay)
• Poor living conditions (unsafe housing)
• Hazardous exposure on the job (agriculture is the
  2nd most dangerous occupation in the U.S.)
• The life expectancy of a migrant farmworker is 49
  years, compared to the national average of 73
  (CDC 1998)

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MSFWs Major Health Problems

• mental health
• substance abuse
• malnutrition
• dental problems
• musculoskeletal problems
• dermititis
• chemical poisoning

• diabetes
• hypertension
• cardiovascular disease
• cancer
• tuberculosis
• anemia
• parasitic infections

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Obstacles for Health Care Access

• MSFWs and their families face many obstacles in
  regards to Health Care Access in Oregon and
  Washington.
• Obstacles are socio-economic and lack of
  information in nature

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Obstacle Poverty and Lack of Health Insurance

• Two of the most important factors as MSFWs are
  usually undocumented workers.
• Subject to abuse by frivolous employers
• Pay them well below the minimum wage
• Do not offer them health insurance.

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Obstacle Distance from health care facilities
and lack of transportation

• Many MSFW work and live in locations where the
  closest health care facility is many hours away.
• This problem is compounded as many of them lack
  transportation and have to rely on friends and
  sadly on their bosses (major reason why they do
  not complain) to get to some help.

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Obstacle Lack of Knowledge About Available
Services

• They do not know what kind of health care
  services are available to them and their
  families, whether they have or lack health
  insurance.
• Many times language is an issue.
• Other times educational level is the issues issue
  as many MSFWs cannot read.

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Obstacle Lack of Understanding of Health
Problems and Risks

• MSFWs many times do not know medical problems
  they have and what risks they are taking on the
  job
• Many do not understand the dangers of pesticides,
  or the needs of vaccinations.

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Obstacle Lack of Understanding of the U.S.
Health Care System

• Many simply cannot navigate the process of how
  our health care system works (even if they have
  health insurance)
• Many do not pursue care, even if it is an
  emergency as they do not know laws exist in this
  country that emergency rooms must follow to
  assure all emergencies are seen.

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Obstacle Cultural and Linguistic Differences
with Providers of Care

• Many MSFWs cannot communicate effectively with
  their clinicians as they do not speak English,
  sometimes missing important aspects of their
  desired treatment.
• Also, cultural aspects in regards to modesty,
  family values and expectations are sometimes
  taken for granted by clinicians as they seek to
  heal the patient.

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Obstacle Fear or Mistrust of the Health Care
Establishment or Governmental Assistance

• Overall, MSFW's still associate health care
  agencies as agencies lead by governmental
  agencies and are of course afraid to go to a
  clinic or hospital and compromise themselves with
  their undocumented status.

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What would Steinbeck say??
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