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
Introduction
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MSFW’s are an
indispensable aspect
to the U.S 200 billion
agricultural industry.
OR - 60 billion
WA – XX billion
Role of Farmworkers
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Thousands of
workers harvest the
bountiful produce,
assuring the country
have at their table
accessibility to
delicious, healthy,
affordable foods
What they do …
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Working in the heat,
cold and rain
Bent over and
crouched most of the
time
Tilling soil
Planting seeds
Transplanting seedlings
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Removing weeds
Applying pesticides
Staking and pruning
plants
Harvesting crops
Packing crops
Preparing for the
market
What we owe to them
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It would be prudent for
our society to ensure
that this vulnerable,
economically
disadvantaged, hardworking group of
people and their
families, have in return,
accessible health care.
State of Oregon
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Oregon has an estimated
174,484 MSFW’s and
their families (State of
OR Migrant Health)
Largest concentration
found in the fertile
Willamette & Hood
River Valleys.
Most MSFW’s do not
have health coverage.
State of Washington
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Washington has an
estimated 186,976
MSFW’s 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.
MSFW’s Health Problems
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MSFW’s experience a higher incidence of
health problems due to the following factors:
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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)
MSFW’s Major Health Problems
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diabetes
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mental health
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hypertension
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substance abuse
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cardiovascular disease
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malnutrition
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cancer
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dental problems
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tuberculosis
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musculoskeletal problems
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anemia
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dermititis
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parasitic infections
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chemical poisoning
Obstacles for Health Care Access
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MSFW’s 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
Obstacle: Poverty and Lack of
Health Insurance
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Two of the most important factors as
MSFW’s are usually undocumented
workers.
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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
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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.
Obstacle: Lack of Knowledge About
Available Services
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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 MSFW’s cannot read.
Obstacle: Lack of Understanding of
Health Problems and Risks
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MSFW’s 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.
Obstacle: Lack of Understanding of
the U.S. Health Care System
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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.
Obstacle: Cultural and Linguistic
Differences with Providers of Care
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Many MSFW’s 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.
Obstacle: Fear or Mistrust of the
Health Care Establishment or
Governmental Assistance
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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.
What would Steinbeck say??