A STATEWIDE ASSESSMENT OF THE HEALTH NEEDS OF HISPANIC FARMWORKERS IN VERMONT

• Sponsoring Institution: National Institute of Food and Agriculture
• Project Status: COMPLETE
• Funding Source: HATCH
• Reporting Frequency: Annual
• Accession No.: 0227530
• Project Start Date: Oct 1, 2011
• Project End Date: Sep 30, 2013
• Program Code: [(N/A)]- (N/A)

Recipient Organization
UNIVERSITY OF VERMONT
(N/A)
BURLINGTON,VT 05405

Performing Department
Community Development and Applied Economics

Non Technical Summary
In the past decade Hispanic workers have arrived in Vermont and become a significant portion of the Vermont dairy labor force. Their health status has been investigated in only two regional studies, leaving most of the state with little information about how these workers are faring. This research proposes to conduct a statewide assessment of the health of Hispanic dairy workers, and compare their health to Vermont's domestic dairy workers. Health care providers in Vermont have been challenged to adapt to this new foreign population and the research includes an assessment of the challenges rural health care providers face in meeting the needs of Hispanic farmworkers. Concerns about the health of migrant workers in Vermont entered the public consciousness in 2009 when a Mexican worker was killed on a dairy farm in Franklin County (Galloway, 2009). Although it was an isolated incident, it raised concerns throughout the state about how Vermont's Hispanic migrants have been faring. To date only two studies have considered the health status of Hispanic dairy workers in Vermont. In 2007 the Vermont Department of Health sponsored a study of Hispanic migrants in Addison and Franklin counties. They interviewed a total of 49 workers on 21 farms to characterize the "typical" health status of a Hispanic migrant and assess the barriers they faced in obtaining health care. The study found that worker's health was similar to that found in national studies of migrant health. Primary care during childhood was inconsistent; it was not clear that vaccinations had been completed or were up-to-date. Additionally workers had not been screened for tuberculosis and had very limited access to dental care. Common ailments were skin problems, MMS pain and injuries related to dairy work. The authors also noted that they had not assessed the health status of non-migrant farm workers making it difficult to evaluate whether the health issues faced by migrant farmworkers differed from their local counterparts (Ona, 2007). The only other health care study of Hispanic migrant workers conducted in Vermont was done by the P.I. and Research Specialist. This paper has been presented at a number of meetings in Vermont. The findings are discussed below under preliminary results. Relatively little was known three years ago about how Hispanic migrants are integrated into the Vermont dairy sector. During these past three years we have interviewed farmers, local (domestic) farm workers and migrant Hispanic workers to develop a profile of the Vermont dairy workforce. Non-farmer perspectives on Hispanic labor were collected through two statewide surveys. The project team also began to develop information sharing networks on Hispanic Labor in Vermont. Finally, outside funding was obtained to research Hispanic migrant health in the Northeast Kingdom, leading directly to this 2011-2014 research proposal.

Animal Health Component

(N/A)

Research Effort Categories

Basic

(N/A)

Applied

(N/A)

Developmental

(N/A)

Classification

Knowledge Area (KA)	Subject of Investigation (SOI)	Field of Science (FOS)	Percent
803	6050	3080	50%
805	6050	3080	50%

Knowledge Area
805 - Community Institutions, Health, and Social Services; 803 - Sociological and Technological Change Affecting Individuals, Families, and Communities;

Subject Of Investigation
6050 - Communities, areas, and regions;

Field Of Science
3080 - Sociology;

Keywords

dairy labor

hispanic labor

latino labor

farmworkers

Goals / Objectives
Our specific objectives are to: 1) Identify the health status and needs of Vermont's dairy farmworkers, with an emphasis on Hispanic migrant dairy workers. Discussion Objective 1: Our previous research found that barriers to care differ within Vermont due to differences in law enforcement and proximity to resources, often related to colleges and universities that offer access to students and faculty with bi-lingual and/or health care skills. To understand these differences within the state, as well as complete the state's profile of migrant health issues, the research will investigate farmworker health status statewide using data available through health centers and key informant interviews. Understand the challenges Vermont's health care providers face as they seek to meet the needs of Hispanic dairy workers Discussion Objective 2: Vermont's health care system has been adapting to the needs of this new foreign labor force. This research builds on our initial study of access to social services by documenting the challenges, strategies and needs of Vermont's health care system as it evolves to the presence of Hispanic farm labor. Vermont's Hispanic migrant community has only recently arrived and their health care needs will evolve over time. We also intend to compare workers health self-assessments to the conditions observed in the health clinics as recommended by Villajero. 2) Facilitate improved coordination, strategic planning and policy development between Vermont farmers, health care and other service providers who work with Hispanic migrant dairy workers. Discussion Objective 3: The P.I.'s previous research found strong support throughout the state for improved information sharing about the health and well-being of Hispanic workers in Vermont. Strategies to improve outreach to farmers through innovative social marketing efforts have been found to increase adoption of safer production practices on dairy farms (Chapman, Brunnette, Karsh, Taviera & Josefsson, 2011). Improving farmer education and involving farmers in the design of similar strategies could provide similar benefits in Vermont. 4) Track changes in public opinion toward Hispanic migrant workers through annual statewide surveying. Discussion Objective 4: Changes in public opinion can affect migrant health in a number of ways. Supportive environments facilitate the development of community groups and volunteers who can assist Hispanic workers with transportation and translation. Conversely, public attitudes trending more hostile can increase stress and isolation among workers, making it more difficult to access health services and potentially worsening mental health issues. Finally, changes in public opinion influence public policies that directly enable or hinder the ability of Hispanic farmworkers to access healthcare.

Project Methods
Research Objectives 1 &2 Existing data and key informant interviews with health care providers will be collected and analyzed to better understand the trends and issues faced by health care providers in their efforts to service the Hispanic farmworker population in Vermont. In addition to the data analysis and interviews from the health centers key informant interviews with workers within the health centers service area will be conducted to compare workers perspectives with those of the health care providers. Key informant interviews with health center staff will assess the types of data currently collected on Hispanic workers, health issues they are seeing and challenges they face serving this population. Key informants will be selected based on their "special knowledge" of the subject, in this case their understanding of the work the health center has done with Hispanic workers in Vermont. Preliminary research indicates that some health centers have been pro-active in coding for Hispanic patients and can access data on their health issues and needs (with all personally identifiable information removed). The sampling frame for the health centers is drawn from a list of health care providers serving Hispanic farm workers in VT through Hatch Project VT-H01509. The sampling frame for workers will be Hispanic workers on dairy farms within the service area of the health centers. Interview questions will be designed based on findings from the P.I.'s previous research and recent literature. Semi-structured interviews will be used to permit a balance between collecting data on known factors affecting the health care status of workers and provision of health care, and allowing additional information to be obtained during the interview. Research Objective 3 The third objective will be met by a series of community forums following a group processes similar to those outlined under Objective 2. Facilitated discussion preceded by presentations of data was well received by the health care community during the P.I.'s previous research. The make-up of participants will also include farmers, farmworkers, migrant service agencies and advocacy organizations in addition to health care provides as the objective is to develop strategies that improve outreach to migrant workers. In addition to the community forums, key informant interviews will be used to identify and understand potential policy interventions or strategies that may be useful to improve health outcomes on dairy farms. Data is primarily anticipated to be qualitative and oriented toward policy analysis and planning. Research Objective 4 This objective tracks public opinion on Hispanic migrants. It builds on the P.I.'s previous research and enables evaluation of how public opinion in Vermont is changing regarding the migrant population. Survey questions will be asked as part of the annual Vermonter Poll. A random sample for the poll will be drawn from a list of Vermont phone numbers. The 2011 Vermonter Poll there were 628 respondents and the results based on a group of this size had a margin of error of plus or minus 4 percent at a confidence interval of 95 percent.

Progress 10/01/11 to 09/30/13

Outputs
Target Audience: Agricultural labor specialists, farmers and regional planners. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? Nothing Reported How have the results been disseminated to communities of interest? The results of this project have been disseminated through journal articles, presentations to farmer groups, and meetings with individual farmers and health care providers. What do you plan to do during the next reporting period to accomplish the goals? Conference presentation in June 2014, meetings with health care providers and agricultural agencies.

Impacts
What was accomplished under these goals? The project has four objectives: 1) Identify the health status and needs of Vermonts dairy farmworkers, with an emphasis on Hispanic migrant dairy workers. 2) Understand the challenges Vermonts health care providers face as they seek to meet the needs of Hispanic dairy workers. 3) Facilitate improved coordination, strategic planning and policy development between Vermont farmers, health care and other service providers who work with Hispanic migrant dairy workers. 4) Track changes in public opinion toward Hispanic migrant workers through annual statewide surveying. In 2013 the P.I. and project partners met with staff from Sen. Leahys office to provide data on current migrant labor issues facing Vermont dairy farmers. Dr. Baker co-presented with Erin Shea, director of UVM Extensions Vermont Migrant Program at the 2013 Northeast Organic Farming Associations (NOFA) annual conference on current agricultural labor visa issues, trends and policy. The P.I. also surveyed residents statewide through the Vermonter Poll on their perceptions of migrant dairy labor, contributing to a longitudinal study of public opinion. The research was disseminated to a broad regional audience in an article published by the Federal Reserve Bank of Boston. New research was conducted on to the practice of self-care, self-prescription and traditional health practices by Hispanic migrant farmworkers in Vermont. This is a qualitative study that included interviews with 34 participants on 32 dairy farms located in 10 Vermont counties. Twenty nine participants were male and five were female. Preliminary results from the projects research on self-care by migrant workers found that workers had been on their current farms ranged from over 7 years to two months. An estimated 50 percent of participants have requested medications and vitamins from their country of origin. Our statewide survey of Vermont residents found support for migrant dairy labor remains strong and awareness is high. We found in 2013 that 65 percent of respondents (n=622) said that they had personally spoken with a farmer or family member, similar to what we found in 2012. When asked in 2013 how they felt about a bias free policing policy, 84.5 percent (n=576) were in favor, up from 72 percent who said they favored the adoption of such a policy in Vermont in 2012. Support for development of a 3-year guest worker program also rose in 2013 to 89.7 percent (n=609), an increase from 83 percent (n=699) in 2012.

Publications

• Type: Journal Articles Status: Published Year Published: 2013 Citation: Baker,D. (2013) Latino Dairy Workers in Vermont Communities & Banking 24:2, 5-7. Federal Reserve Bank of Boston.
• Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Shea, E. & Baker, D. (2013) Keeping Up with VT Farm Labor: H2A, Immigration Policy & The Immigrant Dairy Worker. Presentation at the Northeast Organic Farming Association (NOFA) Conference. Burlington, VT. Feb 17, 2013.

Progress 10/01/11 to 09/30/12

Outputs
OUTPUTS: The project has four objectives: 1) Identify the health status and needs of Vermonts dairy farmworkers, with an emphasis on Hispanic migrant dairy workers. 2) Understand the challenges Vermonts health care providers face as they seek to meet the needs of Hispanic dairy workers. 3) Facilitate improved coordination, strategic planning and policy development between Vermont farmers, health care and other service providers who work with Hispanic migrant dairy workers. 4) Track changes in public opinion toward Hispanic migrant workers through annual statewide surveying. In 2012 we held a statewide forum with stakeholders that included representatives from Vermont state government agencies, non-profits working on migrant workers issues and agricultural interests, private industry, academia, health care agencies, farmers and representatives from Vermonts congressional delegation. The Mexican consulate in Boston also sent representatives and participated in the forum. We also surveyed residents statewide on their perceptions of migrant dairy labor, contributing to a longitudinal study of public opinion. The research was disseminated broadly and in a variety of formats. Two articles were published in peer-reviewed journals, testimony was provided to the Vermont state legislature, research data was provided to the Vermont congressional delegation and other media wrote about the research. A no-cost extension was requested and approved to complete the objectives in 2013. The focus will be on surveying health care providers to provide the other side of the health status of Latino dairy workers. This will complement our published research on dairy workers health self-assessments. In 2014 we will conduct research into the mental health issues faced by migrant dairy farm workers. This follows from our research findings that anxiety and depression are among the top health issues reported by Latino dairy farm workers. PARTICIPANTS: Dan Baker - PI/PD David Chappelle - Research Specialist Partner Organizations: UVM Extension Vermont Migrant Education Program Vermont Agency of Natural Resources TARGET AUDIENCES: Dairy Farmers Agricultural Labor organizations and non-profits State agricultural agencies Health care clinics serving migrant labor Communities supporting local dairy farms PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.

Impacts
Our statewide survey found support for migrant dairy labor remains strong and awareness is high. In 2010 we found that 72% of Vermonters (n=642) had heard about the migrant farm worker issues. We found in 2012 65% of respondents (n=699) said that they had personally spoken with a farmer or family member and 86% said they agreed that undocumented workers help Vermonts farms stay in business. When asked in 2012 how they felt about a bias free policy, 72% said they favored the adoption of such policies in Vermont and 83% (n=699) favored development of a 3-year guest worker program. Isolation is the greatest challenge for Latino workers on Vermonts farms. Located in rural areas, few workers speak English and few farmers speak Spanish. A quarter of Latino workers reported using hand signals to communicate with their employers. The potential for miscommunication heightens the risk of both physical and economic injury. Many workers rarely leave the farm, with 60% (n=82) reporting they never leave the farm. The P.I. provided testimony to the Vermont House Agricultural Committee in 2012 reporting the results of the project. Vermont state legislators approved a bill establishing a study committee on migrant labor. The general assembly found that inability to access medical care, obtain basic services and fulfill employment responsibilities was a significant challenge for migrant workers in Vermont. The recommendations of the study committee are due in Jan. 2013. Dairy is the largest sector of Vermonts agriculture, dominating the states farm sector and providing 74% of all income from agricultural sales. Regionally, Vermont is the largest dairy state in New England, producing more than 62% of all milk 2010. Dairys extensive land use and pastoral image provides the backdrop for Vermonts tourism industry attractive to new businesses. A marketing study in 2010 found that the image most closely associated with Vermont was a dairy farm with cows grazing in the pasture. Vermonts dairy farms have faced a difficult economic environment that has led to the loss of farms. Amidst the challenges of volatile milk prices and high input costs the chronic shortage of farm labor has received less attention. As have many other dairy states Vermont has turned to Latino labor to support its dairy farms. Our research helps dairy farmers, state and non-profit agencies understand the challenges farmers and migrant workers are facing. This contributes to a safer, more productive and profitable working environment on the States farms. It also contributes to maintaining Vermonts working landscape, an economically and socially important goal for Vermont. Our research assists Vermonts dairy farmers, migrant laborers, health centers, state agencies and non-profits working with farm labor. The influx of Spanish speaking labor is a new phenomenon on Vermonts dairy farms. Vermonters are working on many levels to understand this new labor force and make the educational, cultural, institutional, farm management and policy adjustments necessary to maintain and healthy and productive dairy labor force.

Publications

• Baker, D. and D. Chappelle (2012) Health Status and Needs of Migrant Farm Workers in Vermont. Journal of Agromedicine
• Baker, D. and D. Chappelle (2012) In Vermont, Se Habla Espanol. Experiences In Occupational Spanish Instruction. Journal of Extension.