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North Carolina’s Farmworkers
North Carolina Farmworker Health ProgramOffice of Rural Health and Community CareNC Department of Health and Human Services
www.ncfhp.org
www.ncfhp.org
Overview
Farmworkers in North Carolina The North Carolina Farmworker Health Program Internship and Service Learning Opportunities
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Farmworkers in North Carolina
Demographics
Environmental and occupational health risks and other health concerns
Access to care issues
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Agriculture
North Carolina’s agriculture ranks among the state’s most vital industries, contributing over $59 billion annually and representing 22% of North Carolina’s income.
At the heart of this industry are migrant and seasonal farmworkers whose hand labor is relied upon to plant, tend, and harvest tobacco, sweet potatoes, cucumbers, apples, bell pepper, Christmas trees, and a variety of other crops.
Each farmworker’s labor contributes annually over $12,000 in profits to North Carolina’s agricultural industry.
North Carolina ranks 6th in the nation for having the largest number of farmworkers (CA, TX, WA, FL, OR)
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North Carolina’s Farmworkers
There are approximately 92,603 farmworkers working in the state
– 63,956 Migrant; 7,671 are H2A
– 28,647 SeasonalEmployment Security Commission Estimate, 2006
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Some are…Migrant Farmworkers
62.5% have home base in Florida, Georgia or Mexico
90% of Latin-American descent
Mostly young, unaccompanied, poor Mexican-born men
Spanish-speaking, with little or no English
Less than 9 years of formal education, average 6th grade
Earn less than $11,000 per year
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Migrant H2A Workers
H2A is a guest worker visa
Contracted by farmer to enter country as farm laborers, either directly or through North Carolina’s Grower Association
Do not come with their family
Usually do not know where they will be working until they arrive
May stay for 6 - 9 months
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Some are…Seasonal Farmworkers
37.5% permanently reside in the state and work in
agriculture for part of the year
Made up of African-Americans, some settled migrant
workers of Mexican-American descent, and a few
American Indians
Mostly low-income, poor
population
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Challenges Farmworkers Face
Geographic constraints (rural) and social isolation
Subject to extreme weather conditions and occupational hazards such as pesticides
Poor working & living conditions
Limited or no transportation
Limited or no access to phones
Work long hours, with little or no breaks
Subject to and dependant on farmer and/or crew leader
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Language and cultural barriers Unfamiliarity with US systems Lack of information about resources No health insurance or worker’s comp Limited or no daycare services Limited access to healthcare services
Challenges Farmworkers Face
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Occupational Health Issues
Pesticide exposure
Green Tobacco Sickness
Heat illness
Musculoskeletal strains and fractures
Dermatitis
Eye – Pterygium, trauma
Insect/Animal Bites
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Other Health Concerns
Sexually Transmitted Diseases, particularly high risk for HIV/AIDS
Tuberculosis Hypertension Diabetes Oral Health Depression Motor vehicle accidents
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TOP CONCERN: Pesticide Exposure
Estimate 10,000-20,000 cases/yr Exposure: Chronic, Acute
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How Does it Happen?
Accidental contact with spray (51%)
Residue on plants or produce (25%)
In soil or irrigation water
On pesticide equipment
In pesticide storage and handling areas
On work clothes and boots
In the home
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Health Effects
Where? Systemic poisoning:
(inside the body) 43% Skin injury: 31% Eye irritation: 23% Nose, throat irritation
When?
Acute – right away
Chronic- later
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Acute Systemic Poisoning
Nausea, vomiting Dizziness Blurred vision Increased salivation or drooling Muscle cramps or twitches Difficulty breathing Unconsciousness Pinpoint pupils
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Chronic Effects of Pesticides
Allergic reactions Effects on pregnant women,
such as birth defects Effects on reproductive system…
infertility, miscarriage Neurological problems.. .
Anxiety, Parkinson’s disease, developmental delay, neuropathy
Increase in tumors... leukemia, lymphoma, myeloma, sarcoma, & in brain, testicle, stomach
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There are children in the fields!
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Access to Care Concerns
Significant barriers to health care– Language– Transportation– Geographical isolation– Cost (lack of insurance)– Knowledge of services– Hours of operation of clinic services– Fear– Lack of phone– Immigration status
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Who is providing services?
NCFHP contract sites Migrant and Community
Health Centers Rural Health Centers Health departments
Hospitals
Free clinics
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Reaching NC Farmworkers
NC Farmworker Health Program Community Health Centers Migrant Health Centers Migrant Head Start Programs Migrant Education Programs Student Action with Farmworkers North Carolina Grower’s Association Farm Labor Organizing Committee- NCO and other farmworker advocacy groups or
health services providers
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NCFHP Sites & FW Density
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North Carolina Farmworker Health Program’s Mission
…to improve the health of migrant and seasonal farmworkers and their families in the state
...working with and through a statewide network of service providers
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We achieve our mission by…
Funding health centers and reimbursing private providers to provide health care and dental services to farmworkers
Building organizational and workforce capacity through training and technical assistance
Disseminating information about the needs and contributions of farmworkers in NC
Building relationships and collaborations to connect and leverage resources in the community.
Advocating for access to quality healthcare and a better healthcare system.
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NCFHP Enabling Services Model
The program utilizes an enabling services “outreach” model to link farmworkers with services.
An outreach team works to… – Identify farmworkers– Share clinic information– Conduct health assessments– Provide health education – Provide case management– Link farmworker families with medical, dental,
specialty and/or and social need services
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NCFHP funded sites… Hire a Farmworker Health Coordinator and outreach staff
that represent the racial and ethnic background of the farmworker population in your service area
Establish policies that outline culturally and linguistically appropriate service delivery focused to meet the needs of farmworker families
Determine method for communication between multiple sites and Farmworker Health Coordinator
Eliminating Barriers to Care
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Incorporating Outreach Staff
Orient agency staff (including providers) about farmworker health needs and the role of the outreach worker
Train front desk staff and eligibility officers to determine farmworker status
Document farmworker status of agency patients and services provided
Work with outreach team to communicate follow-up of high need patients (patient case management)
Assure participation of coordinator and/or outreach team at agency staff meetings.
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Visit the Fields with your Outreach Team!
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North Carolina Farmworker Health ProgramOffice of Rural Health and Community Care, NC DHHS
2009 Mail Service Center
Raleigh, NC 27609
(919) 733-2040
www.ncfhp.org
