Health Medical

¶ … healthcare problems facing this nation is that of migrant workers, primarily those from Mexico, who work both legally and illegally on this side of the border. While other immigrant populations are also underinsured and under-treated --most notably Asians -- the Hispanic problem is by the far the most significant because of the shear numbers and the structural poverty which create stagnant population pools too large to ignore.

By allowing this problem to continue, we face the more direct health threat of the Mexican migrant worker population becoming a breeding ground for infectious diseases that can spread quickly into the general population. While humanitarian reasons alone should call for our involvement in solving this problem, we should be aware that the problem is an economic one as well. The Mexican workers, especially since the passage of NAFTA, have become an intergral part of the U.S.

workforce in that they are performing low paying work that simply would not get done if farmers were totally dependent on U.S. workers. In addition, medical resources are being used up to meet the crisis, but not in an especially efficient manner.

While it is a temptation to dismiss this problem as a Mexican one and leave solutions up to the Mexican government, we must recognize that the Mexican government is not going to respond to this crisis, as they simply don't have the resources to deal with medical issues within their own borders, let alone those occurring in what they view as the wealthy United States.

The problem is especially acute in Texas along the border towns this side of the Rio Grande and in California where much of that state's economy has always been dependent on crops harvested by migrant workers.

According to one health official working along the Rio Grande, There really are massive problems down here, mainly because the area is very economically disadvantaged...There is a lot of disease, but the average income in the Rio Grande Valley is half that of the rest of the United States whereas the health costs are the same. So we've got half the money to pay for the same thing that everybody else does." (Pinkerton) The rates of illness and death from disease is significnatly high for the migrant worker population.

In the lower Rio Grande Valley and all along the Texas-Mexico border, women are dying at twice the national rate of cervical cancer, a disease that is quite treatable if detected early enough. Tuberculosis and liver disease rates are twice as high along the border as in the remainder of the state. (Pinkerton) The situation in California is just as grevious.

A highly comprehensive study done in California's Central Valley with 971 participants (Stanley 2001), indicates that only 11.4% of those surveyed had health insurance, and that the healthcare rights of migrant workers were "routinely violated." Other findings from the study showed that nearly 18% of migrant farm workers have at least two of three high risk factors for heart disease. These are high serum cholesterol, high blood pressure, and especially excessive body weight, as 81% of males and 76% of females in the study were shown to be dangerously overweight.

Anemia was significantly greater among this population than the United States average. More than 33% of males and nearly 40% of females had at least one untreated tooth that was in a state of decay. This correlates with the fact that over 50% of males and 44% of females said they had never been to a dentist. Less than half (48%) said they had even been to a doctor's office during the past two years. The lifestyle of the workers doesn't help matters either.

"Farm workers tend to eat a lot of fast food, loaded with fat and sugar, which puts them at a greater risk of obesity and high cholesterol, and in turn ups their chances of getting chronic conditions such as diabetes and high blood pressure."(Lanzendorfer) The survey also showed that workers were unaware of what rights they have under California law. Only about 30% knew about mandatory California Workers Compensation, which covers those who are injured while working or as a result of working.

Even if workers do know about this law, they are hesitant to take off for sick days, as the seasonal nature of the work means they cannot afford to be out even for a few days without compromising their earning capacity. Little more than half of those surveyed said they received safety training, even though federal law requires employers to provide such training. Thirteen percent said they don't have drinking water available to quench them on hot days in the fields of the Valley.

In Texas the problems are just as grave and the numbers just as alarming as in California. Diabetes, for which Mexican-Americans tend to be at greater risk for, is far more lethal along the border because of the large numbers of Mexicans who live there. The death rate for diabetes in Texas averages 17.8 deaths per 100,000 residents; however, the death rate is 24.9 in El Paso, 26.4 in the McAllen area and nearly 33 in Laredo, all areas which a high concentration of Hispanic workers.

(Pinkerton 2002) What is even more scary is the fact that the border regions are becoming incubators for diseases that are typically considered more part of the Third World than the U.S. "Outbreaks of mosquito-borne dengue fever, a plague of deadly birth defects, drug-resistant strains of tuberculosis, rabies, leprosy, high rates of children with hepatitis A, and even cholera are crowding the plates of border health workers." (Pinkerton) What we have is a full-blown health crisis in these border counties," warns state Sen. Eliot Shapleigh, D-El Paso.

"What others in Texas need to know is soon this will affect them -- the infectious TB not treated in Laredo soon ends up at Parkland (Hospital) in Dallas." (Pinkerton) The biggest health issue might simply be lack of insurance. And while the statistics vary about just who and who doesn't have insurance, most studies indicated that at least one-third and as many as two-thirds of the migrant population does not have insurance.

"A recent survey by the Border Health Office indicated that in the border's colonias, nearly 64% of the people did not have health insurance." (Pinkerton) Even in cases where the workers have insurance, with annual incomes of under $10,000 they haven't the funds to manage copayments and even if they can are often so intimidated by the system that they won't seek out health care except in the most dire circumstances (which usually means seeking care often too late in the expensive emergency room).

And when clients fail to pay their bills, the costs for everyone goes up. According to Chief Operating Officer Irene Chavez, "The 494-bed Providence Hospital in El Paso provided $10 million to $11 million in free health care last year." (Pinkerton). Of that amount, only about three million was recovered by the hospital. It's the same story for all the hospital and medical facilities in the area, and whereas the hospitals must provide patient care regardless of the ability to pay, a.