This is related to the fact that the use of pesticides is very poorly regulated. (Protect Farm Worker's Health) the use of pesticides has become an area of research and concern by the health authorities. This aspect has been well documented but experts are of the opinion that there are "...insufficient studies examining the effects of multiple pesticide exposure." (Rosenbaum and Shin, 2005)
2.2.3. Access to health benefits and care
The general consensus from the literature on the subject is that migrant and seasonal farm workers and their families are "…overwhelmingly uninsured." (Rosenbaum and Shin, 2005) the 2005 study of the health of migrant farm works by Rosenbaum and Shin indicates that in 2000, "…85% of migrant and seasonal farm workers were uninsured, compared to 37% of low-income adults nationally." (Rosenbaum and Shin, 2005) the study also found that both migrant and seasonal farm workers had less access to health care than other low-income groups. This fact is emphasized by the finding that only 42% of women in farmworker families reported seeking early prenatal care compared to over three-quarters nationally. (Rosenbaum and Shin, 2005) This negative picture also applies to the children of the workers and as many as one out of every ten had no medical or health insurance. (Rosenbaum and Shin, 2005) Villarejo summarizes the situation as follows: "…only a very small proportion of hired farm workers, in the range of 5% to 11% of the total, have health insurance provide by their employer" and " only a few…have been able to obtain Medicaid to other government needs-based health insurance coverage, despite the fact that their poverty would other wise qualify them." (Villarejo, 181)
On the other side of the coin it has been found that female farm workers are on some instances better provided for. As Villajero points out, "…programs targeting women farm workers, such as WIC or & #8230;emergency MediCal, are more effective in helping them obtain needed services." (Villarejo, 175) Hired farm workers are also provided for to a certain extent by Federally funded health centers. In 2002 "…843 federally funded health centers received funds specifically targeted to meet migrant health needs." (Rosenbaum and Shin, 2005) This does not include those health centers that are not funded and which serve the migrant and seasonal farm workers.
Migrant works face particular problems with regard to Medicaid Coverage. Immigrant status and poor and fluctuating income levels are serious obstacles to this source of healthcare coverage. The bottom line is that the overwhelming majority of migrant and hired workers are not eligible for Medicaid.
….under current law, states cannot provide Medicaid coverage to non-disabled low income adults without dependent children. Further, since 1996, recent immigrants, including legal immigrants, have been excluded from Medicaid for the first five years they reside in the United States.
(Rosenbaum and Shin, 2005)
To add to the complexity of the situation, research has found that many workers who are eligible for assistance have certain difficulties in enrolling for Medicaid. This is mainly due to language competency issues and cultural- communication problems. For example, the worker may have difficulty in completing certain forms necessary for obtaining health care. Given their limited English skills, "…it can be very difficult for them to complete long application forms or meet extensive verification requirements, particularly if there is limited availability of language assistance." (Rosenbaum and Shin, 2005) This suggests that key factors in remedying the situation would be more attention to language competency issues.
Furthermore, access to healthcare and medical aid is also hampered by the fact that this workers move frequently and this is also related to various residency barriers to medical assistance. (Rosenbaum and Shin, 2005)
3. Policies, solutions and reform
Over the past few year that the have been renewed efforts to deal with the health problems and issues that are so prevalent among hired farm workers in the United States. For instance, there have been efforts by the authorities in many states to improve the availability of Medicaid to these workers.
However, many commentators and experts are of the opinion that much more can be done to positively influence the present situation -- especially with regard to access to healthcare and medical insurance.
Among the many suggestions that have been put forward is the view that "…. A number of actions could be taken to facilitate farm workers ability to enroll in and utilize Medicaid coverage." (Rosenbaum and Shin, 2005) These could take the form of "fast track" enrollment option, or by changing the existing criteria for eligibility. Related to this is the suggestion that to establish "…separate eligibility standards for farmworkers and their families that could be consistent across states." (Rosenbaum and Shin, 2005) This would help to deal with the problem of mobility among these workers that was noted above.
In terms of broader policy initiatives it has been suggested that a new federal coverage program for farm workers and their families be created in order to enroll farm worker on national basis with Medicaid. This would alleviate the problem of interstate movement by these workers. Hove these solutions still does not take account of those non-eligible and non-documented farm workers and their precarious health situation.
The above section presents a few of the more viable solutions to the problem of healthcare among farm workers. There is little doubt that the increasing number of hired farm workers has meant that health issues and problems surrounding access to health insurance and aid has been exacerbated. However, while these are serious health problems, the number of workers is relatively low. This has led many commentators to suggest that relatively small changes and innovations in the present system can lead to far-reaching improvements in health care for these workers. For instance, issues such as language and cultural barriers are aspects that create real barriers to proper health care and these aspects can be remedied with organized assistance.
The importance of these workers for the agricultural economy requires that a far -- reaching and comprehsive solution to these issues be reached. As Villarejo states; "What is clear is that poverty status, lack of health insurance and cultural and language barriers prevent a very large share of these workers from obtaining the healthcare services they need." (Villarejo, 188) However a point that Villarejo makes is also echoed in many other studies; namely that there is still a great need for more comprehensive and detailed research and analysis into the problem. This refers to the important fact that, "…the health of this population is still not well understood." (Villarejo 188) it is therefore imperative that there be more detailed research into this area of concern. It follows that only once these different aspects and variables have been careful researched and analyzed can the correct assistance be properly and effectively implemented.
Health Problems among Migrant Farmworkers' Children in the U.S. ERIC Digest.
September 27, 2008.
ILO warns on farm safety Agriculture mortality rates remain high Pesticides pose major health risks to global workforce. September 27, 2008.
Overview of America's Farmworkers. September 27, 2008.