Farmworker Health Study

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The state of California is a major producer of agricultural products in the country. It accounts for a third of the country's vegetables and two-thirds of the country's fruits and nuts. It is the leading state for cash farm receipts, contributing over 13 percent of the nation's total agricultural value and nearly one third to half of all agricultural workers in the country reside in California. Approximately 75 percent of California's agricultural workers are undocumented. In recent years changes in patterns of immigration, advances in robotics and climate change have led to a fundamental change the industry. The rising temperatures are also likely to pose a serious threat to agricultural workers, especially vulnerable groups such as pregnant women and older workers.

The last comprehensive assessment of California agricultural workers, the California Agricultural Health Workers Survey (CAWHS), was conducted in 1999. The study’s publication, Suffering in Silence, concluded nearly 70 percent lacked any form of health insurance, and one third of males said that they had never been to a doctor or clinic in their lives. Since that time, there have been several studies which have identified the lack of access to healthcare as a contributor to poor health. The barriers to accessing healthcare include a lack of health insurance, inability to pay, language barriers, long waiting times, and rushed encounters with providers. Studies also suggest that many agriculture workers try home remedies first, and only seek western medical care when they conclude that these home remedies were ineffective.

Despite the focus in recent years on the health of agricultural workers and access to care, there has been no comprehensive study addressing agricultural worker health since the initial CAWHS study. Given the changes that have occurred over the past 20 years in the working conditions on farms, including changes in crop mixes, technology, climate change, and pesticide use, and with the advent of the Affordable Care Act, we propose to conduct a comprehensive study on the health of agricultural workers in California. The aim of the study will be to assess the health of agricultural workers using comparable measures to those used in the initial farm study, but extend that previous study with a focus on the long term health of agricultural workers, the ability to access high quality health care, and the ability of the workforce to meet the changing demands of the industry. The information developed by this study will be used to develop effective policy and healthcare interventions to improve the lives of agricultural workers in California and beyond.


The primary purpose of this project is to determine the health of agricultural workers in California. Secondary aims include to determine:

• What is the current access to healthcare?

• Has the access to care improved since the advent of the Affordable Care Act?

• How do local and state policy changes impact health status and access to care?

• What are the health and training needs of the agricultural workforce going into the future?

Timeline and stages of the study

Duration- 26 months

  • Date of initiation of project- 5/1/2020
  • Proposed date of termination of project-6/30/2022.
  • The project will have three phases:
    • Phase 1 - Setting the stage (5/1/2020 to 12/31/2020) trial and finalize the survey materials and the methodology
    • Phase 2 - Measuring health (1/1/2021 to 12/31/2021) primary data collection
    • Phase 3 - Dissemination (1/1/2022 to 06/30/2022) analyze the results, prepare the reports and research papers, and disseminate the results