Trouble in the Fields: Effects of Migrant and Seasonal Farm Labor on Women's Health and Well-being

Martin Donohoe, MD, FACP

Disclosures

March 04, 2004

Behind every meal we enjoy lies, quite literally, the blood, sweat, and tears of the 1.4 million migrant and seasonal farm workers (MSFWs) in the United States, many of whom labor under unhealthy and unsafe conditions to bring food to our tables.[1] This article describes the health and social consequences of migrant and seasonal farm work, many of which affect both sexes, but some of which are borne solely or disproportionately by women.

Of the 2.5 million laborers currently employed by the US agriculture industry, 1.4 million are MSFWs.[2] Although only 20% of MSFWs are women, many male workers are accompanied by wives (or girlfriends) and children. Two thirds of MSFWs are shuttle migrants, returning annually to their countries of origin (predominantly Mexico). Spanish is the predominant language for 84%; 20% are completely illiterate, 38% functionally illiterate.[1]

About one half of hired crop workers have incomes below federal poverty levels.[2] Those living in labor camps face overcrowding, poor ventilation, and faulty plumbing. Others sleep in tents, their cars, open fields, or in substandard local housing (eg, only 1 sink may be available and thus is used for bathing and for washing pesticide-laden clothes and food preparation -- typically a woman's duties). Although the Occupational Safety and Health Administration regulations require employers to provide drinking water and hand-washing and toilet facilities, compliance is poor, and farms with fewer than 11 employees (ie, 95% of US farms) are exempt.[3]

Agriculture is the second most hazardous occupation in the United States, after mining.[4] Specific health problems affecting both sexes include the following:

  • Musculoskeletal injuries from intense, repetitive tasks;

  • Dermatitis from exposure to pesticides, fertilizers, latex, chemicals, and allergenic plants;

  • Urinary tract infections secondary to urinary retention, a consequence of a lack of toilets and infrequent bathroom breaks;

  • Heat stroke;

  • Asthma, allergies, and chronic lung ailments;

  • Tuberculosis as a result of overcrowding;

  • Tooth decay;

  • Increased morbidity and mortality from viral infections and various cancers (the latter a consequence of exposure to such carcinogens as pesticides, solvents, oils, fumes, and ultraviolet radiation from chronic sun exposure).[1]

Each year, 950 million tons of insecticides, herbicides, and fungicides are applied across the United States,[5] and each year, 300,000 US farm workers suffer acute pesticide poisonings.[1] Acute organophosphate pesticide exposure causes increased salivation, tearing, blurred vision, nausea, vomiting, abdominal cramps, urinary and fecal incontinence, increased bronchial secretions, cough, wheezing, and sweating. In cases of more severe acute intoxication, dyspnea, bradycardia, heart block, hypotension, pulmonary edema, paralysis, convulsions, or death may occur. Long-term pesticide exposure may cause permanent neurologic problems (including peripheral neuropathy and deficits in motor skills, attention, and memory) and cancer. The US General Accounting Office has acknowledged that current Worker Protection Safety standards are ineffective.[5]

In women, prolonged standing and bending, overexertion, dehydration, poor nutrition, and pesticide and chemical exposures contribute to an increased risk of spontaneous abortion, premature delivery, and fetal abnormalities.[1] Moreover, low socioeconomic status, frequently young maternal age, and inadequate prenatal care contribute to an infant mortality rate among MSFWs that is twice the national average.[6]

The persistent organic pollutants in certain pesticides have serious endocrine, reproductive, and oncogenic effects on pregnant women and on growing children.[1,7] Breast and reproductive organ malignancies are associated with pesticide exposures. Pesticides, as endocrine disruptors, can cause abnormal genital development (and sexual precocity) and may be responsible, in part, for dramatically decreasing male sperm counts over the past 50 years. Higher maternal levels of organochlorine pesticides correlate with an increased risk for spontaneous abortion in mothers, as well as higher rates of gastrointestinal problems, respiratory and kidney infections, and asthma in their children.[8]

Although the US government limits the legal age of child labor in most industries to at least 16 years, for agricultural labor it is 12 years.[1] Children are particularly vulnerable to pesticide exposures.[1,7] The majority of preschool-age farm worker children are not appropriately vaccinated. Many are below average height. They suffer more frequent respiratory, parasitic, and skin infections, chronic diarrhea, vitamin deficiencies, and dental problems than other children. They experience homelessness, frequent moves, poverty, and interruptions of schooling and friendships that pose psychosocial and developmental risks. These difficulties create stress for their caregivers (predominantly their mothers).[1]

MSFWs face numerous social stressors, including job uncertainty, social and geographical isolation, intense time pressures, intergenerational conflicts, separation from family, and lack of recreation. Barriers to medical care include lack of transportation, insurance, or sick leave; the threat or fear of wage or job loss; language barriers and illiteracy; and limited clinic hours. Treatment is often sought for acute rather than for chronic conditions or preventive services. MSFWs have increased rates of hospitalization and death due to many common conditions.[1] The migrant healthcare system of approximately 400 federally authorized clinic sites reaches only 12% to 15% of the this population annually.[9] As few as 15% to 20% obtain assistance program benefits because of impractical requirements and fear of deportation. Since many employers do not report wages, MSFWs are often unable to prove claims for Social Security, workers' compensation, occupational rehabilitation, or disability benefits. As few as 1% to 2% have protections afforded by labor union representation. Harvest work is considered "at will." There is usually no contract, no seniority, no obligation beyond the day-to-day.[10] Growers hire and fire at will, without need for explanation. Maintaining the current level of poverty among MSFWs saves the average American household just $50 per year, according to Schlosser.[10] Moreover, despite sending substantial amounts of money to family members in their countries of origin, undocumented immigrants contribute more to the US economy (through the production of goods and services and in taxes) than they receive in benefits (despite a common misconception that they are a "drain on the economy").[11,12]

The MSFWs constitute a cheap labor force that performs the jobs that American citizens do not want. Yet most of these workers have risked their lives for the opportunity to work in the United States. As the Immigration and Naturalization Service (now part of the Department of Homeland Security) has tightened up border patrols, undocumented immigrants are attempting more dangerous border crossings in isolated areas, and hundreds of would-be laborers have died as a result of dehydration and exposure trying to get into the United States from Mexico.[13,14] Regrettably, the injustices inherent in current agricultural industry practices are a reflection of an increasing emphasis worldwide on economic practices that promote the production of cheap goods by poor workers, inadequately protected from occupational and environmental health risks, for the primary use and consumption of consumers in the developed world.[15] The North American Free Trade Agreement, Free Trade Association of the Americas, International Monetary Fund and World Bank, despite promises to the contrary, have adversely affected the health and economies of the developing world.[16]

Until the United States and the world confront global policies and institutions that support injustice, the income distribution between rich and poor and men and women (both within and between countries) will worsen, and the problems of MSFWs will only increase, as will suffering among agricultural workers worldwide.[15] This suffering will especially impact women, given their poor status in the developing world, where they already face social, legal, educational, and political marginalization.[17]

Furthermore, outside the United States, agriculture is becoming increasingly feminized. Officially, women represent 40% of agricultural workers worldwide, but much of women's farm and food production work is uncounted. In many countries, women grow, harvest, and prepare virtually all the food consumed by their families.[18] They are thus subject to many of the health and social problems noted above, sometimes more so (for example, many pesticides produced, yet outlawed, in the United States, are sold abroad and continue to be applied liberally to crops in other nations.[7,19]).

I urge interested readers to contact their legislators and encourage them to support increased state and federal funding for healthcare and community outreach workers, and broadened legislation and protective standards to eliminate overcrowded and unsanitary living conditions and workplace hazards and exposures for MSFWs. Educators in the health professions should conduct research on this marginalized, understudied group and encourage their schools to include didactic and experiential requirements for health professionals-in-training. Consider supporting universal healthcare coverage in the United States, including coverage of guest workers. (In the long run, universal healthcare could be cost-saving for Americans, according to a report by the Institute of Medicine.[20]) Consider supporting organic farmers, who ideally use agricultural methods that do not deplete the soil or hurt environmental systems or farm workers. Finally, consider donating to an organization providing social or healthcare services to MSFWs.

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