The Role of Community Health Centers in Promoting Health Care Access and COVID-19 Prevention for Agricultural Workers

Community health centers (CHCs) play a key role in increasing health care access for agricultural workers across the U.S., providing much-needed preventative and primary care that might otherwise be unaffordable or unavailable to many.  CHCs, nonprofit clinics that provide services to medically-underserved communities, are an essential component of the health care delivery system for this population, and the COVID-19 pandemic has made their services even more vital. Migrant health centers (MHCs) are CHCs that provide health care services to migratory and seasonal agricultural workers (MSAWs) and their families. MHCs served over 887,000 patients in 2018, or about 20% of the nation’s agricultural workers.

Agricultural workers encounter many barriers to accessing health care. Fifty-three percent of them lack any form of health insurance, and only 18 percent have comprehensive health insurance through their employer. Given that the mean income for an agricultural worker family is about $20,000, health care costs are unaffordable for a large number of these families. MHCs help bridge this financial need by making medical care available on a sliding-fee scale based on ability to pay. However, even those who have insurance face additional obstacles that may prevent them from obtaining care. Being employed in agriculture means they often live in underserved rural areas with insufficient numbers of clinics, hospitals and health professionals. Lack of transportation, long work hours and language barriers compound these problems. By offering supporting services such as transportation, mobile clinics and language interpreters, MHCs help break down these barriers.

Access to COVID-19 testing has been a constant challenge for agricultural communities. As far back as May, 90 percent of health centers offered COVID-19 tests. Some MHCs have found ways to bring testing to agricultural workers, using mobile testing sites in communities and farm sites. As agricultural areas have seen increasing numbers of infections, MHC personnel have been on the front lines performing tests and educating workers and employers on COVID-19 prevention. They have also expanded their telemedicine services in response to the pandemic and performed contact tracing to reduce the spread of disease.

Farmworker Justice works with MHCs to promote agricultural worker access to health care. As a member of the Farmworker Health Network (FHN), FJ brings together community health center staff to share best practices, ascertain needs, and identify resources  to better serve their communities. In addition, FJ provides training and technical assistance (T/TA) to migrant health centers on issues concerning federal policy and occupational health and promotes collaboration between health centers and community-based organizations, including legal services organizations and Migrant and Seasonal Head Start. Complementing these efforts are publications aimed at health center staff, such as clinician guides, and outreach materials designed for outreach staff and agricultural workers. These materials cover subjects such as occupational health, diabetes prevention, and health insurance, and are available in the Health section of our Resource Center.

As part of our COVID-19 work, we  created a page on our website listing resources for farmworker-serving organizations, such as COVID-19 information in Spanish and indigenous languages, as well as state policies on COVID-19 prevention in agricultural workplaces. As we continue our advocacy efforts, we will also develop worker outreach resources and provide T/TA to CHCs on COVID-19 policies and regulations. These activities will support MHC’s efforts as they provide services to the agricultural community and address the impacts of the pandemic.

During this National Health Center Week, we thank the dedicated community health center staff, who make health care access possible for medically underserved communities around the country, including America’s agricultural workers.