Reversing America’s Declining Health Trend Means Focusing in Equity

For the first time in decades, the current generation isn’t as healthy as the one that came before.” The theme for day five of National Public Health Week is “Be the Healthiest Nation in One Generation” and is dedicated to turning around the declining trend in health faced by Americans today. To address this trend, it’s important that we understand the barriers to good health faced by all people in the United States. At Farmworker Justice, we spend a lot of time contemplating migration as a social determinant of health. Specifically, we discuss the roadblocks that affect good health and quality of life and we think about ways to lift those roadblocks, either through advocating for policy change or through health promotion and education projects.

In terms of farmworkers, migration from their home to the U.S. has a lot to do with their health. Just a few factors related to migration that affect farmworkers include poverty, language, discrimination, and national policies.

Most farmworkers live at or below the poverty line. Health outcomes of people who live near the poverty line are worse than for those who enjoy higher incomes.
Eighty-one percent of farmworkers speak Spanish but immediately after arriving in the U.S. they need to navigate everything from grocery stores, public schools, housing, and health clinics almost entirely in English.
• Discrimination, both overt acts of discrimination and microagressions (every day, more subtle forms of discrimination), is associated with increased anxiety, anger, depression, and stress levels.
• Policy can be discriminatory when it is does not provide protections to workers equitably across professions. For example, many states do not require agricultural employers to provide workers’ compensation insurance coverage for farmworkers, even though agriculture is ranked among the most dangerous occupations by the U.S. Department of Labor.
• Policies that don’t seem to be about health, like immigration policy, can actually have a great impact on the health and wellbeing of our community members. For example, children who hear about deportations may constantly fear the separation of their families and people who cannot obtain driver’s licenses may avoid driving to a clinic.

Not only do poverty, language barriers, discrimination, and policy serve as enormous sources of stress, but they also stand in the way of accessing and receiving appropriate medical and mental health services. In addition, sixty-four percent of farmworkers are uninsured, so even when they do seek care, paying for it presents another barrier.

To reverse the decline in the nation’s health outcomes, it is important to address the barriers, social inequalities, and injustices that contribute to the decline. We must also recognize that the health of each individual is affected by the overall health of our communities so working toward better health outcomes for the entire community will create better health for each individual.