Health Care Access and Barriers for Undocumented Mexican Farm-Workers in Texas

1. Health Care Access and Barriers forUndocumented Mexican Farm-Workers in Texas Lisbeth Iglesias-Rios, MS, LADAC UT Health Sciences Center-STEER 2009

2. Objectives • Brief historical context of immigration. • Background and significance. • Public health, environmental medicine and policy implications. • Strategies related to improved health care access for farm workers. • Conclusion.

3. Immigration Characteristics • Context: past and current relations between Mexico and the U.S. • Type of immigration: circular, temporal or permanent process. • Social Networks (e.g. family & friends). • Rural versus Urban areas from Mexico. • First trip or several trips to the U.S. • Level of enculturation and/or acculturation.

4. Background and Significance Flower Petal Policy • Social, Political & Economical factors • Law of supply and demand • Push factors & Pull factors • “I need you, I need you not.” • Bracero Programs • In early 1954, the American government put in place “Operation Wetback”

5. Social impacts THINK ABOUT: • What happens when migrants return home after expanding their horizons and suffering traumas? • What happens to their children in their absence? • Children may be exposed to new opportunities but also very tough social and psychological environments and discrimination.

6. Overview • 12 million undocumented immigrants (estimated) (Pew Hispanic Center, 2009). • About 800,000 undocumented individuals enter the U.S. per year under the current immigration policy(Tarmann, 2005). • The Mexican undocumented population living in the U.S accounts for 7 million people (Pew Hispanic Center, 2009).

7. Undocumented Population by Country or Region of Birth

8. Estimated Undocumented Immigrants in Texas 1.4 million and 1.6 million Source: Pew Hispanic Center estimates based on March 2004 Current Population Survey (Passel 2005) and 1990 Census.

9. Composition of the Undocumented Population

10. Composition of the Undocumented Population

11. General Demographic Characteristics • High labor-force participation rate (96%). • Lower compensations. • Undocumented immigrants pay payroll taxes and they contribute $6–7 billion in Social Security funds that they will be unable to claim.

12. General Demographic Characteristics • The vast majority of undocumented immigrant workers hold blue collar jobs. • 50% of farm-workers in the U.S. are undocumented immigrants. • Farming has the highest concentration of undocumented workers in Texas.

13. Public Health and Environmental Medicine Implications • The majority of Texas’ agricultural workers are seasonal workers and are some of the poorest agricultural workers in the nation. • For 25 weeks a season, they labor seven days a week, 10 to 14 hours per day, for an average of $5,000-$7,000. • Overwhelmingly uninsured.

14. Public Health and Environmental Medicine Implications • Nearly 60% of Texas farm workers reside in the four southernmost counties of the Rio Grande Valley • Most Valley farm workers live in rural colonias.

15. Public Health and Environmental Medicine Implications • Agriculture is the 2nd largest industry in Texas, generating $80 billion for the economy annually. • Agriculture consistently ranks as one of the nation’s three most hazardous industries.

16. Public Health and Environmental Medicine Implications • In an average year, 516 workers in the United States die while doing farm work and each day about 243 workers suffer lost-time injuries. • The fatality rate for farming was more than 7 times the overall rate of 4.0 fatalities per 100,000 workers. • The cost of farm-related injuries is approximately more than five billion dollars each year.

17. Public Health and Environmental Medicine Implications • Work‐related respiratory and lung diseases from exposure to pesticides. • Noise‐induced hearing loss. • Skin diseases (e.g. rashes). • Back pains from stooping for long hours. • Heat exhaustion from sun exposure. • Badly injured or amputated limbs from machinery accidents. • TB from sharing crowded living quarters.

18. Risk Factors • Racism and Discrimination • Segregation • Broad network of smugglers (coyotes) • Confront problems of social adjustment and disruption • Lack of sense of community in the host country • Susceptible to engage in risky behaviors

19. Health Care Access and Barriers for Undocumented Mexicans Immigrants Critical factors that shape their relation with the health care system are: • Fear of deportation, • Lack of health insurance, • Language and cultural barriers, • Lack of timely access to adequate health care service interventions (preventive, chronic, and acute) and options of health care services as well as, quality of treatment.

20. Policy Implications and Strategies Related to Health Care Access • Progressive and comprehensive immigration reform. • Increasing affordable and comprehensive health insurance access for minorities. • Making cultural competency part of the policy making, infrastructure, and daily health care practice.

21. Policy Implications and Strategies Related to Health Care Access • To develop mutual aid organizations or employing immigrant health promoters and outreach workers. • Inter-state and bi-national coordination and service linkage that will allow undocumented individuals to continue to receive uninterrupted services.

22. Policy Implications and Strategies Related to Health Care Access • Provide tax incentives for employers in low-skilled industries and/or small businesses to provide health insurance. • Building “health care safety networks” to serve the Latino population may decrease the fear commonly reported by the undocumented population of being discovered and deported by Immigration Services.

23. Policy Implications and Strategies Related to Health Care Access • Bridge the gap between community members, researchers, practitioners, stakeholders, and policymakers. • Empowerment and community based-participatory interventions. • Key components while working with underserved or excluded populations (Wallerstein, 2006).

24. Conclusion • Multidisciplinary work, partnership and collaboration. • Active support and participation of the whole immigrant community.

25. Todos somos inmigrantesWe are all immigrants • Healthy workers keep us all healthy • Immigrants and their children are our future • They will be a major segment of the US workforce in the coming years • THANK YOU!

26. Acknowledgements • STEER Program: Dr. Miller, Pat Bortoni, Dr. Tapia, Dr. Garza. • UT Health Sciences Center-Regional Academic Health Center: Faculty and Staff. • Presenters from the STEER program. • STEER colleagues

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