Maria de Jesus Diaz-Perez, Ph D (c) November 19, 2010

1. Health Status of a Group of Migrant Farmworkers in Colorado: Lessons learned to improving services Maria de Jesus Diaz-Perez, Ph D (c) November 19, 2010 * This research was possible with financial support from a Fellowship program from the LUCHAR project (NHLBI grant HL079208); University Scientific Teams grant, University of Colorado at Denver; NSF Doctoral Dissertation Improvement Grant.

2. Outline: • Brief overview of background of farmworkers in Colorado • Description of the study • Health status indicators findings • Implications for services

3. Background

4. History of Mexican Immigration • 1942 – 1964 • Bracero Program • 1964 – 1986 • Start of undocumented immigration • 1986 – Now • Era of misguided legislation

5. Bracero Program:1942 - 64 • Federal program to subsidize growers • Immigrants worked in agriculture and farms • Great number of immigrants were documented • Temporary nature

6. Era of undocumented immigration: 1964-86 • Characteristics of immigration: • Increasingly undocumented • Circular movement of male workers • Identifiable, predictable patterns

7. Era of Misguided Legislation:1986 - Present • 1986 • Immigration Reform and Control Act (IRCA) • 1996 • Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA)

8. 1986: Immigration Reform and Control Act (IRCA) • Employer Sanctions • Border control enforcement • Amnesty Program Goal: Reduce undocumented immigration

9. 1996: Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) • Welfare reform to exclude immigrants • Federal actions to deny means tested programs to immigrants • State actions to restrict services to immigrants Goal: Reduce undocumented immigration

10. IRCA and IIRIRA • Increased risks of injury and death • Geographic diversification • Shift toward permanency • Declining wages Ever increasing migration, worsening living conditions

11. How successful has this legislation been in stemming the flow of undocumented immigrants?

12. Mexican Migration Today • Will continue growing • New sending communities • More undocumented migration from Southeast and Central regions • More migration from rural places from Southeast region, going to South in the US

13. New origins

14. Mexican Migration Today • Likelihood of having a work permit depending on Mexican region of origin: • Border (26%) • Historical (12%) • Central (5%) • Southeastern (9%) • Border and Historical region flows tend to be shorter in duration

15. Mexican Migration Today • More permanent • Feminization and urbanization of migrant populations • New receiving communities

16. New destinations 2000 – 2007: Main, New Hampshire, Western Virginia had over a 100 times MX population increases Mexican population increased from 14 to 18 times in the 90’s: Alabama, Tennessee, Kentucky, North and South Carolina Leite, P., Angoa, M., Rodriguez, M. (2009). La emigración Mexicana a EstadosUnidos: balance de lasúltimasdécadas. Situacióndemográfica. México: CONAPO.

17. Factors Against Immigration • No jobs • High anti-immigrant sentiment • Federal raids • State laws • Very dangerous to cross

18. Relative employment growth Leite, P., Angoa, M., Rodriguez, M. (2009). La emigración Mexicana a EstadosUnidos: balance de lasúltimasdécadas. Situacióndemográfica. México: CONAPO.

20. Description of the Study • Cross sectional survey Spring to Summer 2009 • Sampling • Colorado: Farmworkers working under labor program, whose community of origin is several towns in the municipality of Valle in Guanajuato. • Mexico: All 18-49 years men from 5 villages. • Sample size • In Colorado: 164 farmworkers • In Mexico: 220 men

21. Study Design • Male-only agricultural labor stream: Specific geographic area in Mexico Valley region in the State of Guanajuato

22. Study Design Platte Valley region in Colorado

23. Sociodemographic Characteristics

25. Motivations to migrate • Economic: • Able to give more money to family • Make more money in the US • Able to save working in the US • Personal • Hardworking • Healthy enough to work hard • Never gets sick • Social • Acquaintances who encouraged and helped him to migrate • Friends who have worked or were working in the US

26. Self Rated General Health & Relative Physical Health * p < .001

27. Depressive Symptoms * p < .001; ** p < .05

28. Presence of Diagnosed Chronic Diseases Chronic diseases included: hypertension, diabetes, heart conditions, asthma or other chronic respiratory diseases, arthritis, back and digestive problems that have been diagnosed by a health provider.

29. Diagnosed Chronic Diseases

30. Blood pressure * p < .001

31. Visited Doctor in Previous 6 Months * p < .05

32. Waist Circumference * p < .05

33. Physical Activity* Numbers are means of hours per week spent on the activity; ** p < .001

34. Diet Indicators1 1) Numbers are means (sodas or pieces of fruit per day; number of times per week eating read meat; * p < .05; ** p < .001

35. Body Mass Index* * p < .001

36. Obesity by Age and Migrant Status

37. Obesity and Cumulative Time in the US by Migrant Status

38. How healthy they are if we compare to other groups?

39. Self rated health • Finch et al, analysis of N HANES III 88-94 data • Recent Latino Immigrants: 60.94% at least good health • Long time Immigrants: 57.5% at least good health • Rubalcava et al, Mexican Family Life Survey • Rural males 15 to 29, 67.9 at least good health • Rural males 15 to 29, 30.4 good health compared to others • Sample: • At least good self rated health: 60.42% • Good health compared to others: 37.47%

40. Depressive Symptoms • Finch, Kolody, Vega, 2000 • CESD score mean for males: 9.88 • CESD score mean for transnational migrants: 8.88 • CESD score mean in sample: 7.87

41. Health Behaviors Smoking: • National Males: 20-29 yo, 35%, 40 to 49 yo, 30% • Guanajuato Males: 20-39, 35.9%; 40-59 38.5% • Sample: 33.42% Drinking 5 per occasion at least once in previous month: • National: Males, 60% at least once a month • Guanajuato: Males, 23.9% at least once a month • Sample: 48%

42. Hypertension • National: 30.8%; • Guanajuato (has among highest prevalence): between 32.5% and 34.9% • Hypertension national prevalence males 20 and older: 20.1% (survey finding) • Sample (finding): 28.18% • Migrants 39%

43. Waist Circumference • National (Males): 20-29 yo 59%, 30-39 yo 38.2%, 40 to 49 yo 26.4% • Guanajuato: Rural males 20 yo and older, 60.9% • Sample: 44.09% (NM 73.8%, RM 46.5%, M 29.8%)

44. Body Mass Index • Obesity prevalence has increased in Mexico: • 1993: 21.5%, • 2000: 24%, • 2006: 30% • Overweight and Obesity, Guanajuato: 70.7% • Rural adult males: 62.4% • Sample: 69.62% (NM 58%, RM 66%, M 77%)

45. Final Comments • Learn about health indicators of potential immigrants • Recent arrivals show good health, long-stay migrants report worse health in a number of indicators  • Immigration will continue, the health status of immigrants and their descendants will play a central role shaping health outcomes of the American people  • Health centers have the opportunity to impact immigrant populations as they arrive shaping their future health trajectories

46. Mexico - US Migration • “Revolving door” effect • Binational circuits that make possible a permanent exchange of ideas, culture, language, values and lifestyles between the two countries.

47. Thanks! “The most important thing to have here [in the United States] is your health. If you are strong and healthy, then you can work…The way I think about it, if you don’t have your health, you can’t reach any of your other goals.” (p.171).* Quote from Vicente’s Story, from: Miles A. (2004). From Cuenca to Queens. An Anthropological Story of Transnational Migration. Austin: University of Texas Press.