A Profile of Food Security, Nutrition and Youth Development Among Migrant Workers in Five Pennsylvania Counties

1. Agriculture is Pennsylvania�s single largest industry and migrant farm workers constitute a significant portion its labor force. Their contributions harvesting and processing farm crops have a positive economic impact on the farms and communities wherein they work and live. Each year approximately 45,000 to 50,000 migrant farm workers enter Pennsylvania to assist in harvesting the commonwealth�s fruit, vegetable, and mushroom crops (Rural Opportunities, Inc., 2002). It is tragically ironic that the efforts of migrant farm workers allow the U.S. population access to high quality and affordable foods while they often suffer from food insecurity, malnutrition, poor health status, poverty, low job security, and often live and work in unsafe and unsanitary conditions (Slesinger, 1992 ). These poor living and work conditions contribute to a myriad of health, mental health, and social and behavioral problems that include chronic health conditions (Slesinger, 1992; Slesinger, Christenson, & Cautley, 1986; Slesinger & Ofstead, 1993) substance abuse (Alaniz, 1994), domestic violence (Van Hightower & Gordon, 1999; Martin & Gordon, 1995; Tan, Ray, et al., 1991), and other co-morbid mental health problems (Alderete, Vega, et al., 2000; Kupersmidt & Martin, 1997). The families and children of migrant farm workers are not immune to these problems and often suffer from child abuse and neglect, poor physical and mental health, and limited educational opportunities (Belton, 2000; Elder et al, 2000; Kupersmidt & Martin, 1997; Larson et al., 1987; Larson et al., 1990; Lee et al., 1990; Martinez & Gingras, 1996; Slesinger & Cautley, 1986). Agriculture is Pennsylvania�s single largest industry and migrant farm workers constitute a significant portion its labor force. Their contributions harvesting and processing farm crops have a positive economic impact on the farms and communities wherein they work and live. Each year approximately 45,000 to 50,000 migrant farm workers enter Pennsylvania to assist in harvesting the commonwealth�s fruit, vegetable, and mushroom crops (Rural Opportunities, Inc., 2002). It is tragically ironic that the efforts of migrant farm workers allow the U.S. population access to high quality and affordable foods while they often suffer from food insecurity, malnutrition, poor health status, poverty, low job security, and often live and work in unsafe and unsanitary conditions (Slesinger, 1992 ). These poor living and work conditions contribute to a myriad of health, mental health, and social and behavioral problems that include chronic health conditions (Slesinger, 1992; Slesinger, Christenson, & Cautley, 1986; Slesinger & Ofstead, 1993) substance abuse (Alaniz, 1994), domestic violence (Van Hightower & Gordon, 1999; Martin & Gordon, 1995; Tan, Ray, et al., 1991), and other co-morbid mental health problems (Alderete, Vega, et al., 2000; Kupersmidt & Martin, 1997). The families and children of migrant farm workers are not immune to these problems and often suffer from child abuse and neglect, poor physical and mental health, and limited educational opportunities (Belton, 2000; Elder et al, 2000; Kupersmidt & Martin, 1997; Larson et al., 1987; Larson et al., 1990; Lee et al., 1990; Martinez & Gingras, 1996; Slesinger & Cautley, 1986).

2. Objective of Today�s Talk Describe our on-going study. Provide a profile of health and well-being of migrant farm workers in PA and nationwide. Discuss the development of migrant youth and some of the challenges they face.

3. Purpose of the PA Study The purpose of this study is to examine the health, well-being and food security of migrant farm workers in Pennsylvania, and the development of their youth. The purpose of the PA study is to examine the health and well-being of migrant farm workers in Pennsylvania. Existing information on the health and well-being of migrant farm workers comes mainly from national data sets or regional and state-specific studies, although none from PA. We know very little about the unique circumstances, if any, of PA migrant farm workers. The purpose of the PA study is to examine the health and well-being of migrant farm workers in Pennsylvania. Existing information on the health and well-being of migrant farm workers comes mainly from national data sets or regional and state-specific studies, although none from PA. We know very little about the unique circumstances, if any, of PA migrant farm workers.

4. Study Objectives The study objectives are to: 1. Collect pilot data on the basic nutrition, barriers to good nutrition, food program participation, food security, and food sufficiency maintenance practices of migrant farm workers; 2. Identify areas where food assistance programs and policies can be modified to better serve this population;The study objectives are to: 1. Collect pilot data on the basic nutrition, barriers to good nutrition, food program participation, food security, and food sufficiency maintenance practices of migrant farm workers; 2. Identify areas where food assistance programs and policies can be modified to better serve this population;

5. Project Objectives 3. Provide reliable and current pilot data that can serve to objectively identify priorities for outreach education and interventions and inform the development of a larger project on this topic in Pennsylvania; 4. Compare survey data to existing data (NAWS, CPS) to determine how factors such as ethnicity, migrant status (seasonal, settled), and other factors impact usage of food assistance programs. 3. Provide reliable and current pilot data that can serve to objectively identify priorities for outreach education and interventions and inform the development of a larger project on this topic in Pennsylvania; 4. Compare survey data to existing data (NAWS, CPS) to determine how factors such as ethnicity, migrant status (seasonal, settled), and other factors impact usage of food assistance programs.

6. Project Counties The methodology involves the collection of quantitative and qualitative data (focus group interviews and surveys) to examine the food and nutritional context of migrant farm workers. The focus groups have three main objectives: 1) identify barriers to achieving good nutrition; 2) understand the programmatic, social, cultural, and lifestyle factors to which these barriers can be attributed; and 3) reveal practices employed to increase food security. The survey consists mostly of the 18-item CPS Food Security instrument, information on utilization of food assistance programs, and demographic characteristics. The Pennsylvania survey data will be compared to existing data (NAWS, CPS) to determine how factors such as ethnicity, migrant status (seasonal, settled), and other factors impact usage of food assistance programs among migrant workers in five Pennsylvania counties (Adams, Berks, Chester, Erie, Franklin). These data also will function as pilot data for a larger future study of the physical, mental and behavioral health and social context of migrant farm workers in Pennsylvania. The methodology involves the collection of quantitative and qualitative data (focus group interviews and surveys) to examine the food and nutritional context of migrant farm workers. The focus groups have three main objectives: 1) identify barriers to achieving good nutrition; 2) understand the programmatic, social, cultural, and lifestyle factors to which these barriers can be attributed; and 3) reveal practices employed to increase food security. The survey consists mostly of the 18-item CPS Food Security instrument, information on utilization of food assistance programs, and demographic characteristics. The Pennsylvania survey data will be compared to existing data (NAWS, CPS) to determine how factors such as ethnicity, migrant status (seasonal, settled), and other factors impact usage of food assistance programs among migrant workers in five Pennsylvania counties (Adams, Berks, Chester, Erie, Franklin). These data also will function as pilot data for a larger future study of the physical, mental and behavioral health and social context of migrant farm workers in Pennsylvania.

7. Sample Characteristics It is estimated that 95% of Pennsylvania�s migrant workers are minorities, most of who are Hispanic (including Mexican-Americans as well as Mexicans, Puerto Ricans, Cubans, and workers from Central and South America). The migrant population also includes Black Americans, Jamaicans, Haitians, Laotians, Thais, and other racial and ethnic minorities. Today, 95% of Pennsylvania�s hired farm workers are foreign-born (91% born in Mexico), twice the proportion of just a generation ago. It is estimated that 61% of the state's hired farm workers live in poverty, 42% are unauthorized immigrants, the average educational attainment is just six years of school, 24% are illiterate, and another 43% are functionally illiterate (Rural Opportunities Inc, 2002). The composition of the diverse migrant population varies in each county. The major producers of apples, peaches, and cherries in Pennsylvania include Adams, Franklin, Berks, and Erie Counties. Most of the seasonal and migrant farm workers in these counties are Spanish-speaking workers from Mexico. While some migrant follow the tree fruit harvests from state to state, others are �settled.� For example, numerous farm workers are hired for the nearly year-round mushroom industry in Chester County. The farm worker population in Chester County consists of predominantly �settled� workers-- since the mushroom season is longer than the fruit-growing season. (Rural Opportunities Inc, 2002) Nearly 98% of the mushroom workforce is Hispanic, with the majority of the population of Mexican descent. The population to be studied will therefore consist primarily of Hispanic farm workers of Mexican descent, and will include those who follow a migratory stream as well as those who are more �settled.�It is estimated that 95% of Pennsylvania�s migrant workers are minorities, most of who are Hispanic (including Mexican-Americans as well as Mexicans, Puerto Ricans, Cubans, and workers from Central and South America). The migrant population also includes Black Americans, Jamaicans, Haitians, Laotians, Thais, and other racial and ethnic minorities. Today, 95% of Pennsylvania�s hired farm workers are foreign-born (91% born in Mexico), twice the proportion of just a generation ago. It is estimated that 61% of the state's hired farm workers live in poverty, 42% are unauthorized immigrants, the average educational attainment is just six years of school, 24% are illiterate, and another 43% are functionally illiterate (Rural Opportunities Inc, 2002). The composition of the diverse migrant population varies in each county. The major producers of apples, peaches, and cherries in Pennsylvania include Adams, Franklin, Berks, and Erie Counties. Most of the seasonal and migrant farm workers in these counties are Spanish-speaking workers from Mexico. While some migrant follow the tree fruit harvests from state to state, others are �settled.� For example, numerous farm workers are hired for the nearly year-round mushroom industry in Chester County. The farm worker population in Chester County consists of predominantly �settled� workers-- since the mushroom season is longer than the fruit-growing season. (Rural Opportunities Inc, 2002) Nearly 98% of the mushroom workforce is Hispanic, with the majority of the population of Mexican descent. The population to be studied will therefore consist primarily of Hispanic farm workers of Mexican descent, and will include those who follow a migratory stream as well as those who are more �settled.�

8. Research Methods: Data Sources Survey data collected from 401 migrant workers in 5 PA counties. NAWS data from 1993-2000 for migrant farm workers. CPS data from 1999-2000 for U.S. farm workers. Key informant interviews from Adams, Franklin and Chester counties. Focus groups from 5 PA counties. Descriptive statistics will be used to compute the frequency of responses for socioeconomic and demographic characteristics, and food security. Analysis of variance will be used to test for significant differences across relevant variables (i.e., measures of predisposing, enabling and reinforcing factors, acculturation scale scores, indexes from the dietary assessment, and measures of food security, and relevant demographic variables). Duncan�s multiple range test will be used to assesses which groups differ significantly from each other. Linear regression analyses will be used to examine associations of dietary measures with the psychosocial factors, controlling for relevant demographic characteristics. Descriptive statistics will be used to compute the frequency of responses for socioeconomic and demographic characteristics, and food security. Analysis of variance will be used to test for significant differences across relevant variables (i.e., measures of predisposing, enabling and reinforcing factors, acculturation scale scores, indexes from the dietary assessment, and measures of food security, and relevant demographic variables). Duncan�s multiple range test will be used to assesses which groups differ significantly from each other. Linear regression analyses will be used to examine associations of dietary measures with the psychosocial factors, controlling for relevant demographic characteristics.

9. Results �Demographic Characteristics of PA Sample N=401 Mean age = 31.6 48% Male; 52% Female 77% born in Mexico Mean years lived in U.S.= 7.7 81% speak Spanish in home 100% Hispanic, Mexican or Latino Mean years of school completed = 8.0

10. Participation in Food Assistance Programs

11. What best describes your situation during childhood and now?

12. Adult Hunger: Have You Ever�?

13. Child Hunger: Has Your Child Ever�?

14. Levels of Food Insecurity

15. Description of 1999/2000 CPS Sample N=2,112 81.9% Male; 18.1% Female 20.9% born in Mexico 72.9% lived in US their entire life 28.5% Hispanic, Mexican or Latino 45% less than a HS education 40.2% below poverty line

16. The PA and 2000 CPS samples are very different. A higher percent of the PA sample is Latino, born in Mexico, participate in assistance programs, and have low educational attainment. Thus, a larger percent of the CPS sample is food secure and a smaller percent experience all four levels of food security. The PA and 2000 CPS samples are very different. A higher percent of the PA sample is Latino, born in Mexico, participate in assistance programs, and have low educational attainment. Thus, a larger percent of the CPS sample is food secure and a smaller percent experience all four levels of food security.

17. Description of 1993-2000 NAWS Sample N=20,578 Ag workers 92% born in Mexico 53% migrant farm workers Analyses on 8,077 migrant farm workers born in Mexico 16.3% 19 or younger, 59.5% 29 or younger 88.7% male; 11.3% female 75% less than a HS education 70% below poverty 54% work 20 or fewer weeks a year Half have lived in U.S. 1 year or less.

18. Do you, your spouse and your child(ren) have any health insurance from any source?

19. Employee Health and Injury Benefits

20. Barriers to Using Health Services

21. Language and Literacy

22. Language and Literacy

23. Public or Social Support in Past 2 Years

24. Results from key informant interviews Purpose Corroborate (or refute) survey results Provide deeper and richer information Better understanding of policies and programs Advice and input into ideas for future research

25. Migrant farm worker children: What shapes their lives?

26. Migrant farm worker children: What shapes their lives?

27. Special determinants of health

28. Are traditional culture and Amercanization related to nutrition and health?

29. Are traditional culture and Amercanization related to nutrition and health? I think when they get a taste of our worst nutritional nightmares in this country, you know, the Big Mac and French fries and what have you�.we see a lot of obesity in kids and the older kids�. It�s from sugary drinks and candy and fast food, because their diet is really a very good diet and if they could stick to it� but again the kids are exposed to television� They�re coming from countries where I have to say that a lot of these kids come to us pretty healthy an end up very unhealthy in our culture. It�s interesting because they�re coming from a country where their main diet would be rice and beans and corn�they�re coming over here and are exposed to sugar and high fat.

30. Does traditional culture impact access to and negotiation of the U.S. health care system?

31. Does traditional culture impact access to and negotiation of the U.S. health care system? I mean health and healing are very intimate where these people come from and very holistic, and so our system puts people off. We�re very businesslike about our health care. You know, boom, boom, boom, you�ve got ten minutes with the doctor. You have to say what�s wrong with you. You have to answer the questions and this is difficult for them, even if they understood the language. and so they might not comply or they might not have the money to comply� so there�s the inability to comply or the unwillingness to comply because �that man doesn�t even like me, so could he heal me.�

32. How about legal status and income as determinants of access?

33. How about legal status and income as determinants of access? No [they don�t have access to health services] because of the kind of work that they do they don�t have any insurance�.so they�re going to have to pay to take the kids, and sometimes they prefer not to go because they don�t have the money. Also, you�re dealing with a population that falls through the cracks and qualifies for nothing. A lot of these families don�t have valid social security numbers and whatever so they quality for none of our government funded programs. Migrant Health is open July to October, four months out of the year. Then where do the people go? They do not have access to health care unless they pay for it and, of course, I mean, they can�t afford it. I think primary health care is accessible and good�.the problem comes for elective surgery, which we cannot cover, or if you need a specialist.

34. What are children�s educational aspirations and what affects them?

35. What are children�s educational aspirations and what affects them? They just want to reach their high school diploma and then get a job so they don�t tend to speak about pursuing college. They pretty much stop with that. They get their diploma and start working. A lot of them feel the need to work. I don�t think that education is stressed as much in the families as it is in other cultures. I think a lot of them still understand that school is important. They may not like school but I still think that a majority of them see the importance of it, especially since a lot of their parents sometimes don�t have and education themselves�.I think they see how staying in school can be advantageous in the long run as opposed to stopping school and immediately working. They are becoming more aware of what�s required to set themselves up for success with whatever endeavor they may have following high school

36. What are children�s educational aspirations and what affects them? There�s not a lot of emphasis put on education from a young age up. The emphasis is on survival and the family unit, whereas I believe from the Vietnamese culture there is more of an emphasis put on education. The majority of the parents didn�t go that far in school, maybe second or third grade. It doesn�t matter for them. Kids say, �I don�t want to go to school anymore� and parents are like, �oh, okay, if that�s want you want to do that�s fine.� Their main concern is family versus the individual and obtaining their own personal goals. Family is very important. Because they�re brought up with the mentality of providing for the family, that work takes priority for them. A lot of times they feel that once they graduate from high school they have to go to work because they have t o help their parents. Especially if they have three or four brothers or sisters, they feel that they are obligated to find jobs and help the parents.

37. What are children�s educational aspirations and what affects them? [The parents] haven�t graduated high school and here they have their daughter now who�s 18 or 19 who�s grown up, graduated high school, something they didn�t do themselves, and now asking I want to leave home and continue to have more education. I think it�s a decision [parents] are unfamiliar with making�its sometimes difficult for the father to say yes, I think they�re quicker to say yes to their male children. There�s not a lot of promoting of girls or even the boys for that matter, but especially for the girls to finish school, get a good job, go to college, have a career. Yeah, that�s not promoted by our families.

38. How do work, educational attainment and family formation relate?

39. How do work, educational attainment and family formation relate? We have some of the seniors this year that are working as waiters, others in landscaping. Kids work typically teenager jobs I don�t think they�re actually working in the fields or [in ag processing], it�s more like working at a pizza place or restaurant, that kind of thing. Some do ag work but more go into your part-time movie theatres and such. Some will drop out of school to work full time. Not a lot, but it does happen. We do have student who stay in school and work part time.

40. How do work, educational attainment and family formation relate? The boys can be 16 and the girls even younger and they say to the parents �we�re going to get married� The young men go out and work and the [wife] has to stay home. She gets pregnant right away and starts having kids. They follow the same patterns as the parents do. This is for them something normal. They normally tend to have children before married and get married because having children out of wedlock [is frowned upon]. They are getting married young because they�re having babies young.

41. Are youth becoming assimilated, Americanized?

42. Are youth becoming assimilated, Americanized? [Youth resist becoming Americanized.] America for them is to come and make money and they don�t want to forget about their culture. They make sure that you know by listening to the music or eating Mexican foods, so I don�t think they want to become Americanized, but they came because of the money. The parents feel the same way. The love being Mexican. They love being Latino. They love being Puerto Rican. Whatever they are they�re proud of that and they don�t hide it. I think though they become torn when they start finding that they are starting to fit in more within the community that they�re living, and not just the Hispanic community. Then [youth] get into this world where they�re coming in contact with kids who at least talk a certain way, dress a certain way, and so on, and I think it�s exceptionally difficult for them. There�s anxiety and the feeling of not fitting in. Either not fitting in their family or not fitting in at school, I mean they�re struggling with two worlds.

43. Are youth becoming assimilated, Americanized? A lot of our kids who don�t speak English, yet you�ll see them wearing a lot of American styled clothing, a lot of the phrases they�ll pick up on. America�s phrases, they�ll know those before they can actually speak in coherent sentences. They become Americanized very quickly and I think some are very happy and content with that. I think there are others who do arrive here and never feel comfortable with the idea of becoming Americanized. They look forward to going back home. I think the younger you come here, the more time you�ve spent here leads to becoming more Americanized. I think that when you�re older you already have some values established and you already have different ideas established about who you are. They maintain their cultural roots, but sure, a lot of the younger ones want the cell phones and the car�what I would call more American materialistic young people. Parents complain about it all the time.

44. Summary and Conclusions Cost, lack of insurance, language and cultural differences are main barriers to health care utilization. Food insecurity is not a widespread problem, is more common for adults than kids, and some experience hunger. Poor nutrition rather than hunger is problematic and may be caused partly by Americanization of adults and youth.

45. Summary and Conclusions Low participation in food and other assistance programs. Families and family roles are highly valued. Lack of fit between traditional Mexican and American culture, constrained opportunities, poverty, lack of English proficiency, and other factors contribute to lower educational and occupational attainment, especially for girls.

46. Summary and Conclusions Youth get married and start families at a young age. Assimilation to American culture is occurring even though some parents and children resist it.