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California and the West

Fieldworkers' Nutrition, Health, Access to Care All Poor, Study Finds


The agricultural workers in California who help put nutritious fruits and vegetables on American tables themselves suffer from a "startlingly high" risk for chronic illnesses such as heart disease and stroke--probably because of poor nutrition.

This is true despite the workers' relative youth and vigorous physical exertion, according to the most comprehensive study of farm workers' health ever done in California, released Tuesday. The researchers traced at least part of the problem to limited access to health care.

"The irony is inescapable--that the fruits of their labor provide us such health, yet their health status suffers in ways that most Americans would never tolerate," said Dr. Robert K. Ross, president of the California Endowment, which sponsored the research by the California Institute for Rural Studies.

The ongoing study of 971 agricultural workers--most of them young men--involves full physical examinations and chemical analyses, as well as interviews. It is intended to provide a window on the health and well-being of the state's more than 1 million migrant and seasonal workers.

Researchers found that young workers of both sexes suffered more than twice the rate of high blood pressure of comparable U.S. adults. In addition, male workers had substantially higher rates of serum cholesterol than expected.

Even more startling, 81% of the men and 76% of the the women surveyed were overweight, and 28% of the men and 37% of the women were deemed obese. In the U.S. population overall, 20% of men and 25% of women are obese, researchers said.

All of these factors--obesity, high cholesterol and high blood pressure--put people at high risk for heart disease, stroke, gall bladder disease and diabetes.

Beyond that, researchers found that the workers suffered disproportionately from anemia and dental diseases. More than a third of the male workers had at least one decayed tooth and nearly 40% of the women had at least one broken or missing tooth.

As possible causes, the findings point to poor nutrition--high intake of fatty, salty, sugary or otherwise unhealthful foods--as well as abysmally low access to basic medical care. In general, poor nutrition and obesity are correlated with poverty.

Women had far better access to medical treatment because of maternal and child health services. But a third of the men surveyed said they had never been to a doctor or a clinic. Half of the men and two-fifths of the women said they had never been to a dentist.

"As a public health official, I was quite appalled at those figures," said Don Villarejo, founder and director emeritus of the rural studies institute.

"The other thing that was surprising was the extent to which people live with pain . . . go a year with a toothache. That was a shocker to me."

Marc Grossman, a spokesman for the United Farm Workers, said the findings weren't surprising to him at all.

"It just affirms what the UFW has known for decades," he said.

The problem, he said, is that most Americans obtain their health insurance through employment--but most farm workers don't. The study found, in fact, that nearly 70% of agricultural laborers lack insurance.

Grossman said the workers can get health benefits through UFW contracts, but just a small minority of workers are covered by such contracts.

Other factors contribute to the marginalized status of the workers and, in turn, limit their access to health care. Nine in 10 are foreign-born, many lack citizenship or residency papers, most have less than sixth-grade educations, just 5% can read English well and, on average, they make less than $10,000 a year, researchers found.

The jobs themselves can also put workers at risk, researchers confirmed. Nearly one in five workers reported suffering a work-related injury at some time in the past that led to a workers' compensation claim--and nearly 5% in the last 12 months.

The study found that workers reported good sanitation conditions on the job, but only about half indicated they had received pesticide safety training.

One food processor who sits on the California Endowment's board said the agricultural industry--as well as government agencies on both sides of the border and farm workers themselves--need to take a greater interest in improving the workers' lot.

"As a businessman, I know that if you want to stay the best you have to make sure you have the best workers," said Fred Ruiz, chairman of Ruiz Food Products in Tulare County, which employs 1,300 workers. "Part of that is having the healthy employees."

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