Delivery of Health Services to Migrant and Seasonal Farm Workers.

Facts

    -513 foreign-born workers

    -Collected from summer 2009 salud services

-Used to test the influences of relevant predisposing and enabling factors of the  behavioral model of health care utilization among vulnerable opulations

    -Participants

        -majority male 87%

        -avenge age 33 years

        -over half either married or living with partner 54%

        -few spoke english 5%

        -⅓ had more than 6 years of formal education

        -⅔ had a full time job (65%) and shared housing (67%)

        -one of five workers (19%)  had health insurance

Intro

Extensive agricultural work can pay a toll on one's mind and body and without proper access to health care one could become seriously ill. According to the study conducted by Lopez-Cevallos, Garside, Vazquez and Polanco (2012), agricultural work can be extremely dangerous for farmworkers and can put them in harms way of acquiring unwanted diseases from pesticides and chemicals used in their work as well as being prone to injury on the job. Many vineyard, winery and farm workers usually have limited access to healthcare services due to their long hour time consuming jobs. Vineyard and winery workers are usually temporary seasonal workers and do not have access to health insurance through their employers. There are also many other barriers that stand in the way of them having access to health care services that could improve their health and wellbeing as well as their families’. Data that was collected from the summer of 2009 from the Salud to health program was used in this study to help explain the barriers that vineyard and winery farm workers are faced with. According to Lopez-Cevallos et. al., “lack of documentation, working conditions, limited number of facilities and providers, non-flexible working schedules or overburdened clinics that reduce utilization of needed services” are barriers that can affect the vineyard and winery workers from getting healthcare services (2012). The research objective for the study conducted by Lopez-Cevallos et. al., was to analyze the use of health care services among vineyard and winery workers in the North Willamette Valley, Oregon (2012).

Methods

The study was conducted using The Behavioral Model of Health Care Utilization among Vulnerable Populations (BMVP) as a theoretical framework and a data analysis was done using data from the Salud! Program. Salud staff collected data during the summer of 2009 from its mobile health screenings (Lopez-Cevallos et. al., 2012). Predisposing  and enabling factors were taken into account, some predisposing factors being age, sex, marital status, having children, speaking English years of education(more than 6) and working full time; while enabling factors were health insurance, school enrollment and sharing housing (Lopez      ). A analysis done by the Predictive Analysis Software (PASW) and a multivariate logistic regression model was used to determine the link between the predisposing and enabling variables and the use of healthcare services shown in tables 1 and 2 (Lopez    ).

Results

Only one of every five workers which is 19% had health insurance.

MLR showed that predisposing factors that women, having children, more than 6 years of education and working full time are linked to health service use.

“Female workers were 3.5 times more likely to use health services in the previous two years while those with children in the household were 60% more likely”

Full time job equals 2 times more likely to use health services and having more than 6 years of edu increases it to 44%

Enabling factors- Winery or vineyard workers that had health insurance and were attending school were more likely to use health services

Conclusion

Speaking english was not statistically significant barrier to use.

    -related to growing bilingual services provided to spanish-speaking farmers via migrant health centers and other programs.

Lack of health insurance, low wages and migration status make it hard for farm workers to afford health care services.

Vineyard and winery workers in this sample showed slightly higher insurance rates 19% compared to a farmworker study 14%

The ACA increases funding for community health centers but it won’t be helpful for  undocumented workers and their families children because are not eligible for insurance subsidies or purchasing Health insurance.  But will help immigrant workers and their families

Help from state, local governments, wine industry and workers unions will be needed to to protect the health status of this vulnerable population