Today, day five of National Health Center Week, is set aside to recognize the role of Health Centers in caring for farmworkers. Federal law covering migrant health defines farmworkers as individuals who are employed in agriculture on a seasonal basis and take up temporary residence for the purpose of such employment.
While making up 42% of the co-worker workforce in the United States, migrant farmwokers are some of the most economically disadvantaged people in the country. They frequently suffer from poor living and working conditions that lead to an array of health problems, most of which are similar to those found in developing countries. They experience heightened incidences of dermatitis, work-related injuries, respiratory problems, musculoskeletal ailments, eye problems, hypertension, diabetes, and pesticide related illnesses, and higher rates of infectious diseases such as tuberculosis.
The extensive list of health problems that farmworkers endure is exacerbated by their frequent inability to obtain health insurance. Employer-sponsored health insurance is rare for migrant farmworkers, and although their income levels would normally qualify them for most state Medicaid programs, they are generally precluded from obtaining Medicaid and/or other state insurance programs because of the migratory nature of their employment, minimum state residency requirements, varying state Medicaid eligibility requirements, and lack of Medicaid portability from state to state.
Migrant Health Centers are a source of quality health care for migrant farmworkers. They were established in 1962 to provide comprehensive primary care services to migrant and seasonal agricultural workers and their families in a culturally sensitive way. Today they are funded as part of the Consolidated Health Centers program. Currently, 140 Migrant Health Centers with approximately 1,150 delivery sites around the nation and Puerto Rico deliver care to 807,000 migrant and seasonal farmworkers and their families.
Michigan has the seventh largest farmworker population, with 90,716 migrant and seasonal farmworkers and dependents living and working within the state’s borders at some point during the year. The majority of these individuals come to Michigan from Texas and Florida, and over 41,000 of them are children between the ages of birth and 20 years.
Five Migrant Health Centers in Michigan and many other of the state’s Community Health Centers provide care to migrant and seasonal farmworkers and their families. In 2007, Michigan’s Migrant Health Centers served 15,092 migrant and seasonal farmworkers, and an additional 5,137 migrant and seasonal farmworkers received health care from Community Health Centers throughout the state.
Migrant and Community Health Centers provide culturally appropriate care in languages their patients can understand, at times that are convenient for the patients, and at locations near migrant and seasonal farmworkers. They employ bilingual health personnel and lay outreach workers, and also provide translation and transportation when needed. Migrant and Community Health Centers provide care regardless of the patients’ ability to pay or insurance status, and keep patients’ costs down by treating their illnesses and injuries early so they avoid debilitating disease and do not have to seek expensive emergency room care.
Michigan Primary Care Association is coordinating efforts to make Medicaid portability a possibility.